Why Your Core Exercises Aren’t Fixing Your Back

In this article, neurosurgeon Dr. Alexander Taghva explains that chronic lower back pain is frequently driven by the failure of the multifidus, a deep, reflex-driven spinal stabilizer muscle that regular gym routines cannot target. When a back injury occurs, a protective neurological reflex called arthrogenic inhibition causes the brain to shut down this specific muscle to avoid further joint irritation.

If the multifidus is left inactive, its muscle tissue is gradually replaced by fat and fibrosis within months, which leads to chronic joint instability and long-term pain. Traditional core and back exercises fail to resolve this issue because the brain compensates by using larger, superficial muscles rather than reactivating the underlying stabilizer. Ultimately, effective rehabilitation requires interventions that can specifically targeting and re-engage the multifidus during a critical early recovery window before irreversible structural degeneration sets in.

Source: https://alexandertaghvamd.substack.com/p/why-your-core-exercises-arent-fixing