Myofascial Trigger Pain Affecting The Quadratus Lumborum

Introduction

The lower back works with the body’s lower extremities by stabilizing the hips and helping support the upper body’s weight. The lower back also has many functions when it comes to mobility. The lower back allows the person to bend, twist, and rotate the torso without any pain inflicted on the body. When normal factors or traumatic issues start to cause low back pain in the individual, the pain-like symptoms can correlate to the development of trigger points in the lower back muscles. Today’s article examines the quadratus lumborum, how myofascial trigger pain affects the low back, and how to manage myofascial trigger pain through various treatments. We refer patients to certified providers who incorporate multiple techniques in low back pain therapies related to trigger points to aid individuals dealing with pain symptoms along the quadratus lumborum in the lower back. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

What Is The Quadratus Lumborum?

Have you been experiencing low back pain? Do you feel relief when you stretch your lower back, only to have the pain return later? Do you feel tenderness or soreness on the sides? Many of these complaints are correlated with low back pain associated with trigger points along the quadratus lumborum. The quadratus lumborum is a flat, quadrangular-shaped muscle in the iliac crest and deep back. This muscle plays an important part in the thoracolumbar fascia that covers the posterior body area while involving the lower and upper parts of the limbs. According to “Myofascial Pain and Dysfunction: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., mentioned that the quadratus lumborum functions to control the side bending to the opposite side by lengthening contraction. Other studies reveal that various actions on the lumbar spine have been attributed to the quadratus lumborum. When the quadratus lumborum goes through these different actions, it can cause the muscles to become overused, or when injuries occur in the lower back, it can lead to various issues that can develop into overlapping conditions in the lower back.

Myofascial Trigger Pain Affecting The Low Back

When it comes to the lower back, many individuals worldwide experience some pain in their backs, and low back pain is common. Various factors cause low back pain from lifting heavy objects, over-exerting the sides with rapid turning, or even normal wear and tear of the body, which can cause lower back pain. When low back pain affects the quadratus lumborum, it can develop trigger points or myofascial trigger pain. Studies reveal that low back pain from the quadratus lumborum can present myofascial pain, causing the individual to have an acute pain episode in their lower back. Myofascial trigger pain is developed when the affected muscle has been overused and causes tiny knots to form along the muscle fibers. When myofascial trigger pain is in the quadratus lumborum, it becomes activated acutely through awkward movements or sudden trauma in the lower back, affecting the mobility of the lower back and the hips. Additional studies reveal that the prevalence of myofascial trigger pain in the quadratus lumborum, when being diagnosed, can display significantly less hip abduction strength. Low back pain associated with myofascial trigger pain can correlate with other chronic issues affecting the body’s lower extremities.

Trigger Point Release: Quadratus Lumborum- Video

Are you experiencing mobility issues in your hips? Do you feel symptoms of tenderness or stiffness in your lower back? Does it hurt when you are bending down to pick up an item? Most of these symptoms correlate with low back pain, potentially involving trigger points along the quadratus lumborum. Trigger points are formed when the muscle has been overused or been through a traumatic event like an auto accident, and since low back pain is common worldwide, it can mask other chronic conditions that overlap the pain. The video explains where the quadratus lumborum is located in the back, where the trigger points are marked, and how to manage the trigger points through manual manipulation while reducing pain away from the lower body. When myofascial trigger pain begins to wreak havoc on the affected muscles in the lower back. Various treatments applied to the lower back can help alleviate the symptoms caused by trigger points associated with the lower back along the quadratus lumborum.

Managing Myofascial Trigger Pain Through Various Treatments

Since low back pain is common worldwide and can potentially lead to the development of trigger points along the various lower back muscles, especially the quadratus lumborum, many individuals would utilize medication specifically for low back pain to reduce the pain symptoms; however, it only masks the pain caused by myofascial trigger pain. Studies reveal manual trigger-point therapy techniques that healthcare providers use to assess patients who are in pain from myofascial trigger pain. Many will go to a pain specialist to manage trigger points when the pain becomes too much for the individual. Another method that many people should utilize as part of their daily practice is doing gentle side stretching on the quadratus lumborum to loosen up the stiff muscles and reduce the chances of trigger points forming in the affected muscle in the future. 

Conclusion

The quadratus lumborum is a flat, quadrangular-shaped muscle in the iliac crest and deep back. This muscle helps with posterior mobility of the lower extremities and, when overused, can develop myofascial trigger pain associated with the low back. This can lead to various common back pain issues that affect how a person moves and become unstable when in motion. Fortunately, low back pain associated with myofascial trigger pain is treatable through various treatments that can reduce the pain and manage trigger points located in the low back. When people incorporate treatments to alleviate pain in their lower back, they will begin to experience relief and have their sense of purpose back in their lives.

References

Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Abdomen and Pelvis, Quadratus Lumborum.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 July 2022, www.ncbi.nlm.nih.gov/books/NBK535407/.

de Franca, G G, and L J Levine. “The Quadratus Lumborum and Low Back Pain.” Journal of Manipulative and Physiological Therapeutics, U.S. National Library of Medicine, Feb. 11AD, pubmed.ncbi.nlm.nih.gov/1826922/.

Grover, Casey, et al. “Atraumatic Back Pain Due to Quadratus Lumborum Spasm Treated by Physical Therapy with Manual Trigger Point Therapy in the Emergency Department.” Clinical Practice and Cases in Emergency Medicine, University of California Irvine, Department of Emergency Medicine Publishing Western Journal of Emergency Medicine, 29 May 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6682240/.

Phillips, S, et al. “Anatomy and Biomechanics of Quadratus Lumborum.” Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine, U.S. National Library of Medicine, Feb. 2008, pubmed.ncbi.nlm.nih.gov/18441751/.

Roach, Sean, et al. “Prevalence of Myofascial Trigger Points in the Hip in Patellofemoral Pain.” Archives of Physical Medicine and Rehabilitation, U.S. National Library of Medicine, Mar. 2013, pubmed.ncbi.nlm.nih.gov/23127304/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

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