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Three Important Factors in Successfully Recovering from Chronic Back Pain

Part 2: Restoring Normal Muscle Response

In this series about chronic back pain I am addressing what I feel are the three key components to a successful recovery from chronic back pain here at Muscle IQ - Physical Therapy.  Part 1 addressed the need to identify and treat the fibrotic changes (or fascial distortions) in the low back.  In this blog I will discuss the need to restore normal muscle response. 

Restoring Normal Muscle Response

Every patient with chronic low back pain will also present to our clinic with back muscles that do not work right.  There are muscles we find in the low back that do not respond or contract like they are supposed to during certain testing.  Normal muscles will respond quickly and solidly to this testing, however, the back muscles in a patient with chronic back pain will respond slowly, weakly, or will not turn on at all.  When a muscle does not respond the way it is supposed to this is called muscle inhibition.  

What causes muscle inhibition?

The spinal cord is in constant communication with every muscle in the body.  Every muscle maintains a certain level of tone (muscle tone) even when at rest because of this communication from the spinal cord telling the muscle what to do.  When an outside force is applied to a body part the muscles will want to contract to respond to that force.  This is a reflex. It is what happens when the body is healthy.  

When people have chronic back pain the spinal cord knows that the back is not healthy and it does not allow the muscles to contract fully.  The spinal cord tells the muscles “Do Not Contract” in response to the outside force.  As long as the spinal cord thinks there is a problem with the back it will not let the muscles contract fully.  At Muscle IQ we perform testing on our patients that reveals which muscles are being told “Do Not Contract”.  We do testing to see where the problem is originating from.  In order for these muscles to contract fully again we must treat the problem area until the spinal cord is no longer worried about that area.  Once the correct area has been satisfactorily treated the spinal cord will allow the muscle to contract more fully again, restoring the normal muscle response (in medical language: restoring normal spinal cord excitability and reducing muscle inhibition).


To treat chronic low back pain effectively we must restore normal muscle response.  To do this, we must:

  1. Identify the weak muscles (muscle inhibition) through muscle testing

  2. Identify the area causing the weakness

  3. Treat the problem area

  4. Re-test, looking for restoration of normal muscle response

In my next blog I will address the third component to a successful recovery with chronic low back pain: Re-conditioning the back muscles. If you, or someone you know, has been living with chronic back pain now is the time to give Muscle IQ a call.  801-310-0851

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