The Multifidus Back Pain Solution Book Review

The Multifidus Back Pain Solution by Jim Johnson, P.T. offers an exercise program for people who live with chronic back pain. The program is based on scientific evidence regarding how one specific back muscle, the multifidus, plays an important role in almost all non-nerve-related back pain. The author is a licensed physical therapist, and the book provides excellent background information as to why the program works; it may also arm you, the spine health consumer, with the concrete medical knowledge you need to effectively shop for your care.

Man standing at his desk holding his back in pain

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Rather than taking a diagnostic approach (i.e., describing and prescribing exercise for conditions such as herniated disc or spondylolisthesis) the author is concerned with overall physical functioning. Johnson supports this approach with research findings demonstrating that for approximately 85% of low back pain cases, there is no diagnosis. (These would be cases of non-specific low back pain.)

Johnson's writing style is friendly, and his explanations of complex anatomical and scientific facts are easy to understand. Most chapters have a page of key points at the end.

Why a Book on Just One Muscle?

The author explains the anatomy of the spine and of the multifidus muscle specifically. He discusses why he believes the multifidus is so significant in the presence and absence of back pain; in fact, he strongly believes that the multifidus muscle is significant in nearly all cases of back pain.

Johnson provides numbers comparing a strong link between an abnormally functioning multifidus muscle and the presence of low back pain, as well as a normal multifidus muscle in conditions which are commonly associated with pain, but where there is none.

Specific Back Pain Conditions

Even though Johnson takes mainly a physical functioning approach, he also covers the specific conditions found in some way to involve the multifidus muscle. Examples include spondylolisthesis, back pain due to pregnancy, post back surgery back pain, and herniated disc.

True to Johnson's style, the conditions are explained clearly and simply for the non-medical reader, and the background information provided is of excellent quality. Among other things, the author clarifies the activity of the multifidus muscle in each condition (as revealed by EMG and/or ultrasound studies).

Scientific Research

Chapter 3 reviews scientific research on the role the multifidus may play in chronic back pain and talks about using exercise as a treatment. As part of this discussion, he briefly outlines how evidence-based medicine works and includes distinctions between natural history studies, anecdotal evidence, and randomized controlled trials.

This chapter will likely help you understand Johnson's rationale for his exercise program, as well as for becoming an educated consumer of back pain treatments in general.

Multifidus Back Pain Exercise Program

The exercises proposed by the author are geared for beginners—i.e., either people do don't know much about their backs and/or those who don't like to exercise. To help you implement his program according to current fitness standards, Johnson gives strength training guidelines, including definitions for reps and sets and a discussion of intensity and time. He also talks about how to progress yourself and how to maintain your strength gains once you've achieved them.

Comment on the Exercise Program

Interestingly enough, Johnson's program consists of only three exercises (plus variations that are meant to progress you as you become stronger). These exercises can also be found in the Pilates repertoire and other systems too. But in Johnson's program, they are adapted to target the multifidus muscle as it affects back pain.

The author instructs the reader to do the exercises in a neutral position, but he does not offer a lot of explanation has to how to establish, maintain, and recognize that position.

Further Resources in Back Pain Treatment

Chapter 6 reviews (mostly) non-exercise ways to address back pain. Treatments covered include spinal manipulation, ergonomics, weight loss, McKenzie exercises, and stretching. Johnson also discusses stress as it relates to low back pain as well as the most effective treatments per spinal diagnosis.

All in all, The Multifidus Back Pain Solution is worth the read. If your chronic back pain has proven tough to resolve, this book may inspire you to try a new approach. At the very least, it will likely help you increase your knowledge about your condition.

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  1. Suzuki H, Kanchiku T, Imajo Y, Yoshida Y, Nishida N, Taguchi T. Diagnosis and characters of non-specific low back pain in Japan: the Yamaguchi low back pain studyPLoS One. 2016;11(8):e0160454. doi:10.1371/journal.pone.0160454