DAVID W. LEE, M.D.
INTERVENTIONAL PAIN & SPINE
FULLERTON ORTHOPEDICS
UNIVERSITY OF CALIFORNIA IRVINE AFFILIATE
RESTORATIVE MULTIFIDI MUSCLE STIMULATION - REACTIV8®
The source of chronic low back pain may be caused by weakness of the multifidi muscles in the lower back that support the spinal column. In the presence of low back pain it may be difficult to perform normal daily activities and/or exercise. The muscles that normally prevent painful movements then weaken and atrophy over time. If this is not addressed, patients may develop multifidi dysfunction, where the low back muscles have limited or no activation. This results in a negative cascade of increased stress and instability in the lower spine. This often then leads to increased severity of pain over time and further loss of function and quality of life. One can often see multifidi atrophy by reviewing magnetic resonance imaging (MRI) of the lumbar spine. The muscle appears to have fatty infiltration, indicating the severity of the atrophy.
Restorative multifidi stimulation (otherwise known as ReActiv8) is a therapy that stimulates the nerves of the muscle directly responsible for stabilizing your lumbar spine. The therapy can interrupt your low back’s cycle of pain, degeneration, and loss of function by strengthening the connection between your brain and the low back muscles. It may also allow for increased strength of the lower back muscles over time.
Patients with multifidus atrophy or dysfunction often describe their pain symptoms to be in the middle of their low back or upper buttock, made worse by physical activity, prolonged sitting, and household tasks. These symptoms are generally localized to the lower back only and do not tend to radiate into the legs.
The ReActiv8 procedure involves placing two small wires in the lower back. These wires are on the outside of the spine and stimulate the multifidi muscles on both sides of the back. The wires are then attached to a generator that is implanted underneath the skin. The procedure is performed as an outpatient with twilight anesthesia for comfort. ReActiv8 generates comfortable electrical pulses that cause your multifidus muscle to contract and relax. This therapy is patient controlled and used twice a day in 30 minute sessions. As with any muscle contraction, the more you utilize the therapy, the stronger the muscle will get.