Small bursae at the deep laminar and mammillary process origins of the multifidus, reducing friction as the muscle fibres attach to the bony posterior elements. They may become inflamed in facet joint arthropathy where multifidus origin loading is increased.
Multifidus origin bursitis is associated with lumbar facet arthropathy and contributes to paramedian lumbar pain at the spinous and mammillary process level. Dry needling and medial branch nerve ablation address the adjacent innervation. Post-laminectomy changes may produce adhesive bursitis at the multifidus reattachment site.
Bursal inflammation at the deep lumbar multifidus attachment points producing paramedian low back pain in facet arthropathy patients, managed with medial branch blocks and stabilisation exercises.
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