9. Transversospinalis Group

Transversospinalis Group

  • Semispinalis
  • Multifidus
  • Rotatores

*Note: Although we may be needling the entire transversospinalis group at once, we typically only speak of needling the multifidus.

Multifidus

Origin: Posterior sacrum, posterior ilium including the posterior superior iliac spine (PSIS), mamillary process of the lumbar spine (Lsp), TVPs of T1-T3 and articular process of C4-7

Insertion: Fibers pass supero-medially to SPs of the vertebrae above, spanning 2-4 segments

Action:

  • Assists with stabilization of the vertebrae
  • Assists with extension of the spine segmentally
  • May act as organs of proprioception (true for all muscles in this group)

Innervation: Dorsal rami of segmental spinal nerve

Table 1.1 Deep Back Muscles: Semispinalis and Rotatores
Muscle Origin Insertion Action Innervation
Semispinalis TVPs of C4-T12 Fibers run superomedially to occipital bone and SPs of Tsp and Csp spanning 4-6 segments Extends the head, thoracic and cervical spine and rotates them contralaterally Dorsal rami of the segmental spinal nerve
Rotatores TVPs of all vertebrae, most robust in the Tsp Fibers run supero-medially to attach to the junction of lamina and TVP or the SP of the vertebrae above spanning 1-2 segments
  • Assists with vertebral stabilization
  • Assists with segmental extension and rotation
 Dorsal rami of the segmental spinal nerve
Multifidus.
Figure 1.23 Multifidus, adapted by Uwe Gille, from the original image by Henry Gray and Henry Vandyke Carter (Public domain).

Needling

Palpation: Palpate within the lamina groove of the vertebrae in the lumbar and sacral regions – Actual palpation of these muscles is only possible in the sacral region and occasionally L4/5 vertebral levels

Technique: Needle perpendicularly posterior to anterior using the lamina as a bony backdrop – Stay within one finger’s breadth of the spinous process

Caution: Moderate-High: depending on which part of the spine – Lamina groove narrows around the thoracic-lumbar junction – Lung field is directly lateral to the lamina groove in the thoracic and upper lumbar spine

Needling multifidus perpendicularly within one finger width of the spinous process.
Figure 1.24 Needling multifidus perpendicularly within one finger width of the spinous process, original image by Nadine Crocker, CC BY-NC 4.0.

Video 1.14 Needling multifidus, original video by Nadine Crocker, CC BY-NC 4.0.

Interspinalis muscle group: Not needled

  • Interspinales: Paired muscles that run between the SPs of each vertebrae, occasionally absent in the thoracic spine – Act as stabilizers and most likely proprioceptors
  • Intertransversarii: Paired muscles that run between the TVPs of each vertebrae, occasionally absent in the thoracic spine – Act as stabilizers and most likely proprioceptors
  • Levator costarum: Originate on the TVP of C7-T11 and run inferior to attach to the rib directly below it – Assist in elevating the ribs in inspiration

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Sinew Channel Needling Copyright © 2026 by Nadine Crocker is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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