Back Pain Gone, But Is the Muscle Still Off? — Muscle IQ in Orem

Your back went out last spring. Maybe it was a weekend of yard work in Orem, or a long drive up to Salt Lake. A few weeks later it settled down, you went back to normal life, and you figured that was the end of it.

Then it happened again. If that sounds familiar, there may be a reason that has nothing to do with how careful you were.

Meet the Muscle Nobody Talks About

Deep along your spine sits a series of small muscles called the multifidus (MUL-TIF-ih-dus). You cannot see them or flex them on purpose. Their job is quieter: they switch on a split second before you move, steadying each spinal segment before the load arrives.

When they do their job, you never notice them. When they stop, the back feels less trustworthy.

Why Back Pain Keeps Coming Back After It Goes Away

When your back hurts, research suggests your nervous system can turn down the muscle tone dial on the muscles around your spine. When that happens, muscles go offline.

You would expect the dial to turn back up once the pain is gone. A 1996 trial in the journal Spine suggests that may not happen on its own. Researchers followed 39 people with a first episode of low back pain. Using ultrasound, they found the multifidus was smaller on the painful side.

Half the group received medical care only. The other half also did specific, targeted training for that muscle. By four weeks, pain and disability were about the same in both groups. The muscle was not. Without targeted training, the multifidus had not recovered, even though the pain was gone. The group that trained it recovered it more completely.

In plain terms: the pain went away first, and the muscle did not. It was a small trial of first-episode back pain, so it does not tell you what is happening in your own back.

It Can Show Up Between Episodes

A 2016 study in the Journal of Orthopaedic and Sports Physical Therapy compared people with a history of back pain, who were pain-free at the time, with people who had no history. As walking sped up, the people without back pain used their deep multifidus more. The people with a history used it less. It was a small study, but it fits the same pattern: a muscle can be pain-free and still not be doing its job.

Why This Matters for Coming Back

The Muscle IQ ultrasound imaging page notes that back pain returns in about 80 percent of people within a year of a first episode. It adds that when the deep stabilizing muscles are not rehabilitated, the recurrence rate is about the same as with no treatment at all.

That is not a reason to worry. It is a reason to ask a better question than "does it still hurt?" Ask instead: "is the muscle that protects my spine working again?"

What Ultrasound Lets Us See

You cannot feel the multifidus, and an X-ray or MRI shows structure, not how a muscle is behaving. At Muscle IQ in Orem, we use real-time ultrasound imaging to watch the deep back muscles on a screen while you move, for patients across Utah County. A 2018 study cited on our site found that patients activated their deep muscles more efficiently with that visual feedback.

Combined with hands-on muscle testing, this helps us find where a muscle is switched off and what may be keeping it that way. You can learn more on our ultrasound imaging page, see how we approach low back pain, or read about muscle inhibition. The deep muscle research is also summarized in Volume 3 of the Journal of Muscle IQ.

A Note on Safety

Most back pain is not dangerous, but some symptoms need medical attention right away: numbness in the groin or saddle area, loss of bladder or bowel control, new leg weakness, fever with back pain, or pain after a serious fall. If you have any of these, seek medical care first.

Your Back Can Get Stronger Again

If your back pain keeps returning, or it is gone but never quite feels trustworthy, that is worth looking into. You can get better, and your deep back muscles can get stronger again. The key to long-term relief is finding what is switched off and fixing the cause.

Take control of your health today by calling Muscle IQ at (801) 310-0851 to schedule your first appointment.

Learn more at MuscleIQ.com.