Quadratus lumborum pain involves discomfort in the muscle that is located deep in the lower back on both sides of the spine.
The quadratus lumborum muscle starts at the pelvis and runs up to the lowest rib. It plays an essential role in stabilizing the pelvis when a person is upright.
It also helps support the core of the body when breathing. The quadratus lumborum muscle is one of the primary sources of lower back pain.
Symptoms of quadratus lumborum pain include tightness and discomfort in the lower back region. The type and severity of the pain may vary.
Lower back pain is often described as a deep aching pain, but it may also be felt as sharp and acute, depending on the cause.
Although the discomfort often occurs at rest, it may become worse with movement. Walking, standing, and rolling over in bed may aggravate the pain.
Sharp pain may also be felt when sneezing or coughing. Quadratus lumborum pain can even interfere with doing everyday activities, such as walking and sitting.
Quadratus lumborum pain may also be chronic, which means it is long-lasting. Long-term pain often interferes with a person’s quality of life and well-being as well as affecting them physically.
Also, if one part of the body is causing pain, other regions may compensate to try to support the injured area.
For instance, if the quadratus lumborum is tight and painful, it may cause someone to change how they bend or walk. The change may place added stress on another part of the body, such as the hips, which can lead to further injury.
Trigger points and referred pain
A trigger point is a sensitive or tender area in the muscle or connective tissue that hurts when stimulated or pressed. Trigger points are often described as small knots.
When a trigger point is pressed, it may also cause referred or radiating pain. Radiating pain is discomfort that is felt in a different region of the body than the one being pressed or stimulated.
Quadratus lumborum trigger points may cause pain in the lower back, pelvis, and hips.
There are several potential causes of quadratus lumborum pain, including:
Sitting too long
Sitting for a long time causes continuous contraction or tightening of the quadratus lumborum muscle. Constant contraction can lead to muscle fatigue. If blood flow to the muscle is decreased, it can become stiff and painful.
Poor posture when standing or sitting can place added stress on the quadratus lumborum and lead to pain.
Slouching, leaning to one side, or sitting without back support can cause the muscle to become sore and tight.
If muscles surrounding the quadratus lumborum are weak, it can cause other muscles to work harder than necessary.
When other muscles in the back and pelvic area are weak, the quadratus lumborum has to work harder to support the body. Eventually, the quadratus lumborum muscles may become overworked and tense.
Unequal leg length
Uneven leg length may place added strain on various muscles in the body, including the quadratus lumborum.
If one leg is shorter than the other, the pelvis may be higher on the side of the longer leg.
The tilting of the pelvis may also lead to a shortening of the quadratus lumborum, which can strain the muscle.
Like any muscle, the quadratus lumborum can be injured. Trauma to the muscle from a car accident or sports injury can lead to quadratus lumborum pain.
Common everyday activities done in the wrong way can also lead to an injury. For instance, awkward or incorrect lifting of heavy objects can strain the quadratus lumborum.
Several treatments may help relieve quadratus lumborum pain. In some cases, home treatment may be effective. In other cases, a combination of home care and medical treatments may be needed to reduce the discomfort.
Depending on the severity of the pain, the following treatments may be helpful:
Yoga involves a series of poses and stretches that may be helpful in decreasing quadratus lumborum pain.
A 2015 review found that yoga is helpful in reducing discomfort and disability associated with ongoing low back pain.
Along with improving physical function, yoga may also improve mental well-being in people with ongoing back pain.
Drugs such as muscle relaxants and pain medication may help decrease quadratus lumborum pain.
Some pain medications can have side effects, such as drowsiness, dry mouth, and fatigue, and should only be taken as prescribed.
Trigger point injections
A trigger point injection involves administering medication directly into the trigger point to decrease tenderness.
The injection may be an anesthetic, which numbs the area. In some cases, a steroid is injected to decrease inflammation.
Trigger point injections may be effective to reduce muscle spasm and quadratus lumborum pain.
Massage therapy can be useful to treat quadratus lumborum pain. Massage may reduce muscle tightness and increase blood flow to the area.
Heat or ice
Applying ice to the area may decrease inflammation and heat may increase blood flow and reduce pain.
A person can try alternating between heat and ice packs to alleviate back pain. A warm bath can also be helpful.
Also helpful are certain stretches to prevent the quadratus lumborum muscles from becoming too tight, such as the ones below:
Standing with the feet hip-width apart, reach the left arm up and over the head and lean to the left, as far as is comfortable. Hold for 20 seconds then repeat with the other arm.
Lying down quadratus lumborum stretch
Lying face up, extend the arms fully to either side. Bend both knees and cross the right leg over the left leg. Let the legs drop to the right, as far as possible. Hold for 20 seconds then repeat with the other leg.
Following some simple steps may prevent pain or help reduce discomfort if pain develops.
Steps a person can follow to deal with any pain they experience include:
- practicing good posture when sitting and standing
- using a lumbar support pillow when sitting
- lifting objects bending at the knees not the waist
- maintaining a healthy weight
- taking frequent breaks when sitting to prevent stiffness
- avoiding sleeping on only one side
The outlook for quadratus lumborum pain varies based on its severity. The pain can often be managed successfully, especially if treated early when symptoms first begin.
In some cases, it can be a lengthy process to heal the muscle. However, using a combination of the above treatments leads to an improvement in symptoms for most people.