Muscle atrophy and fatty infiltration of the lumbar extensors is associated with LBP. Exercise-based rehabilitation targets strengthening these muscles, but few studies show consistent changes in muscle quality with standard-of-care rehabilitation.
Full Answer
Does fat infiltration of the lumbar muscles affect the function of lower back muscles?
Nevertheless, a correlation between duration of acute or chronic LBP and decreased lumbar flexion could not be demonstrated. In summary, our results revealed that fat infiltration of LMM has little impact on the measured functions of the lower back muscles.
How to prevent fatty infiltration of muscles with aging?
One of the most effective countermeasures against fatty infiltration of muscle with aging is physical activity and regular exercise.
Is the severity of lumbar dysfunction related to fat infiltration of LMM?
An increasing fat infiltration of LMM may lead to lumbar dysfunction. The purpose of this study was to investigate whether there is a correlation between the severity of lumbar dysfunction and the severity of fat infiltration of LMM. In a cross-sectional study, 42 patients with acute or chronic LBP were recruited.
What is fatty infiltration in skeletal muscle?
Fatty Infiltration in Skeletal Muscle: Cellular and Molecular Mechanisms. There are several stem cell populations in skeletal muscle, the most well defined being muscle satellite cells (SCs), which lie below the basil lamina of muscle fibers and contribute to myogenesis during the process of muscle regeneration.
Can fatty infiltration of muscles reversed?
Fatty infiltration is irreversible and progressive if left untreated. Slight reversal of muscle atrophy has been noted after repair in some studies.
What does fatty infiltration of muscle mean?
Fatty Infiltration in Skeletal Muscle: Cellular and Molecular Mechanisms. Aging in humans is accompanied by a loss of subcutaneous fat but an accumulation of AC and lipids in non-adipose depots, such as bone marrow, liver, and skeletal muscle (2).
What is fatty infiltration of lumbar spine?
Moreover, lumbar muscle degeneration is a common feature in low back pain. Visibly, this muscle degeneration is characterized by a decreased cross-sectional area (muscle atrophy) and an increase in fat content (fatty infiltration) in the lumbar paraspinal muscles (14).
What causes fatty infiltration of muscle?
The main causes of fatty infiltration are muscular disuse and spinal injury, similar to the causes of atrophy (Elliott et al., 2006; Hodges et al., 2006).
How does fatty infiltration develop?
More specifically, a full-thickness tear of a rotator cuff tendon can result in retraction of the muscle belly and its tendon. Retraction of the muscle belly may lead to a change in the pennation angle between the muscle fibers and the subsequent development of fatty infiltration [9].
Can fatty muscle atrophy be reversed?
Abstract. Muscle atrophy and fat accumulation occur after rotator cuff tearing. Whether these changes are reversible after a successful repair is still unknown.
How do you treat paraspinal muscle pain?
Back spasms can be divided into the following two categories:1) Acute Lumbar Muscle Spasms. ... 2) Chronic Lumbar Muscle Spasms. ... 1) Massage. ... 2) Heat or Ice Application. ... 3) Over-the-Counter Medication. ... 4) Water and Electrolytes. ... 5) Use a Foam Roller.
Is lumbar spondylosis arthritis?
This age-related condition is called lumbar spondylosis. It's also frequently called arthritis of the lower back and results in chronic lower back pain that worsens with age and increases with movement. When this condition occurs in the neck, it's called cervical spondylosis.
What is Foraminal narrowing in lumbar spine?
Foraminal narrowing, or foraminal stenosis, is a condition of the spine that can cause pain and other symptoms resulting from spinal nerve root compression. At every level of the spine, a pair of nerve roots runs through the spinal column via small openings called foramina (singular: foramen).
What happens when a muscle atrophies?
If you have atrophied muscles, you'll see a decrease in your muscle mass and strength. With muscle atrophy, your muscles look smaller than normal. Muscle atrophy can occur due to malnutrition, age, genetics, a lack of physical activity or certain medical conditions.
What kind of exercise causes muscle hypertrophy?
lifting weightsHypertrophy refers to an increase in muscular size achieved through exercise. When you work out, if you want to tone or improve muscle definition, lifting weights is the most common way to increase hypertrophy.
Can fat form under muscle?
Subcutaneous fat is present underneath the skin and on top of abdominal muscles. 2. Visceral fat is stored within the abdominal cavity (underneath the abdominal muscles) and surrounds your organs. As a quick rule of thumb: if the fat is visible or pinchable it is most likely subcutaneous fat.
Abstract
Lumbar multifidus muscles (LMM) are important for spinal motion and stability. Low back pain (LBP) is often associated with fat infiltration in LMM. An increasing fat infiltration of LMM may lead to lumbar dysfunction.
Background
Low back pain (LBP) has a very high incidence rate with a lifetime prevelance of up to 84% [ 1 ]. Persisting pain for more than 12 weeks is defined as chronic low back pain (CLBP) [ 1 ].
Methods
This cross-sectional study was conducted in a private physiotherapy outpatient clinic in Bern, Switzerland, according to the Helsinki declaration of ethics in medical research. The duration of the study was 8 months (May-December 2013).
Discussion
The main result of our study was that increased severity of fat infiltration in the lumbar multifidus muscles correlated with decreased flexion range of motion of the lumbar spine.
Conclusion
Fat infiltration in LMM can be found both in acute or chronic LBP patients and in healthy subjects and therefore is not a pain-specific peculiarity. The presented study is the first that investigated the relationship between the severity of fat infiltration in LMM and the severity of lumbar dysfunction.
Acknowledgements
The authors would like to acknowledge Dr. Alfred Schlup for rating the MRI scans and the idiag AG of Switzerland for placing a Spinal Mouse® at our disposal at no charge. Further we would like to acknowledge the input from reviewers who contributed to an improved manuscript.
Author information
Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, Technikumstrasse 71, 8401, Winterthur, Switzerland
Abstract
Fatty infiltration (FI) and muscle atrophy are common findings following RC tears. Fatty degeneration varies among rotator cuff muscles. The pathophysiology is complex, and is characterized by increased fibrosis. Age is reported to correlate with degeneration and atrophy.
About this chapter
Hantes M., Komnos G. (2020) Fatty Infiltration and Muscle Atrophy. What It Means and What Happens After Repair?. In: Sampaio Gomes N., Kovačič L., Martetschläger F., Milano G. (eds) Massive and Irreparable Rotator Cuff Tears. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61162-3_10
Why does the cross sectional area of the muscle not decrease?
However, the cross-sectional area of the muscle may not decrease, due to fatty infiltration in the muscle bundle. Fat infiltration can be seen on magnetic resonance imaging (MRI) and in human cadaver studies.
Is MRI a good way to detect fat?
Unaided MRI has been shown to be a valid method of identifying muscle volume and the amount of fat in human skeletal muscle but is not particularly sensitive to early fat infiltrative changes. These changes have been shown to occur; however, a more sensitive modality is required to detect them.
Is paraspinal muscle volume included in lumbar MRI?
Assessment of paraspinal muscle volume may be worthwhile to include on a lumbar spine MRI report. From a clinical perspective, this finding may be of use in substantiating LBP and the need for treatment. There are several grading scales used for quantification of fatty paraspinal muscle atrophy.
Does LBP cause atrophy?
Based on the understanding of the scientific literature in this area, it is hypothesized that acute LBP leads to altered neuromuscular functioning, which, in turn, results in changes in muscle histology, seen as atrophy. However, the cross-sectional area of the muscle may not decrease, due to fatty infiltration in the muscle bundle.
Is muscle atrophy more diffuse in chronic LBP?
Overall, the muscle atrophy tends to be more diffuse in chronic LBP, and, thus, it is surmised that it may be related to deconditioning or disuse. There has been reported change in the multifidus cross-section area only 24 hours post-acute lower back pain episode. However, the latency and mechanism for these rapid changes remain controversial.
Is LBP a disability?
LBP is also one of the leading causes of disability during one’s working years (2) (3). Within the past several years, there has been increasing attention paid to the concept of decreased paraspinal muscle mass/fatty replacement and its relation to the development and persistence of LBP. There has been speculation about the significance ...
Is muscular insufficiency linked to LBP?
It is generally believed that muscular insufficiency and LBP are linked, even though the main direction of this link is unclear. Is LBP caused by insufficient muscular strength or control, or does LBP affect the muscles and their function? Advertisement. Atrophy of paraspinal muscles is common in LBP (15A).
Why does the cross sectional area of a muscle not decrease?
However, the cross-sectional area of the muscle may not decrease, due to fatty infiltration in the muscle bundle. Fat infiltration can be seen on magnetic resonance imaging (MRI), and in human cadaver studies, MRI has been shown to be a valid method of identifying muscle volume and the amount of fat in human skeletal muscle.
Is fat infiltration a degenerative disease?
Fat infiltration seems to be a late stage of muscular degeneration and can be measured in a non-invasive manner using magnetic resonance imaging. Specifically, fatty atrophy of the multifidus muscle group has been linked in a number of studies to an increased incidence of lower back pain.
Is paraspinal muscle volume included in lumbar spine MRI?
Assessment of paraspinal muscle volume may be worthwhile to include on a lumbar spine MRI report. This finding may be of use in substantiating LBP and the need for treatment. There are several grading scales used for quantification of fatty paraspinal muscle atrophy. One system utilizes the presence of fatty infiltration within muscle.
Does LBP cause atrophy?
Based on the understanding of the scientific literature in this area, it is hypothesized that acute LBP leads to altered neuromuscular functioning, which in turn results in changes in muscle histology, seen as atrophy. However, the cross-sectional area of the muscle may not decrease, due to fatty infiltration in the muscle bundle.
Does MRI show LBP?
To recap, fatty atrophy of paraspinal musculature may be linked to an increased incidence of chronic LBP and possibly acute LBP as well. MRI is well suited to demonstrate quantitatively paraspinal muscle volume loss. Demonstration of loss of paraspinal muscle volume may help to substantiate LBP and the need for treatment.
Abstract
Muscle atrophy and fatty infiltration of the lumbar extensors is associated with LBP. Exercise-based rehabilitation targets strengthening these muscles, but few studies show consistent changes in muscle quality with standard-of-care rehabilitation.
Background
Low back pain (LBP) is a debilitating condition, and is highly prevalent in the United States, affecting 65–85% of the population during their lifetime [ 1, 2 ]. Although acute LBP is thought to be self-limiting, recurrence and progression to chronic LBP is common, even when early treatment is sought [ 3 ].
Methods
The University of California, San Diego Institutional Review Board approved this study. All subjects provided oral and written consent to participate.
Results
Fourteen patients volunteered for this study (Table 1 ). The majority of patients ( N = 13) participating in this study were being seen for a primary diagnosis of degenerative disc disease, with secondary diagnoses of stenosis ( N = 8) or spondylosis ( N = 2). One subject was diagnosed as having nonspecific LBP.
Discussion
This was a preliminary study, evaluating changes in mCSA and FF in response to a standardized, high-intensity, machine-based resistance exercise program in patients with LBP. We hypothesized that increased mCSA and decreased FF would be observed after this program in conjunction with improvements in patient functional outcomes.
Conclusions
In this study, we assessed mCSA and FF of the lumbar paraspinal muscles over the course of high-intensity resistance rehabilitation in patients with LBP. Although only slight group wide changes in average muscle size or fatty infiltration were observed, overall patients experienced large improvements in pain and strength.
Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.