What are the methods of needling the multifidus muscle

In the lumbar region, the multifidus muscle is located next to the lumbar vertebrae and its physiological function is to ensure the close connection of the lumbar vertebrae and to finely distribute the pressure on the lumbar vertebrae, so that the five vertebrae from the first to the fifth lumbar vertebrae work in a coordinated manner, being flexible and able to bear the forces acting on the lumbar region year after year. However, the multifidus muscle is very susceptible to atrophy. In volunteers who spend a lot of time in bed, the lumbar multifidus muscle atrophies in a similar way to that of patients with lower back pain. The lumbar multifidus is located deep in the erector spinae muscle and is unusually thick, with more fibers running longitudinally and significantly more powerful. The longitudinal orientation of most of the muscle fibers keeps them from directly participating in spinal rotation, which is in line with the lumbar facet, thus allowing flexion, extension, and lateral flexion while preventing rotation. Their spasm can induce disc bulge or herniation. Because the force line of the multifidus is located posterior to the lumbar curve, it acts as a “bowstring” to keep the spine extended and increase the lumbar lordosis. The oblique muscle fibers allow the upper body to rotate, and without the multifidus muscle, lumbar flexion would be forced to restrain the lumbar spine, preventing injury from hyperflexion. At the same time, the spine remains upright (without forward flexion) during simple rotation. The multifidus muscle fibers are the only muscle fibers located posterior to the lumbosacral junction (L5-S1), and because of the pronounced anterior tilt in this area, the multifidus must generate enough tension to ensure that the L5 vertebrae do not slip forward beyond the anterior edge of the sacrum (spinal slippage). Fortunately, the multifidus is heavily and precisely concentrated in this part of the spine, but unfortunately, it is often not exercised and becomes disused and atrophied, and is replaced by adipose tissue penetration. The multifidus muscle in the lumbar region is particularly thick and almost entirely lamellar. Although repeated overuse can affect the function of the multifidus muscle, the outer layer of the erector spinae and latissimus dorsi muscles form a very thick joint tendon membrane here, which also plays a protective role. Multifidus stabbing method 1, if a lumbar 4 and lumbar 5 intervertebral disc disease, first stab the 5th lumbar vertebrae of the articular and transverse processes of the site, first feel the 5th lumbar vertebral spine, it is next to open 2 cm a needle stab to stab the articular periosteum, interspersed several times, no more than 3 times, most people have degenerative lesions. 2, side opening 3.5 cm and 4 cm each a needle, this is the beginning of the stab to the multifidus muscle, the same stab to the periosteum, do not interpolate the number of needles too much, after the point stab quickly out of the needle. Then in elevating 2 vertebrae, feel the spinous process of the 3rd lumbar vertebra, this time to cross the 4th lumbar vertebra. 3, in the 3rd lumbar vertebrae of the spinous process next to about 2 cm up and down around the point of puncture, a total of 4 needles, do not do interpenetrating techniques, puncture quickly after the needle, and then perform cupping treatment.