Muscle Control and Non-specific Chronic Low Back Pain

Russo, Marc; Deckers, Kristiaan; Eldabe, Sam; Kiesel, Kyle; Gilligan, Chris; Vieceli, John; Crosby, Peter

doi:10.1111/ner.12738

Cited by 222Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPain Management and Treatment

Muscle Control and Non-specific Chronic Low Back Pain

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Russo, Marc, Deckers, Kristiaan, Eldabe, Sam, Kiesel, Kyle, Gilligan, Chris, Vieceli, John, Crosby, Peter·2018·Neuromodulation: Technology at the Neural Interface

DOI 10.1111/ner.12738PMC PMC5814909

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Abstract

OBJECTIVES: Chronic low back pain (CLBP) is the most prevalent of the painful musculoskeletal conditions. CLBP is a heterogeneous condition with many causes and diagnoses, but there are few established therapies with strong evidence of effectiveness (or cost effectiveness). CLBP for which it is not possible to identify any specific cause is often referred to as non-specific chronic LBP (NSCLBP). One type of NSCLBP is continuing and recurrent primarily nociceptive CLBP due to vertebral joint overload subsequent to functional instability of the lumbar spine. This condition may occur due to disruption of the motor control system to the key stabilizing muscles in the lumbar spine, particularly the lumbar multifidus muscle (MF). METHODS: This review presents the evidence for MF involvement in CLBP, mechanisms of action of disruption of control of the MF, and options for restoring control of the MF as a treatment for NSCLBP. RESULTS: Imaging assessment of motor control dysfunction of the MF in individual patients is fraught with difficulty. MRI or ultrasound imaging techniques, while reliable, have limited diagnostic or predictive utility. For some patients, restoration of motor control to the MF with specific exercises can be effective, but population results are not persuasive since most patients are unable to voluntarily contract the MF and may be inhibited from doing so due to arthrogenic muscle inhibition. CONCLUSIONS: Targeting MF control with restorative neurostimulation promises a new treatment option.

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Individuals with NCLBP have significant atrophy, fat infiltration, and/or decrease in activation of the TrA and LM muscles.
“Studies have reported that there is significant atrophy, fat infiltration, and/or decrease in activation of the TrA and LM muscles in individuals with NCLBP [8, 9].”
From Effect of m-health-based core stability exercise combined with self-compassion training for patients with non-specific chronic low back pain: study protocol for a randomized controlled trial (2022) · cites this paper as [8]
In the Introduction’s “Clinical Instability and CLBP” section (page unavailable), the paper reports lumbar multifidus atrophy and fat infiltration in people with chronic low back pain. Its “Imaging Assessment of Motor Control Dysfunction” section (page unavailable) also describes diminished multifidus thickness change during activation. The copy does not establish comparable atrophy, fat infiltration, or decreased activation of the transversus abdominis (TrA), so the claim about both muscles is only partially supported. (LLM, conf=0.86)
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Shear wave elastography based analysis of changes in fascial and muscle stiffness in patients with chronic non-specific low back pain
Liu, K., Zhao, T., Zhang, Y., Chen, L., Zhang, H., Xu, X., Yuan, Z., Zhang, Q., & Dong, J. (2024) · Frontiers in Bioengineering and Biotechnology · doi:10.3389/fbioe.2024.1476396 · Cited by 27 · see citing works
Therapeutic Potential of Ultrasound Neuromodulation in Decreasing Neuropathic Pain: Clinical and Experimental Evidence
Pérez‐Neri, I., González-Aguilar, A., Sandoval, H., Pineda, C., & Rı́os, C. (2020) · Current Neuropharmacology · doi:10.2174/1570159x18666200720175253 · Cited by 26 · see citing works
Effectiveness of peloid therapy in patients with chronic low back pain: a single-blind controlled study
Karaarslan, F., Yılmaz, H., Akkurt, H. E., Gül, S., & Kardeş, S. (2021) · International Journal of Biometeorology · doi:10.1007/s00484-021-02137-6 · Cited by 26 · see citing works
Transcatheter Arterial Embolization for Alleviating Chronic Musculoskeletal Pain and Improving Physical Function: A Narrative Review
Wang, B., Liang, K., Chen, C.-H., & Wang, C. (2022) · Diagnostics · doi:10.3390/diagnostics13010134 · Cited by 26 · see citing works
Between guidelines and clinical trials: evidence-based advice on the pharmacological management of non-specific chronic low back pain
Migliorini, F., Vaishya, R., Pappalardo, G., Schneider, M. M., Bell, A., & Maffulli, N. (2023) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-023-06537-0 · Cited by 28 · see citing works
Biologic Drugs as Analgesics for the Management of Low Back Pain and Sciatica
Dimitroulas, T., Lambe, T., Raphael, J. H., Kitas, G. D., & Duarte, R. V. (2018) · Pain Medicine · doi:10.1093/pm/pny214 · Cited by 24 · see citing works
Recognition of Chronic Low Back Pain During Lumbar Spine Movements Based on Surface Electromyography Signals
Du, W., Omisore, O. M., Li, H., Ivanov, K., Han, S., & Wang, L. (2018) · IEEE Access · doi:10.1109/access.2018.2877254 · Cited by 24 · see citing works
Effect of exercise and manual therapy or kinesiotaping on sEMG and pain perception in chronic low back pain: a randomized trial
Blanco-Gímenez, P., Mampel, J. V., Gargallo, P., Maroto‐Izquierdo, S., Martín-Ruiz, J., Jaenada-Carrilero, E., & Barrios, C. (2024) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-024-07667-9 · Cited by 23 · see citing works
Efficacy and safety of thread embedding acupuncture combined with acupuncture for chronic low back pain
Sung, W.-S., Hong, Y., Jeon, S.-R., Yoon, J., Chung, E. K., Jo, H. G., Kim, T., Shin, S., Lee, H., Kim, E., et al. (2020) · Medicine · doi:10.1097/md.0000000000022526 · Cited by 22 · see citing works
Biofeedback Core Exercise Using Hybrid Assistive Limb for Physical Frailty Patients With or Without Parkinson's Disease
Kotani, N., Morishita, T., Yatsugi, A., Fujioka, S., 鎌田, 聡., Shiota, E., Tsuboi, Y., & Inoue, T. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00215 · Cited by 21 · see citing works
Research Progress on the Mechanism of Lumbarmultifidus Injury and Degeneration
Wang, X., Jia, R., Li, J., Zhu, Y., Liu, H., Wang, W., Sun, Y., Zhang, F., Guo, L., & Zhang, W. (2021) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2021/6629037 · Cited by 21 · see citing works
Combined neuromuscular electrical stimulation with motor control exercise can improve lumbar multifidus activation in individuals with recurrent low back pain
Songjaroen, S., Sungnak, P., Piriyaprasarth, P., Wang, H., Laskin, J., & Wattananon, P. (2021) · Scientific Reports · doi:10.1038/s41598-021-94402-2 · Cited by 21 · see citing works
Immediate effects of isometric trunk stabilization exercises with suspension device on flexion extension ratio and strength in chronic low back pain patientss
Cho, S.-H., & Park, S. (2018) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-181298 · Cited by 20 · see citing works
The Neurostimulation Appropriateness Consensus Committee (NACC)®: Recommendations for Spinal Cord Stimulation Long-Term Outcome Optimization and Salvage Therapy
Deer, T. R., Russo, M. A., Grider, J. S., Sayed, D., Lamer, T. J., Dickerson, D. M., Hagedorn, J. M., Petersen, E., Fishman, M. A., FitzGerald, J. J., et al. (2024) · Neuromodulation Technology at the Neural Interface · doi:10.1016/j.neurom.2024.04.006 · Cited by 20 · see citing works
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Twelve Weeks of Yoga for Chronic Nonspecific Lower Back Pain: A Meta-Analysis
Kim, S.-D. (2020) · Pain Management Nursing · doi:10.1016/j.pmn.2020.07.002 · Cited by 17 · see citing works
Restorative Neurostimulation: A Clinical Guide for Therapy Adoption
Chakravarthy, K. V., Lee, D. J., Tram, J. T., Sheth, S. J., Heros, R. D., Manion, S., Patel, V. V., Kiesel, K. B., Ghandour, Y., & Gilligan, C. J. (2022) · Journal of Pain Research · doi:10.2147/jpr.s364081 · Cited by 21 · see citing works
Self-citation
The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: A systematic review
Wang, X., Xiong, H.-Y., Du, S.-H., Yang, Q., & Hu, L. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.935925 · Cited by 18 · see citing works
Hand Strength Deficit in Patients with Neurogenic Thoracic Outlet Syndrome
Fouasson‐Chailloux, A., Daley, P., Menu, P., Louguet, B., Gadbled, G., Bouju, Y., Abraham, P., & Dauty, M. (2021) · Diagnostics · doi:10.3390/diagnostics11050874 · Cited by 16 · see citing works
Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions
Ghamkhar, L., Arab, A. M., Nourbakhsh, M. R., Kahlaee, A. H., & Zolfaghari, R. (2019) · Pain Medicine · doi:10.1093/pm/pnz206 · Cited by 17 · see citing works
Effects of a multimodal exercise intervention on physical and cognitive functions in patients with chronic low back pain (MultiMove): study protocol for a randomized controlled trial
Schega, L., Kaps, B., Broscheid, K., Bielitzki, R., Behrens, M., Meiler, K. J. C., Drange, S., & Franke, J. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02093-1 · Cited by 15 · see citing works
Musculoskeletal ultrasound-guided needle knife therapy in the treatment of refractory nonspecific low back pain: A single-blind, randomized controlled trial
Li, X., Zhang, H., Zhang, S., Wu, M., Wang, S., Tang, Z., & Xiao, J. (2024) · Medicine · doi:10.1097/md.0000000000041066 · Cited by 14 · see citing works
Effect of Whole-Body Vibration Exercise on Pain, Disability, Balance, Proprioception, Functional Performance and Quality of Life in People with Non-Specific Chronic Low Back Pain: A Systematic Review and Meta-Analysis
Zafar, T., Zaki, S., Alam, M. F., Sharma, S. R., Babkair, R. A., Nuhmani, S., & Pandita, S. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13061639 · Cited by 16 · see citing works
Systematic Review and Meta-analysis of Stimulation of the Medial Branch of the Lumbar Dorsal Rami for the Treatment of Chronic Low Back Pain
Copley, S., Batterham, A. M., Shah, A., Foly, A., Hagedorn, J. M., Deer, T. R., Gilligan, C. J., & Eldabe, S. S. (2024) · Neuromodulation Technology at the Neural Interface · doi:10.1016/j.neurom.2024.08.002 · Cited by 14 · see citing works
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Effect of m-health-based core stability exercise combined with self-compassion training for patients with non-specific chronic low back pain: study protocol for a randomized controlled trial
Fuming, Z., Weihui, X., Jiajia, Y., Shufeng, L., Yiyi, Z., Wenjian, L., Yan, L., Zhicheng, L., Siyun, Z., Yingmin, Z., et al. (2022) · Trials · doi:10.1186/s13063-022-06258-0 · Cited by 9 · see citing works
“Studies have reported that there is significant atrophy, fat infiltration, and/or decrease in activation of the TrA and LM muscles in individuals with NCLBP [8, 9].”
Background
Prediction of Subsequent Vertebral Fracture After Acute Osteoporotic Fractures from Clinical and Paraspinal Muscle Features
Xiong, Y., Zhang, C., Chen, X., Li, W., Liang, S., Zhang, Y., Huang, J., Guo, W., Zeng, X., & Xu, F. (2024) · Calcified Tissue International · doi:10.1007/s00223-024-01209-0 · Cited by 13 · see citing works
Electrical Properties of Lumbar Paraspinal Muscles in Young Adults With and Without Chronic Low Back Pain Based on Electrical Impedance Myography: A Cross-Sectional Study
Wang, H.-J., Zheng, J., Yu, Q., Fan, Z., Lo, W. L. A., Li, L., & Wang, C. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2021.789589 · Cited by 12 · see citing works
Adverse Childhood Experiences and Chronic Low Back Pain in Adulthood: The Role of Emotion Regulation
Thomas, P. A., Goodin, B. R., Meints, S. M., Owens, M. A., Wiggins, A. M., Quinn, T. L., Long, D. L., Aroke, E. N., Morris, M. C., Sorge, R. E., et al. (2024) · Journal of Pain · doi:10.1016/j.jpain.2024.104551 · Cited by 11 · see citing works
Reliability of lumbar multifidus ultrasound assessment during the active straight leg raise test
Plaza‐Manzano, G., Navarro‐Santana, M. J., Valera‐Calero, J. A., Fabero‐Garrido, R., Fernández‐de‐las‐Peñas, C., & López‐de‐Uralde‐Villanueva, I. (2021) · European Journal of Clinical Investigation · doi:10.1111/eci.13728 · Cited by 11 · see citing works
Non-Spinal Neuromodulation of the Lumbar Medial Branch Nerve for Chronic Axial Low Back Pain: A Narrative Review
Francio, V. T., Westerhaus, B. D., Rupp, A., & Sayed, D. (2022) · Frontiers in Pain Research · doi:10.3389/fpain.2022.835519 · Cited by 11 · see citing works
The Role of Exercise in Treating Low Back Pain
Essman, M., & Lin, C. Y. (2022) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000982 · Cited by 10 · see citing works
Preoperative Association Between Quantitative Lumbar Muscle Parameters and Spinal Sagittal Alignment in Lumbar Fusion Patients
Moser, M., Okano, I., Sanchez, L. A., Salzmann, S. N., Carlson, B. B., Amini, D. A., Oezel, L., Chiapparelli, E. A., Tan, E. T., Shue, J., et al. (2022) · Spine · doi:10.1097/brs.0000000000004410 · Cited by 10 · see citing works
Changes in psoas and posterior paraspinal muscle morphology after standalone lateral lumbar interbody fusion: a quantitative MRI-based analysis
Moser, M., Amini, D. A., Echeverri, C., Oezel, L., Haffer, H. P. H., Muellner, M., Tan, E. T., Shue, J., Sama, A. A., Cammisa, F. P., et al. (2023) · European Spine Journal · doi:10.1007/s00586-023-07579-7 · Cited by 10 · see citing works
The ghost in the machine – Is musculoskeletal medicine lacking soul?
Wallden, M., & Chek, P. (2018) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2018.02.019 · Cited by 10 · see citing works
The effect of chronic, non-specific low back pain on superficial lumbar muscle activity: a protocol for a systematic review and meta-analysis
Sanderson, A. J. R., Rushton, A. B., Martinez‐Valdes, E., Heneghan, N. R., Gallina, A., & Falla, D. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-029850 · Cited by 10 · see citing works
Analysis of lumbar lateral instability on upright left and right bending radiographs in symptomatic patients with degenerative lumbar spondylolisthesis
Wang, X., Chen, X., Fu, Y., Chen, X., Zhang, F., Cai, H., Ge, C., & Zhang, W. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-022-05017-1 · Cited by 10 · see citing works
Core stabilisation exercises reduce chronic low back pain in Air Force fighter pilots: a randomised controlled trial
Mendes, P. R. F., Gomes, S. R. A., da Costa, L. D. O., Liguori, A. D. A. L., Bulhões, L. C. C., & Brasileiro, J. S. (2022) · BMJ Military Health · doi:10.1136/bmjmilitary-2021-002005 · Cited by 10 · see citing works
Risk factors analysis and risk prediction model construction of non-specific low back pain: an ambidirectional cohort study
Lu, W.-J., Shen, Z., Chen, Y., Hu, X., Ruan, C., Ma, W., & Jiang, W. (2023) · Journal of Orthopaedic Surgery and Research · doi:10.1186/s13018-023-03945-9 · Cited by 11 · see citing works
Using neuromuscular electrical stimulation in conjunction with ultrasound imaging technique to investigate lumbar multifidus muscle activation deficit
Wattananon, P., Sungnak, P., Songjaroen, S., Kantha, P., Hsu, W., & Wang, H. (2020) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2020.102215 · Cited by 10 · see citing works
The Politics of Chronic LBP
Gabel, C. P., Mokhtarinia, H. R., & Melloh, M. (2020) · Spine · doi:10.1097/brs.0000000000003758 · Cited by 9 · see citing works
Slacklining as therapy to address non-specific low back pain in the presence of multifidus arthrogenic muscle inhibition
Gabel, C. P., Mokhtarinia, H. R., Melloh, M., & Mateo, S. (2021) · World Journal of Orthopedics · doi:10.5312/wjo.v12.i4.178 · Cited by 9 · see citing works
Hatha yoga is more effective in improving kinesiophobia and subjective well-being when combined with self-compassion meditation in people with CLBP: a randomized control trial
Giorgio, A. D., Angilletta, S., Matteo, B. M., Bonavolontá, V., Bragazzi, N. L., & Kuvačić, G. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1272919 · Cited by 8 · see citing works
Resting-State Functional Connectivity of the Cerebellum in Patients With Chronic Low Back Pain
Zhang, S., Zhang, G., Bao, S., Tan, J., He, R., Wang, H.-J., Yan, S., & Wang, C. (2024) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000002583 · Cited by 8 · see citing works
The effect of paraspinal muscle morphology on the development of osteoporotic lumbar vertebral fractures
Sönmez, E., Tekin, A., Oğuzhanasiltürk, D. Ü., Anlı, E., Ayhan, L., Dilbaz, S., Öztürk, A., Baş, N. S., Işık, S., & Çevik, S. (2025) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.1177/10538127251340350 · Cited by 8 · see citing works
Alterations in kinematics of temporomandibular joint associated with chronic neck pain
Siu, W.-S., Shih, Y., Lee, S., Hsu, C., Wei, M.-J., Wang, T., Lin, H., & Lin, Y. (2022) · Journal of Oral Rehabilitation · doi:10.1111/joor.13347 · Cited by 8 · see citing works
Effects of low-intensity pulsed ultrasound on pain and functional disability in patients with early-stage lumbar spondylolysis: A randomized controlled trial
Tanveer, F., Arslan, S. A., Darain, H., Ahmad, A., Gilani, S. A., & Hanif, A. (2022) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2022.02.025 · Cited by 8 · see citing works
Relation Between Abnormal Spontaneous Brain Activity and Altered Neuromuscular Activation of Lumbar Paraspinal Muscles in Chronic Low Back Pain
Zhang, S., Wang, Y., Li, T., Ma, J., He, R., Han, X., Wu, W., & Wang, C. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2024.06.012 · Cited by 7 · see citing works
The influence of the trunk muscle activation on occlusion pressure and respiratory muscle strength in healthy participants: Randomized controlled trial
Śliwka, A., Piliński, R., Rosa, W., & Nowobilski, R. (2021) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2021.103682 · Cited by 7 · see citing works
Effects of Sling Exercise on Pain, Trunk Strength, and Balance in Patients with Chronic Low Back Pain
Mun, D.-J., Oh, H.-J., & Lee, S.-H. (2022) · The Journal of Korean Physical Therapy · doi:10.18857/jkpt.2022.34.3.110 · Cited by 7 · see citing works
PILLAR: ParaspInaL muscLe segmentAtion pRoject - a comprehensive online resource to guide manual segmentation of paraspinal muscles from magnetic resonance imaging
Anstruther, M., Rossini, B., Zhang, T., Liang, T., Xiao, Y., & Fortin, M. (2023) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-023-07029-x · Cited by 7 · see citing works
The Role of Orthoses in Chronic Axial Spinal Conditions
Freeman, J., Nikjou, D., Maloney, J. A., Covington, S. M., Pew, S., Wie, C. S., Strand, N. H., & Abd-Elsayed, A. A. (2024) · Current Pain and Headache Reports · doi:10.1007/s11916-024-01233-7 · Cited by 7 · see citing works
Study protocol randomised controlled trial comparison of cost–utility and cost-effectiveness of a face-to-face rehabilitation programme versus a telemedicine programme in the treatment of patients with chronic low back pain
Castro‐Sánchez, A. M., Matarán-Peñarrocha, G. A., Gómez-García, S., García‐López, H., Andronis, L., Cabello, M. A., & Lara‐Palomo, I. C. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-040633 · Cited by 7 · see citing works
Postural cueing increases multifidus activation during stabilization exercise in participants with chronic and recurrent low back pain: An electromyographic study
Winder, B., Keri, P. A., Weberg, D. E., & Beneck, G. J. (2019) · Journal of Electromyography and Kinesiology · doi:10.1016/j.jelekin.2019.03.005 · Cited by 7 · see citing works
Comparison of erector spinae and gluteus medius muscle thickness and activation in individuals with and without low back pain
Farley, J. R., Pokhrel, S., Koppenhaver, S. L., & Fritz, J. M. (2024) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2024.02.042 · Cited by 6 · see citing works
The predictive value of multifidus degeneration in osteoporotic vertebral compression fracture patients with kyphosis deformity
Li, J., Wang, Z., Han, G., Sun, Z., Wang, Y., Yu, M., Li, W., Zeng, L., & Zeng, Y. (2025) · The Spine Journal · doi:10.1016/j.spinee.2024.12.031 · Cited by 6 · see citing works
Spatial patterns of fat within the deep multifidus as a biomarker for chronic low back pain
Khattab, K., Dziesinski, L. K., Ornowski, J., Zhou, J., Bonnheim, N. B., Crawford, R. J., Scheffler, A., Fields, A. J., O’Neill, C. W., Lotz, J. C., et al. (2025) · The Spine Journal · doi:10.1016/j.spinee.2025.07.022 · Cited by 6 · see citing works
ReActiv8 Stimulation Therapy vs. Optimal Medical Management: A Randomized Controlled Trial for the Treatment of Intractable Mechanical Chronic Low Back Pain (RESTORE Trial Protocol)
Gilligan, C. J., Burnside, D., Grant, L., Yong, R. J., Mullins, P. M., Schwab, F., & Mekhail, N. A. (2023) · Pain and Therapy · doi:10.1007/s40122-023-00475-4 · Cited by 6 · see citing works
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BackMov: Individualized Motion Capture-Based Test to Assess Low Back Pain Mobility Recovery after Treatment
Villalba-Meneses, F., Guevara, C., Velásquez-López, P. A., Arias-Serrano, I., Guerrero-Ligña, S. A., Valencia-Cevallos, C., Almeida-Galárraga, D. A., Cadena-Morejón, C., Marín, J., & Marín-Zurdo, J. (2024) · Sensors · doi:10.3390/s24030913 · Cited by 6 · see citing works
Effects of a mat Pilates-based exercise program for low back pain in helicopter pilots of the Brazilian Air Force: Randomized controlled trial
Bulhões, L. C. C., Gomes, S. R. A., Silva, V. K. F., Rodolfo, J. I. D. A., Macedo, L. D. B., & Brasileiro, J. S. (2024) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2024.03.052 · Cited by 6 · see citing works
Efficacy of Back Bracing in Treating Chronic Low Back Pain
Vick, J. S., Zimmerman, J., Hicks, S., Biekert, A., & Abd-Elsayed, A. A. (2024) · Brain Sciences · doi:10.3390/brainsci14111100 · Cited by 6 · see citing works
Spinopelvic malalignment correlates to lumbar instability and lumbar musculature in chronic low back pain-an exploratory study
Seyedhoseinpoor, T., Sanjari, M. A., Taghipour, M., Dadgoo, M., & Mousavi, S. J. (2024) · Scientific Reports · doi:10.1038/s41598-024-83570-6 · Cited by 5 · see citing works
Plasma Pro‐ and Anti‐Inflammatory Cytokines in an Observational Chronic Low Back Pain Cohort
Enrico, V. T., Anderst, W. J., Bell, K. M., Coelho, J. P., Darwin, J., Delitto, A., Greco, C. M., Lee, J. Y., McKernan, G., Patterson, C. G., et al. (2025) · JOR Spine · doi:10.1002/jsp2.70095 · Cited by 5 · see citing works
The immediate effect of anodal tDCS over the motor cortex on postural control and cortical activation in patients with chronic low back pain: A preliminary study
Li, Y., Xie, H., Peng, J., Xu, Z., Xu, Z., Cheng, X., Yang, J., Yu, Q., Xie, H., Wang, X., et al. (2025) · Behavioural Brain Research · doi:10.1016/j.bbr.2025.115827 · Cited by 5 · see citing works
Neuromuscular and Kinetic Adaptations to Symmetric and Asymmetric Load Carriage During Walking in Individuals with Chronic Low Back Pain
Tajik, R., Dhahbi, W., Mimar, R., Tazji, M. K., Ceylan, H. İ., Bayrakdaroğlu, S., Ștefănică, V., & Hammami, N. (2026) · Bioengineering · doi:10.3390/bioengineering13010082 · Cited by 5 · see citing works
Association between seated trunk control and cortical sensorimotor white matter brain changes in patients with chronic low back pain
Gilliam, J. R., Sahu, P. K., Vendemia, J. M. C., & Silfies, S. P. (2024) · PLoS ONE · doi:10.1371/journal.pone.0309344 · Cited by 5 · see citing works
Factors associated with low back pain in air force fighter pilots: a cross-sectional study
Gomes, S. R. A., Mendes, P. R. F., da Costa, L. D. O., Bulhões, L. C. C., Borges, D. T., Macedo, L. B., & Brasileiro, J. S. (2021) · BMJ Military Health · doi:10.1136/bmjmilitary-2021-001851 · Cited by 5 · see citing works
Multifidus Muscle Contractility Deficit Was Not Specific to the Painful Side in Patients with Chronic Low Back Pain During Remission: A Cross-Sectional Study
Thu, K. W., Maharjan, S., Sornkaew, K., Kongoun, S., & Wattananon, P. (2022) · Journal of Pain Research · doi:10.2147/jpr.s363591 · Cited by 5 · see citing works
Postural alteration, low back pain, and trunk muscle resistance in university students
Fischer, R. D. A., Spinoso, D. H., & Navega, M. T. (2022) · Fisioterapia em Movimento · doi:10.1590/fm.2022.35120 · Cited by 5 · see citing works
The automatic activity of abdominal muscles during stable and unstable standing postural tasks in older adults with and without low back pain- A cross-sectional study
Kalantari, M., ShahAli, S., Dadgoo, M., & Tabatabaei, A. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04934-1 · Cited by 5 · see citing works
Percutaneous and Implanted Peripheral Nerve Stimulation for the Management of Pain: Current Evidence and Future Directions
Wilson, R. D., & Kim, C. (2020) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-019-00256-1 · Cited by 5 · see citing works
Referenzwerte in der isometrischen Kraftdiagnostik
Pietsch, A., Schröder, J., Reer, R., Edler, C., Kutasow, A., & Riepenhof, H. (2021) · Der Orthopäde · doi:10.1007/s00132-021-04091-y · Cited by 5 · see citing works
Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation Phenomenon
Aranda-Valera, I. C., Garrido-Castro, J. L., Galisteo, A. M., Peña, J., Gonzalez-Navas, C., Cuesta‐Vargas, A., Jiménez‐Reina, L., Collantes‐Estévez, E., & López‐Medina, C. (2021) · Diagnostics · doi:10.3390/diagnostics11050810 · Cited by 5 · see citing works
The effect of motor control training according to the Kinetic Control concept on the back pain of female football players
Zaworski, K., Gawlik, K., Kręgiel-Rosiak, A., & Baj–Korpak, J. (2021) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-200226 · Cited by 5 · see citing works
Individuals With Impaired Lumbopelvic Control Demonstrate Lumbar Multifidus Muscle Activation Deficit Using Ultrasound Imaging in Conjunction With Electrical Stimulation: A Cross-sectional Study
Sungnak, P., Songjaroen, S., Krityakiarana, W., Wang, H., Richards, J., & Wattananon, P. (2022) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2022.02.010 · Cited by 5 · see citing works
Comparison of compensatory lumbar movement in participants with and without non-specific chronic low back pain: A cross-sectional study
Choi, W.-J., Kim, W.-D., Park, D.-C., & Shin, D. (2022) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-210327 · Cited by 5 · see citing works
A standardized anesthetic/analgetic regimen compared to standard anesthetic/analgetic regimen for patients with high-risk factors undergoing open lumbar spine surgery: a prospective comparative single-center study
Byvaltsev, V. A., Goloborodko, V. Y., Калинин, А. А., Shepelev, V. V., Pestryakov, Y. Y., & Riew, K. D. (2023) · Neurosurgical Review · doi:10.1007/s10143-023-02005-4 · Cited by 5 · see citing works
Core stabilization exercises versus yoga on feedforward activation of core muscles in chronic mechanical low back pain: An experimental study
Desai, R. R., Rathi, M. A., Agrawal, P., & Palekar, T. J. K. (2024) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2024.03.056 · Cited by 4 · see citing works

Restorative Neurostimulation for Patients with Mechanical Chronic Low Back Pain and Impaired Neuromuscular Control of the Lumbar Spine | A New Treatment Paradigm
Gilligan, C. J., Chavda, A. S., Ho, J. S., Lee, D. J., Langhorst, M. L., Yih, E. T., & Amann, M. (2025) · Journal of Pain Research · doi:10.2147/jpr.s525057 · Cited by 3 · see citing works
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ID: 325302 A systematic review of stimulation of the medial branch for chronic low back pain (106)
Eldabe, S. S., Shah, A., Hagedorn, J. M., Copley, S., Batterham, A. M., Deer, T. R., & Foly, A. (2024) · Neuromodulation Technology at the Neural Interface · doi:10.1016/j.neurom.2024.06.459
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Corticomotor control of lumbar multifidus muscles is impaired in chronic low back pain: concurrent evidence from ultrasound imaging and double-pulse transcranial magnetic stimulation
Massé‐Alarie, H., Beaulieu, L., Preuss, R. A., & Schneider, C. (2015) · Experimental Brain Research · doi:10.1007/s00221-015-4528-x · Cited by 79 · see citing works
Lumbar Multifidus Dysfunction and Chronic Low Back Pain: Overview, Therapies, and an Update on the Evidence
Abd-Elsayed, A. A., Kurt, E., Kollenburg, L., Hasoon, J. J., Wahezi, S. E., & Storlie, N. R. (2025) · Pain Practice · doi:10.1111/papr.70044 · Cited by 35 · see citing works
Disease Modifying Therapies: Restorative Neurostimulation for Chronic Low Back Pain
Francio, V. T., & Gilligan, C. J. (2024) · Springer eBooks · doi:10.1007/978-3-031-46217-7_52 · Cited by 1 · see citing works
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Authors: Russo, M., Deckers, K., Eldabe, S., Kiesel, K., Gilligan, C., Vieceli, J., & Crosby, P.
Affiliations: GZA Ziekenhuizen Campus Sint-Augustinus (BE)
James Cook University Hospital (GB)
University of Evansville (US)
Corresponding author: Russo, Marc
ORCID: Russo, Marc
Eldabe, Sam
Venue: Neuromodulation: Technology at the Neural Interface
Publisher: Elsevier BV
Published: 2018-01
Volume: 21
Issue: 1
Pages: 1-9
ISSN: 1094-7159 (ISSN-L)
DOI: 10.1111/ner.12738
PMC: PMC5814909
OpenAlex: W2774951579
Cited by: 222
References: 136
Citations by year: 2026: 23 · 2025: 24 · 2024: 55 · 2023: 27 · 2022: 36 · 2021: 24 · 2020: 18 · 2019: 9 · 2018: 6
FWCI: 1.15
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
Locations: Neuromodulation Technology at the Neural Interface (publishedVersion, cc-by-nc-nd)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Funders: Mainstay Medical International plc
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: chronic non-specific low back pain, lumbar multifidus, lumbar instability, arthrogenic muscle inhibition, neurostimulation, exercise therapy, nociceptive pain
MeSH terms: Electromyography, Exercise Therapy, Humans, Lumbar Vertebrae, Pain Measurement, Low Back Pain, Muscle, Skeletal, Chronic Pain

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Muscle Control and Non-specific Chronic Low Back Pain

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