What is multifidus stimulation?
The multifidus muscles help control and stabilize the lower spine. In some people with long-standing mechanical low back pain, clinical testing identifies impaired multifidus control that may remain despite supervised rehabilitation.
Restorative neurostimulation uses implanted leads to stimulate the nerves that activate these muscles. Treatment is delivered during scheduled sessions, with the aim of supporting muscle activation and rehabilitation over time. It does not correct every structural or neurological cause of back pain.
When is it considered?
It may be considered for selected adults with persistent mechanical low back pain, evidence of multifidus dysfunction and no clear indication for corrective spine surgery. Assessment should also consider whether another pain source, such as nerve-root compression, hip disease or sacroiliac pain, better explains the symptoms.
What does implantation involve?
The system includes leads placed near the relevant nerves and a small implanted pulse generator. After implantation, the device is programmed and checked at follow-up visits. The patient uses it during scheduled sessions at home and continues an agreed rehabilitation plan.
Risks and recovery
Risks include infection, bleeding, discomfort around the generator, nerve irritation, lead movement or damage, device malfunction, revision or removal, and no meaningful improvement. Restrictions after implantation protect the wound and leads while they heal. The team should also explain charging or battery requirements, MRI compatibility and what the device means for future medical procedures.
How we approach your care
- 01
Find the true source
We begin with a thorough history and examination, supported by imaging where appropriate, to pinpoint the precise source of the problem.
- 02
Consider appropriate options
Where clinically appropriate, we consider established non-surgical options before surgery. The plan depends on the diagnosis, symptoms, health and priorities of the individual patient.
- 03
A plan built around you
Every step is explained clearly, so you always understand your options and what comes next.
This may help if
- Mechanical low back pain has persisted despite an appropriate supervised rehabilitation programme
- Clinical assessment indicates impaired multifidus muscle control
- Assessment does not identify a spinal condition for which surgery is the more appropriate treatment
Suitability can only be assessed after reviewing your symptoms, examination, relevant imaging and previous treatment.
Common questions
Is multifidus stimulation a replacement for physiotherapy?
No. The implanted system activates the nerves supplying the multifidus muscles during scheduled sessions. It is intended to support rehabilitation and movement retraining, not replace them.
Does the device run continuously?
No. Restorative stimulation is normally delivered during scheduled sessions while you are resting. The treatment programme, device checks and rehabilitation plan are set for the individual patient.
What are the risks?
Risks include infection, bleeding, discomfort around the implanted generator, nerve irritation, lead movement or damage, device malfunction and the need for revision or removal. Symptoms may not improve. MRI compatibility and future procedures should also be discussed before implantation.