Chronic low back pain is one of the most challenging conditions we treat in Melbourne. Many patients spend years trying physiotherapy, injections, medications, or even surgery, with little or no lasting relief. At Pain Specialists Australia, we hear stories like:
“I’ve tried everything, and nothing worked.”
“Every scan says nothing serious, but I can’t sit, walk, or even sleep without pain.”
“If I could wake up and not plan my day around pain, that would be life-changing.”
This blog explains why standard care often fails, and how multifidus restorative stimulation offers a unique, evidence-based solution that targets the root cause of pain, not just the symptoms. As national, as well as international, leaders in advanced interventional pain medicine, we aim to provide clear education and reassurance for patients who feel they have run out of options.
Walking on the beach with lower back discomfort.
Living With Chronic Back Pain in Melbourne
Chronic back pain is more than physical discomfort; it disrupts every part of life. Many of our patients describe being unable to work, exercise, or enjoy time with family. It’s not just pain, it’s a loss of independence, confidence, and hope.
“I’ve tried everything and nothing worked”
Patients often share frustration at trying multiple treatments: months of exercise therapy, countless injections, and strong medications. They see little progress, or at best temporary relief. Some are told the pain is “in their head” or that they just need more core strength, which adds to feelings of despair.
Why scans say “nothing serious” but pain still controls life
A major barrier is that conventional imaging, X-rays, CT, or MRI, often does not detect multifidus dysfunction. Even experienced radiologists can report scans as 'normal' unless they specifically assess the multifidus for atrophy, fatty infiltration, or asymmetry. In fact, some expert musculoskeletal radiologists highlight multifidus wasting on MRI as a subtle but important finding in patients with persistent back pain. Without this level of specialist assessment, the real problem, spinal stabiliser muscle failure, goes untreated.
Imaging can reveal multifidus dysfunction even when scans look ‘normal’.
What Is Multifidus Dysfunction?
The deep spinal stabiliser most people have never heard of
The multifidus is a series of small, deep muscles that run along the spine. They provide segmental stability, keeping each vertebra properly aligned as you bend, twist, or lift. They act as the body’s “hidden scaffolding” for the spine.
Why multifidus failure causes long-term low back pain
When the multifidus muscle stops firing correctly, spinal instability develops. This instability causes ongoing micro-strain, inflammation, and chronic mechanical back pain. Unlike nerve compression (sciatica), multifidus dysfunction produces aching, stiffness, and pain that worsens with simple daily movements like sitting or walking.
At Pain Specialists Australia, we use targeted clinical testing and imaging to identify multifidus dysfunction, even when routine scans are inconclusive. This diagnostic expertise is critical, as treatment success depends on identifying the true driver of pain.
The multifidus muscle is a hidden stabiliser often linked to chronic back pain.
How Multifidus Stimulation Works
Multifidus stimulation is a minimally invasive implant procedure.
Restoring muscle function – not masking symptoms
Conventional treatments (medications, injections, surgery) usually aim to reduce pain signals. They rarely address why the pain persists.
Multifidus restorative neurostimulation is different: it directly retrains the multifidus muscle, restoring proper activation and spinal support.
The minimally invasive implant and daily sessions
The procedure is performed as a short day-surgery under anaesthetic. A small device is implanted beneath the skin, with leads positioned near the nerves that activate the multifidus. Using a handheld controller, patients run two 30-minute sessions daily at home. Over time, this consistent stimulation “wakes up” the multifidus, improves spinal stability, and reduces pain.
At Pain Specialists Australia, our physicians are among the most experienced in Australia to deliver this advanced therapy. Our experience ensures patients are carefully assessed for suitability and supported throughout the treatment journey.
Who May Benefit in Australia
For patients with failed treatments and persistent pain
Multifidus stimulation is designed for patients with refractory chronic mechanical low back pain, pain that has not responded to:
Physiotherapy
Pain medications
Spinal injections or nerve ablations
Back surgery
These are often patients who have been told “there is nothing more that can be done.”
Signs your pain comes from multifidus dysfunction
Pain despite normal imaging results
Worsening pain with sitting, bending, or prolonged standing
Reduced activity levels despite strong core muscles or years of rehab
History of persistent spinal pain syndrome (PSPS) or previously called failed back surgery syndrome (FBSS)
At Pain Specialists Australia, our team uses advanced clinical evaluation to identify multifidus dysfunction and guide patients toward effective therapy.
Results You Can Expect
Melbourne and international trial outcomes (2–5 years)
Clinical trials and real-world Australian outcomes confirm:
78% of patients achieve at least 50% improvement in pain or disability at 5 years
Many reduce or eliminate opioid and other medications
Improved ability to work, exercise, and participate in family and community life
Long-term improvements continue beyond the first year of treatment
Safety, insurance, and long-term success rates
The procedure is safe, reversible, and backed by extensive research. Serious complications are rare (<5%). In Australia, multifidus stimulation may be covered under Silver Plus or Gold Hospital private health insurance, and our clinic can assist with insurance navigation.
Next Step - Find Out If You’re a Candidate
If you are living with persistent back pain despite years of effort, there may finally be an option that restores stability and function. Multifidus stimulation is evidence-based, durable, and designed to fix the underlying problem.
At Pain Specialists Australia, our fellowship-trained physicians are recognised nationally as key opinion leaders in interventional pain medicine. With decades of combined expertise, we offer comprehensive assessments and advanced therapies tailored to each patient.
Frequently Asked Questions (FAQ)
1. Does multifidus stimulation fix the cause of pain or just mask it?
Most treatments for chronic back pain, such as medications, injections, or ablations, aim to reduce symptoms. They rarely address why the pain is there in the first place. Multifidus stimulation is different. It directly retrains the deep stabiliser muscle of the spine, restoring proper activation and stability. Over time, this improves function and reduces pain at its source, rather than simply blocking pain signals.
2. How long before I notice results?
Results are not usually immediate. Many patients describe a gradual improvement over the first few weeks as the multifidus begins to activate again. Significant functional gains are often seen over 3–6 months. Long-term trial data shows that benefits continue to build over years, with many patients reporting sustained relief and improved mobility beyond the five-year mark.
3. Is it the same as spinal cord stimulation (SCS)?
No. While both are implantable devices, they target different problems. SCS is designed for neuropathic pain such as sciatica, nerve injury, or CRPS. Multifidus stimulation, by contrast, is for mechanical low back pain caused by multifidus dysfunction.
In other words, SCS interrupts pain signals, whereas multifidus stimulation restores the muscle function that stabilises the spine.
4. Is this treatment offered in Melbourne?
Yes. Pain Specialists Australia is one of the leading clinics in Melbourne offering multifidus restorative neurostimulation. Our fellowship-trained specialists provide assessment, implantation, and long-term follow-up, and we also consult with patients from across Australia who are seeking advanced options when standard care has failed.
5. Is it covered by private health insurance?
In many cases, yes, especially with Silver Plus or Gold Hospital cover. Policies vary between funds, and approval may require prior assessment. Our team works closely with patients and insurers to guide them through the process, ensuring they understand their coverage and out-of-pocket costs before proceeding.
READY FOR RELIEF?
References
Further Reading and References on Implantable Multifidus Stimulation:
1. Gilligan C, Volschenk W, Russo M, et al. Five-Year Longitudinal Follow-Up of Restorative Neurostimulation Shows Durability of Effectiveness in Patients With Refractory Chronic Low Back Pain Associated With Multifidus Muscle Dysfunction. Neuromodulation. 2024 Jul;27(5):930-943.
- Five-year data confirms multifidus restorative neurostimulation provides durable pain relief and improved function in patients with chronic low back pain linked to muscle dysfunction.
https://pubmed.ncbi.nlm.nih.gov/38483366/
2. Ardeshiri A, Amann M, Thomson S, Gilligan CJ. Application of restorative neurostimulation for chronic mechanical low back pain in an older population with 2-year follow up. Reg Anesth Pain Med. 2025 Mar 5;50(3):231-236.
- Two-year follow-up shows restorative neurostimulation is safe and effective for chronic mechanical low back pain in older adults, with sustained improvements in pain and function.
https://pubmed.ncbi.nlm.nih.gov/38460963/
3. Cleveland Clinic. Implant reduces chronic back pain after eight years.
- Cleveland Clinic highlights a patient case where multifidus restorative neurostimulation provided lasting relief from chronic back pain after eight years of failed treatments.
4. Abd-Elsayed A, Kurt E, Kollenburg L, Hasoon J, Wahezi SE, Storlie NR. Lumbar Multifidus Dysfunction and Chronic Low Back Pain: Overview, Therapies, and an Update on the Evidence. Pain Pract. 2025 Jun;25(5):e70044.
- Comprehensive 2025 review confirms lumbar multifidus dysfunction as a key driver of chronic low back pain and supports restorative neurostimulation as an emerging evidence-based therapy.
https://pubmed.ncbi.nlm.nih.gov/40361257/
5. Schwab F, Mekhail N, Patel KV, et al. Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction. Pain Ther. 2025 Feb;14(1):401-423.
- The 2025 RESTORE RCT shows restorative neurostimulation significantly outperforms optimal medical management for chronic mechanical low back pain caused by multifidus dysfunction.
