Conflict of interest: No conflict of interest Source of funding: No funding obtained Background There is limited evidence on whether lumbar erector spinae (ES) fibre morphology is altered in people with low back pain (LBP), due to the inherent challenges with biopsy studies. High-density surface electromyography (HDsEMG) provides an opportunity to assess motor unit properties, allowing non-invasive estimation of muscle fibre morphology. Purpose To compare ES estimated fibre size and activity in people with and without chronic LBP and examine correlations with clinical features in those with LBP. Methods HDsEMG data was acquired from the ES from people with and without LBP (28/group) during isometric lumbar extension at maximum and submaximal levels (10%, 30%, 50%, 70%). HDsEMG signals were decomposed to estimate motor unit conduction velocity (MUCV), fibre diameter (FD), and fibre cross-sectional area (CSA). Additionally, global estimates from topographical HDsEMG amplitude maps were assessed including amplitude, entropy and y- and x- barycentre locations. Results There were no significant differences between the groups for MUCV (p = 0.1310), FD (p = 0.1310), or CSA (p = 0.2875). Differences in the regional activation of ES along the y-axis (p=0.009) and entropy (p=0.023) were observed between groups. There was a weak significant negative correlation between CSA estimated at the 50% torque level and perceived disability (r = −0.379, p = 0.049). Conclusion Estimated ES fibre morphology did not differ between people with and without chronic LBP. However, an alteration of the spatial distribution of ES activity was observed for those with chronic LBP. Estimated CSA appears to be lower in people with greater LBP-related disability.
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Purushotham et al. (2026) studied this question.
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