Quadratus Lumborum

Quadratus Lumborum pain can be referred to the lower buttock and tailbone. Less commonly it is referred to the front of the body along the top pubic bone and to the groin and side of the hip.

Activities Which Aggravate the Pain
Coughing, sneezing, sitting or standing in an unsupported upright position. Forward bending, turning or leaning to the opposite side from the pain, rolling onto either side from a supine position, climbing stairs, gardening, bending over to pick up items off the floor.

Holding packages in front of your body while maintaining an upright posture. Awkward lifting of heavy objects with quick forward flexed movements, especially with the waist rotated.

Positions that Aggravate Pain from this Muscle
Sitting or standing without support. This figure shows where the muscle is located in the body and how it is attached to the bones of the body.

Anatomy Facts - Quadratus Lumborum

Muscle Action
Unilaterally, it acts to raise the hip for lower extremity advancement. Acting bilaterally, they extend the lumbar spine and assist in forced exhalation. Also, provides lumbar spine stabilization and assists with lateral flexion of the spine.

Muscle Origin
Arises from the iliolumbar ligament and fibers off the adjacent iliac crest.

Muscle Insertion
Inserts onto the medial half of inferior border of the twelfth rib and the transverse processes of the first four lumbar vertebrae.

Muscle Innervation
Adjacent thoracolumbar spinal nerves.

Trigger Point Locations - Quadratus Lumborum

You can find your own trigger points by using your thumb or finger to press on the spots shown in the picture. They are not difficult to find. Or you can ask a friend or family member to help you. Press firmly in a step-by-step manner until you find the exact spot that is tender. That is the trigger point.

By pressing firmly on the trigger point, and holding that pressure for several seconds, you will discover the pain lessens dramatically. In fact there are devices that can help you do this. We recommend a device called a "TheraCane" that can be purchased at many stores such as Sammons Preston Medical Equipment that has a mail order catalogue that can be contacted at 1 800 323-5547. The TheraCane is their item # 5244. The TheraCane can use be purchased at many local pharmacies.

Unfortunately this technique, known as acupressure, or shiatsu, provides only temporary relief. Some physicians inject drugs like Novocaine into trigger points, but these offer only temporary relief as well, and can cause scar tissue in the muscle.

Isometric Contraction Testing - Quadratus Lumborum

A painful muscle will become more painful if it is forcefully contracted (flexed). Use this picture to test this for yourself with the assistance of a friend or family member.

Follow these Directions
Place the foot of your painful side on a step about 4 inches high. Then lift your hip on the painful side as if you were shrugging your shoulders, while your assistant holds your leg down so your foot maintains contact with the step. Hold this lifted position for one minute. You should feel increased pain either right away or a few minutes later.