Rotatores and Deep Paraspinals: Pain Pattern and Treatment
The rotatores are the deepest muscles of the back, short bundles that run from the side of one vertebra to the spine of the next one or two above, most developed in the mid back. With the interspinales and intertransversarii, the other single-segment muscles, they fine-tune each vertebra as the bigger muscles move the trunk. Their documented pattern is pain at the spine itself at one level: a single sore vertebra the patient can press, that catches when turning. This page covers the three deep single-segment groups together; the multifidi, one layer up, have their own page. All three are sub-pages of the erector spinae group page.
Attachments and action
Origin: Rotatores: the transverse process of each vertebra, most developed from the first to the twelfth thoracic. Interspinales: the spinous process of each vertebra. Intertransversarii: the transverse process of each vertebra.
Insertion: Rotatores: the base of the spinous process of the vertebra one or two above. Interspinales: the spinous process above. Intertransversarii: the transverse process above.
Action: Segmental rotation, extension, and side-bending of one vertebra on the next; they are position sensors as much as movers.
Where the pain is felt: At the spine itself, at one level, on the bone. A short way to either side at that level. A level that catches when turning or straightening. At any level from the neck to the sacrum; the mid back between the shoulder blades and the low back are the common sites in the sources.
Common causes: A sudden twist with a load; a long period turned to one side, as at a desk with the screen off-center; a fall onto the back; a coughing illness; an old disc or facet injury that left the segment guarded; scoliosis.
Patients say: "It is one bone, right here." "It catches when I turn." Pain pressing on one spot on my spine. "The X-ray of that level was normal."
When to get evaluated: Back pain with numbness or weakness in the legs, changes in bladder or bowel control, fever, unexplained weight loss, or pain that wakes you and does not ease with position needs medical evaluation before anything else. Midline spine pain after a fall, or in anyone with osteoporosis or a history of cancer, needs an X-ray first.
How this muscle is examined and treated
Examination presses each spinous process and the groove beside it in turn for the one level that reproduces the familiar catch, tests rotation to each side, and checks the segments above and below. Needling here addresses the deep muscles in the groove beside the spinous process at the level found, with the depth controlled. Assessment and treatment happen in the same visit.
Related conditions
Low Back PainShoulder DysfunctionChronic Pain Patterns
This page is educational. It describes muscle referral patterns commonly associated with pain; it does not diagnose your condition. Individual patterns vary. For evaluation of your specific pain, see a licensed clinician. Seek immediate medical care for emergencies. Eugene Baek, L.Ac. · New Jersey License 25MZ00080600