Multifidus Tear

Good morning,
I am a 63 year old male, and my wife and I are very fit individuals, being athletes since we were children. I am writing because I have had locked muscles on my right side only, including the Paraspinals, the QL, and the Oblique muscles all on the right side, and the Multifidus muscle(s) were discussed with a Physical Therapist earlier this year.

I have had multiple images taken, (X-rays, Ultrasounds, CT scans, and MRIs), and nothing is ever conclusive for what is causing the pain I am in all day, every day. I have been to Chiropractors, Acupuncturists, Physical Therapists, as well as multiple doctors in several specialties. Trigger Point Injections, Dysport Injections, Cupping, and several types of massage have all done nothing at all for the muscles or my pain.

All I keep hearing from the doctors is that I am not a "textbook case", and they shrug their shoulders and walk away. This is why I have been to (5) hospitals, and have seen more than 30 doctors, because many of them give up after the first visit. An image ordered, a blood panel work-up, and a quick exam all showing nothing that they can pinpoint, and they walk away because they didn't figure it out on the first visit.

This has been going on for more than three years (July of 2023 until now), and the only time I am not in pain is when laying on my back. But as soon as I'm up, either standing or sitting, the muscles lock up and I'm in pain until the next chance I have to lay down.

So, I am hoping if there is something to this Multifidus muscle issue, we can figure it out and help each other.

@marcd2k - Yes, I read your other post and considered the possibility that there might be some overlap with my condition. Generally, the only time I am pain-free is while lying flat, too.

When I went for MR (myofascial release) I learned how the fascia can develop tightness. It is a natural protective mechanism to shield the underlying muscles from further damage and is what happened to me during the initial recovery from my multifidus tear over the course of several weeks/months. I think the theory behind MR is that the fascia can become 'trapped' in a rigid state even after the triggering injury has resolved. (I'm sure prior posts have covered this in great detail) I still have some ongoing fascia tightness over my injured area which contributes to the stiffness in the right side of my back, which is why it is important for me to do PT and the techniques that I learned during my MR treatment. These include lower abdominal and hip rotation exercises which stretch the lower paraspinals.

Before my multifidus tear, I remember having some pretty bad strains/sprains in other parts of my back that lasted days or weeks, especially in the lower lumbar area, at which time my lower paraspinal muscles became "locked" over a large area. (Once I remember having a back injury higher up that had a wrap-around effect into my obliques, too). However, I think in that case it was more neurological than fascia and triggered mainly by the pain response.

I am no doctor, but I think any time there is chronic tightness with pain it can be the cumulative effects of everything including joints, muscles, nerves, and fascia.

Have you ever tried infrared sauna therapy or red light? I do both and consider them to be another tool in the toolbox.

@multifidus13 Good afternoon, thanks for replying. I was looking into myofascial release this past week, and there are several places near me that offer this treatment. The problem is these treatments are under physical therapy, and my insurance limit was met months ago. So I've been paying $1,200 a month for physical therapy, and now, the MFR treatments are even more expensive.

It will literally come down to, do we have electricity for the house, or do we have health insurance, in 2027? We can't afford both. We're both retired, fixed-income, so that much of an increase is not possible.

One other thing you mentioned was red light therapy. I tried this back at the beginning of summer, and it made my pain worse, causing the muscles in my right side to lock with hardly any effort being exerted on them. I have to be careful feeding the dog. When I bend down for the bowl, my side can lock up just like that.

The most frustrating thing right now is I just had a comprehensive physical exam on Friday, and if you just see the numbers on paper, this person seems to be very healthy. This is what the tests found Friday:
63-year-old male
5' 8"
148lbs
BP 118/70
HR 53 bpm
O2 98%
PSA 0.4
Cholesterol 164 (HDL 52 / LDL 102)
Triglycerides 50

And this is all with no medications at all, as I do not take any prescriptions. But my pain is there, and no one can see it because they see my imaging, they see my blood work, they see me looking totally normal. But I am far from normal, no matter what everyone thinks they see. All of those numbers do not do me any good if I can't walk my dog around the block, I can't even do warm-up exercises I used to before workouts, and what has really hurt is I have a Grandson that I cannot carry and/or play with how I should be. I've been side-lined from life.

@marcd2k -I can sympathize 100%. My myofascial release (MR) wasn't covered either at the time because it was still considered an 'experimental' therapy. I ended up getting billed for a large portion of it (over $1000). Same thing for platelet rich plasma (PRP) injections: $700+ a session (x3) and not covered by insurance. (I didn't go through with them because I decided my tendon was probably too hard by that point for PRP to be effective without being preceded by an aggressive dry-needling procedure (A.K.A tenotomy)

BTW, I have similar stats and like you, they don't tell the fully story either. I recently had a lumbar X-ray which found "moderate to severe degenerative disc disease at multiple levels", especially at L5-S1. But I haven't had much lower lumbar or pelvic pain at all in the last 10 years.

With regard to sauna and red light, I think it is true that it can backfire, especially if overdone. Shortly after my injury I purchased a portable sauna and would spend 45 minutes in there followed by a hot shower. Then sleeping on a hard ice pack, every night. In retrospect, that was likely counterproductive.

One last story: When I was in my late 30's I had a headache all the time that wouldn't go away. I thought I maybe had a brain aneurysm or something. After about a month, I saw my PCP and she correctly diagnosed it as a tension headache originating from the muscles at the base of my skull. It was from using a flat pillow and sleeping on my back. Funny thing is, the pain at times felt like the hair on the very top of my scalp was being yanked! Just another example of how pain can be completely 'referred' to from somewhere else.

@multifidus13 It seems we can identify with each other's issues, hopefully we can also find out our diagnoses out, as this is not a lot of fun.

I've heard from the beginning of this journey about the opposite symptom imaging, either CT or MRI scans. The first chiropractor I saw said there are people with my spine walking around without a symptom in the world, and then there are people with what is considered normal scans in intense pain. So, an image will not always tell the story.

My wife bought me a red-light device, and it has an automatic timer so it shuts off after 20 minutes. I used it on the lowest setting for the 20 minutes, and within a couple of hours, my right side muscles started locking up. And they have never been back to where they were before I tried the red-light therapy, leaving me in more pain once again.

I also have a strange history with headaches. Back in 1993 I started having migraines. They called it an Ophthalmological Migraine because the first indication I would get is like a sun spot right in the middle of my right eye about 15 minutes before the headache itself started. This ended up giving me a heads-up when I was about to have a migraine, and the prescription Imitrex back then was brand new and only in syringe form. They gave me a spring-loaded device to insert a syringe into, then press the device against my thigh, push a button, and it injected into my leg. I would then lay down for a couple of hours, and I'd be groggy, but the head ache would be gone, when I got back up.

And the migraines stopped on their own in 1996, so I was very fortunate to not have them continue. My boss at the time had monthly migraines his entire adult life. I can't imagine that, it would make me nuts, and that's where I'm getting with my current situation, feeling like I'm going to lose my mind sometimes.

@marcd2k - The upper back sprains that I would get when I was in my teens and twenties wrapped around my ribs (obliques) on one side and made it hard to for me to take a deep breath. It would last up to a week, sometimes longer. I was bedridden a few times from this, if I recall. I think it was in the latissimus muscle or something, but I'm not really sure. It doesn't bear any relationship to my multifidus tear, anyway, since the lat muscles are higher up.. However, there is an indirect relationship to the lower back pain (L5/S1) I experienced when I was younger because of the way I was lifting heavy objects with a side-to-side motion to compensate for that lower lumbar pain. (Lifting in that manner probably ended up causing microtears in my multifidus which led to the more severe tearing later on). In retrospect, I should've taken the time off, avoided lifting heavy objects, and allowed my lower back to fully heal.

Maybe there is a relationship between your current condition and your migraines (??)

Also, have you ever tried using a step-on vibration plate? I use one daily and think it helps, although they can be very intense depending on where your feet are positioned and the selected speed (sometimes the lower speeds can actually be more jarring). From what you have described though, it might make your condition worse -at any speed. I usually tighten my lumbar back belt pretty good before going on it.

@multifidus13 I wouldn't have thought my former migraines could be causing my current medical problems, but with the human body, you never know unless you check.

I just though of another issue I had when I first moved to the city I live in back in 1989. I was rear-ended and almost went through my windshield. My head hit the windshield and pushed it out a few inches, scraping up my forehead and causing quite a mess dripping down my face. I ended up with whiplash and needed physical therapy for my neck.

Almost (4) years later is when the migraines started. I had other issues with my trap and back muscles locking up on me, where you can hardly turn your head to one side because they were so tight. As long as I stayed active, kept exercising and stretching my back, neck, and shoulders, I wouldn't get locked up. But if I skipped out on a workout or two, that's usually when my traps/back would lock up.

I have used those vibration plate chairs at amusement parks, they are great after a long day on your feet. But I have not used one since this started, and you may be right in saying it might not relax my muscles, and it may make them lock up. This really limits what I can try to get my muscles to release.