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Back Muscles

Online Course: Online Course: Low Online Course:

Stratified Care for Back Pain Treatment-Based
Low Back Pain Assessment and Classification
Prognosis System for Low Back
Pain

Introduction

There are three major groups of back muscles:

1. Superficial: attached to the shoulder girdle

2. Intermediate: attached to the posterior thorax
3. Deep: attached to the vertebral column, also known as the
intrinsic muscle group[1]
These groups serve to allow: flexion/extension, rotation, and side
bending of the back; movement of the limbs; locomotor function;
and assistance in the breathing[2].

Additional terminology

1. The superficial and intermediate muscle groups (or

extrinsic muscles) are also called immigrant muscles, since
they actually represent muscles of the upper limb that have
migrated to the back during fetal development. Drawing Back Muscles

2. The deep/intrinsic back muscles, are also called true back

muscles. They are located deep to the extrinsic muscles,
being separated from them by the thoracolumbar fascia[3].
Physiotherapy Relevance

A good understanding of the back muscle anatomy is critical for correct diagnosis and treatment.
Generalized back pain is a common presenting symptom in clients , with the etiology of the pain commonly
traced to a strain of the skeletal muscle.

Superficial Group

The first category is the superficial

back muscles. These muscles are
located posteriorly on the back,
whose function is to move the
scapula.. The superficial muscles
include[2]:

Trapezius
Latissimus Dorsi
Levator Scapulae
A Trapezius D Latissimus Dorsi E Levator Scapulae F Rhomboid Major
Rhomboids
Muscles in this group are fairly
large and superficial and they are easily identified by palpation[4].

Intermediate Muscles

The intermediate group contains two muscles:

Serratus posterior superior

Serratus posterior inferior
These muscles run from the vertebral column to the ribcage, and assist with
elevating and depressing the ribs. They are also thought to have a role as
accessory muscles for respiration[5].

Serratus posterior inferior

Deep/Intrinsic Muscles

The deep muscles of the back are well-developed, and collectively extend from
the sacrum to the base of the skull. They are associated with the movements of
the vertebral column, and the control of posture.

The muscles themselves are covered by deep fascia, which plays a key role in
their organisation.

The deep muscles of the back are subdivided into their own

1. Superficial,
2. Intermediate and
3. Deep layers.
A well muscled back

The Superficial Muscles

There are two muscles in this group

1. Splenius Capitis
2. Splenius Cervicis
They are both associated with movements of the head and neck.
They are located on the posterolateral aspect of the neck, covering
the deeper neck muscles[6].

Splenius capitis and cervicis

Erector Spinae.

The Erector Spinae (ES) group (medially to laterally) consist of:

1. Iliocostalis
2. Longissimus
3. Spinalis
The muscle group is bilateral on either side of the vertebral column and when
both sides are engaged function as the primary extensor of the back.
Unilaterally they assist with lateral bending and rotation of the spine[2].
Erector spinae group

The Deep Intrinsic Muscles - Transversospinales

Transversospinales muscle group is a deep group of back muscles

that lies deep to the Erector Spinae. It consists of 3 major
subgroups:

1. Semispinalis,
2. Multifidus
3. Rotatores.
The transversospinalis muscles group runs obliquely and medially
from the transverse process of the vertebra below to the spinous
process, filling the groove on either side of the spinous process[7].

These muscles assist in bending the back posteriorly when Back: Deep Muscles
contracted bilaterally. When unilateral contraction occurs, they
are responsible for assisting with lateral bending and rotation[2].

Nerves

Nervous supply to the intrinsic/deep back primarily arises from

dorsal rami of the spinal nerves, providing sensation the skin of
the back, and the deep muscles of the back.

This innervation is in contrast to the extrinsic muscles of the back,

which are innervated by ventral rami[2].

Ventral and Dorsal Rami Formation

Core Muscles and Back Pain

The core muscles consist of the major muscles that stabilizes and
controls the pressure inside the trunk; these are the pelvic floor,
abdominal wall, back muscles, and diaphragm muscles.[8]

Through core strength training, patients with chronic low back pain
can strengthen their deep trunk muscles. Core strength training,
including deep back muscles, is more effective than typical resistance Core stability exercises
training for alleviating chronic low back pain[9].

Stratified Care for Low Back Pain

An online course by The Physioplus Team

Learn more on this topic

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Introduction The muscles of the back can be arranged into 3 categories based on their location: Superficial back muscles -
found just under the skin. Includes latissimus dorsi, the trapezius, levator scapulae and the rhomboids. Able to move the
upper limb as they originate at the vertebral column and insert onto either the clavicle, scapula or humerus. Intermediate
back muscles - work to elevate and depress the rib cage. There are two major muscles within this category – the serratus
Anatomy Slings and Their Relationship to Low Back Pain - Physiopedia
posterior superior and the serratus posterior inferior. Back muscles - Includes Erector Spinae and Transversospinalis Group
Introduction Serge Gracovetsky (1988), offered a theory of human motion which he called “The Spinal Engine” stating that
(intrinsic back muscles). These muscles collectively work to help movements of the vertebral column and to also control
quadruple amputees could “walk” on the bones at the base of their pelvises. He reasoned that spinal rotation and the muscle
posture.[1] Not attached to the thoracic spine, but an important group of muscles in this region is the Intercostal Group ie
systems around the lumbo-pelvic region might be at the base of human movement[1]. Thus, the efficiency and harmony of
External Intercostals; Internal Intercostals. Major Muscles[edit | edit source] Superficial Layer[edit | edit source] Trapezius –
these muscle systems are very significant, as the limbs merely amplify movement that originates in the musculature of the
this largeSpinae
Erector back muscle - Physiopedia
attaches to the vertebral column from the base of the skull to the ligamentum nuchae of the neck, to
spine and trunk. It has since been proposed and developed from this, by the likes of Andry Vleeming, Diane Lee, and
the spinous processes
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