Quadratus Lumborum Muscle Pain

Quadratus Lumborum Muscle Pain refers to discomfort or tightness in the deep lower back muscle that connects the spine to the pelvis. This pain is often caused by poor posture, prolonged sitting, heavy lifting, or muscle imbalances.

It can lead to stiffness, aching, or sharp pain in the lower back, hips, and even the ribs. Stretching, strengthening exercises, and proper ergonomics can help alleviate and prevent Quadratus Lumborum pain.

Table of Contents

What is the quadratus lumborum muscle?

The deepest muscle in the abdomen is the quadratus lumborum (QL). It is situated on either side of the lumbar spine in your lower back. It terminates at the apex of your pelvis and begins at your lowest rib. Because you utilize this muscle to sit, stand, and walk, soreness in this area is typical.
One of the main causes of lower back pain is the QL, which can also affect your physical health.

Beginning at the pelvis, the quadratus lumborum muscle extends to the lowest rib. It is crucial to keep the pelvis stable when a person is standing.

Additionally, it supports the body’s center during breathing. One of the main causes of lower back pain is the quadratus lumborum muscle.

Causes of quadratus lumborum muscle pain?

Stress, strain, and excessive use can all cause quadratus lumborum pain. When muscles are weak or overly taut, they can occasionally produce pain and stiffness.

Sitting for extended periods is one activity that might lower blood flow, particularly in the QL and surrounding areas. Weak back muscles and repetitive activities can also cause pain, contributing to bad posture.

These elements can all cause you to lift, bend, or twist incorrectly, which increases tension. If your QL has to overcompensate to maintain your spine and pelvis, it may also become excessively tight. Accidents and uneven leg lengths can also cause pain in this area.

Sitting too long

Long periods of sitting cause the quadratus lumborum muscle to continuously contract or tighten. Muscle exhaustion may result from continuous contraction. A reduced blood flow to the muscle might cause it to become uncomfortable and rigid.

Poor posture

The muscle might get sore and tight when you slouch, tilt to one side, or sit without back support.

Weak muscles

Other muscles may have to work harder than necessary if the quadratus lumborum’s surrounding muscles are weak.
The quadratus lumborum must use more effort to support the body when other back and pelvic muscles are weak. The quadratus lumborum muscles may eventually become stiff and overused.

Unequal leg length

An uneven leg length might put additional strain on the quadratus lumborum and other muscles in the body.
The pelvis may be higher on the side of the larger leg if one leg is shorter than the other.
The quadratus lumborum may shorten as a result of the pelvic tilt, putting strain on the muscle.

Trauma

The quadratus lumborum is susceptible to injury like any other muscle. Quadratus lumborum pain may result from muscular trauma sustained in a vehicle accident or athletic injury.
Injuries might also result from performing commonplace tasks incorrectly. For example, the quadratus lumborum may be strained by improper or awkward lifting of big goods.

Symptoms of quadratus lumborum muscle pain?

Tightness and soreness in the lower back are signs of quadratus lumborum pain. The pain might vary in nature and intensity.
Depending on the source, lower back pain can be intense and abrupt, although it is frequently described as a deep agonizing pain.
Even though the soreness usually happens when you’re at rest, moving around can make it worse. Rolling over in bed, standing, and walking can all make the pain worse.
Sneezing or coughing can also cause sharp pain. Pain in the quadratus lumborum might even make it difficult to do daily tasks like sitting and walking.
Additionally, quadratus lumborum pain may be chronic, meaning it lasts for a long time. Chronic pain frequently affects a person’s physical health as well as their quality of life and general well-being.
One study found that those with persistent low back pain had higher rates of anxiety and depression than those without chronic pain.
Additionally, other parts of the body may try to assist the wounded area by compensating if one component is producing pain.
For example, someone may alter their bending or walking patterns if their quadratus lumborum is uncomfortable and tight. Further harm may result from the alteration putting additional strain on other bodily parts, like the hips.

Trigger points and pain

A location of your body known as a trigger point is one that, when activated, may cause pain. Muscles that are strained or wounded make up trigger points, which are painful and constricted. A sharp pain in your hips or pelvis or a deep pain in your lower back could be caused by quadratus lumborum trigger points. They may also be the cause of any sudden, intense pain you experience when your QL contracts during a cough or sneeze.

A region of muscle or connective tissue that is sensitive or tender and aches when squeezed or stimulated is called a trigger point. Small knots are a common description of trigger points.

Referred or radiated pain can also occur when a trigger point is pressed. pain that originates in a different part of the body than the one being squeezed or stimulated is known as radiating pain. Lower back, pelvic, and hip pain can be caused by quadratus lumborum trigger points.

How is quadratus lumborum pain diagnosed?

If you believe you have quadratus lumborum pain, speak with your physician. They can assist you in identifying the source of your pain. They can also ascertain whether it has anything to do with any underlying medical conditions.

You could be required to describe the type of pain you’re experiencing and carry out specific physical tasks. They can collaborate with you to develop a bodywork-based treatment plan. They will also advise you to take care of yourself and receive therapy at home.

How is quadratus lumborum pain treated?

Quadratus lumborum can be treated in several ways. Inflammation and pain can be lessened by using cold and heat. Additionally, your physician could advise you to take a muscle relaxant or pain reliever. Another method is to use trigger point injections.

If a qualified professional is chosen, the following therapies may help reduce your pain:

massage therapy, such as myofascial release
physical therapy
chiropractic treatment
Rolfing
acupuncture
yoga therapy

Pain in the quadratus lumborum may be alleviated by several therapies. Home therapy might work in some situations. In other situations, it can be necessary to use both medical treatments and home care to lessen the pain.

The following therapies might be beneficial, depending on how bad the pain is:

Yoga

Several yoga positions and stretches may help reduce pain in the quadratus lumborum.
Yoga can lessen the pain and impairment caused by persistent low back pain.
For those with persistent back pain, yoga may enhance mental health in addition to physical function.

Medications

Quadratus lumborum pain may be lessened with the use of medications such as muscle relaxants and painkillers.
Certain painkillers should only be taken as directed because they may cause adverse effects like weariness, dry mouth, and sleepiness.

Trigger point injections

To reduce pain, a trigger point injection is injecting medicine straight into the trigger point.
An anesthetic, which numbs the area, could be used in the injection. Steroid injections are sometimes used to reduce inflammation.
Injections of trigger points may help lessen quadratus lumborum pain and muscular spasms.

Massage therapy

For the treatment of quadratus lumborum pain, massage therapy may be helpful. Massage can improve blood flow to the area and relax tense muscles.

Heat or ice

Applying heat to the area can improve blood flow and lessen pain while applying cold can reduce inflammation.
To relieve back pain, a person can try switching between cold and heat packs. Additionally, a warm bath may be beneficial.

Physical therapy treatment for quadratus lumborum pain:

Patients with low back pain (as previously noted) and patellofemoral pain syndrome are more likely to have quadratus lumborum syndrome. The quadratus lumborum is tense and exhibits trigger points when a person has chronic low back pain. Trigger point pain can be relieved with manual trigger point therapy.

Another therapy option that instantly relieves trigger point pain and lessens the overactive muscle’s sensitivity and tension is dry needling. Ultrasound and TENS are two of the few often-used treatments for this illness. It aids in lessening pain and agitation. Quadratus lumborum stretches are also beneficial for people with generalized low back pain. The patient can continue cryotherapy and self-massage at home.

Exercise of quadratus lumborum pain:

Gate pose

With your toes pointing forward or to the right, extend your right leg to the side while kneeling.
Place your right hand along your leg as you bend to the right.
Reach to the right and raise your left arm up and down.
Roll your left ribcage up toward the ceiling and extend through your left fingertips.
On the other side, repeat.

Side stretch

standing-side-bend-stretch — **Side stretch**

Lift your arms above your head and interlace your fingers while standing.
Tilt to the right and press into your legs and feet.
From your hips to the tips of your fingers, you will experience a stretch.
With your chin tucked in, look down at the floor.
On the left side, repeat.
On each side, repeat two to four times.
Cross one leg in front of the other or grab one wrist with your other hand to extend the stretch farther.

Triangle pose

With your right toes pointing forward and your left toes out at a small angle, stand with your feet wider than your hips.
With your hands facing down, raise your arms until they are parallel to the floor.
As you extend your right fingers forward, hinge at your right hip.
After pausing at this point, drop your right hand on a block or your right leg.
With your palm facing away from your body, place your left hand on your hip or reach it up toward the ceiling.
You can turn your head to look anywhere.
As you contract your lower back and core muscles, lengthen your spine.
Continue on the opposite side.

Revolved triangle pose

With your right toes pointing forward and your left toes out at a small angle, stand with your feet wider than your hips.
Maintain a forward-facing hip position.
With your hands facing down, raise your arms until they are parallel to the floor.
When your torso is parallel to the floor, pause and fold halfway forward.
Drop your left hand to the floor, a block, or your right leg.
Turn your palm away from your body and raise your right arm straight up.
Look up at your outstretched hand, down at the floor, or sideways.
On the left side, repeat.

Extended side angle pose

Place your feet wide, your left toes out at a slight angle, and your right toes looking forward.
Your right knee should be bent forward and above your ankle.
Lift your arms till they are level with the ground.
Bring your right hand down to the floor in front of your calf while bending at the hips.
With your palm facing down, raise and extend your left arm.
Tuck your chin in toward your chest and pull your tummy to your spine.
Continue on the opposite side.

Pelvic tilt

With your feet close to your hips and your knees bent, lie on your back.
Tuck your chin in a little and relax your upper body.
Press the small of your back onto the floor while using your core.
Hold for five seconds.
Take a few deep breaths to relax.
Do this 8–15 times.

Spinal twist

With your chin pulled in toward your chest and your upper body relaxed, lie on your back.
Bring your feet in close to your hips while bending your knees.
While maintaining a solid upper body, slowly lower your knees to the right.
Place your knees on a cushion or block if they are off the ground.
Wait 20 to 30 seconds.
Continue on the opposite side.
Put a flat cushion underneath your head for more support.
For comfort, you can also put a pillow or block between your knees.

Child’s pose

With your big toes touching and your knees slightly wider than hip-width, start on your hands and knees.
Stretch your arms straight out in front of you while lowering your buttocks to your heels.
Focus on relaxing your lower back by bringing your attention to it.
Hold this posture for a maximum of five minutes.
Gently move your hands to the right, pressing them deeper into your hips, to extend the stretch. Next, walk your hands to the left and return to the middle.
For comfort, you can put a pillow beneath your thighs, chest, or forehead.

Revolved head-to-knee pose

Bring your left heel toward your groin and extend your right leg from a seated position.
With your palm facing up, bend to the right and rest your right elbow on your leg, a block, or the floor.
Bring your left arm down toward your right foot after extending it upward toward the ceiling.
Look up at the ceiling while tucking your chin into your chest.
Hold this position for a maximum of one minute.
On the left side, repeat.
Sit on the edge of a folded blanket or flat cushion to increase the stretch.

Knee-to-chest stretch

Recline-Knee-To-Chest — **Knee-to-chest stretch**

With both feet flat on the ground, lie on your back.
Bring both knees gently in close to your chest.
Encircle your legs with your arms.
Using your hands, grasp your opposing elbows or wrists.
Use a strap or clasp the backs of your thighs if you are unable to reach.
Lengthen the back of your neck by slightly tucking your chin in.
Take a few deep breaths to relax.
Do this two or three times.
Do this position one leg at a time for convenience.

What is the prognosis for quadratus lumborum pain?

If you treat QL pain early on, it can usually be managed and get better over time. It may take a while to heal this part of your body completely, but as long as you take action to get better, you should see improvement. Try to maintain your health and get rid of the things that are causing your pain.

The intensity of quadratus lumborum pain determines the prognosis. Many times, the pain can be effectively controlled, particularly if it is addressed as soon as the symptoms appear.

The muscle may take a long time to mend in some situations. However, most people find that their symptoms improve when they use a combination of the aforementioned treatments.

Complications of quadratus lumborum pain?

Other parts of your body may experience stress if your QL pain is not treated. More imbalances and misalignments may arise when your body adjusts to accommodate one asymmetrical part. The pain may worsen and radiate to other parts of your body.

The following are possible outcomes of quadratus lumborum pain:

Hip, buttock, and thigh pain as well as sacroiliac joint pain
low back pain
abdominal pain

How is quadratus lumborum pain prevented?

You may prevent quadratus lumborum soreness by keeping your body as fit as possible. To maintain your body aligned, stay in shape and think about seeing a movement therapist. To prevent pain from getting worse, treat it as soon as it starts.

Engage in exercises designed to strengthen and stretch the affected area. Stretches and side bends are crucial for activating the side muscles and releasing back stiffness. Engage in activities that will increase the distance between your pelvis and ribs. Tai chi, Pilates, and yoga are good ways to improve your core. Back pain can also be reduced by taking mild walks.

Additional advice for avoiding quadratus lumborum pain:

When driving, standing, or sitting, make it a point to keep proper posture.
Make sure you are correctly lifting large goods.
Make sure you sleep in a position that helps ease your back pain.
Using a lumbar support pillow when sitting, lifting objects, and bending at the knees rather than the waist are all examples of good posture when standing and sitting.
keeping a healthy weight
Taking frequent breaks to avoid becoming stiff while sitting
Refraining from sleeping on just one side.

FAQs

Is it possile to massage the quadratus lumborum?

To promote circulation and keep things moving, I usually provide some friction across the QL fibers, which allows the local cells to repair and regenerate. In the days following a massage, simple side exercises can typically assist sustain the work’s alleviation.

How long does it take for the quadratus lumborum to heal?

How much time does the QL take to recover? Depending on how severe the strain is, the quadratus lumborum may take different amounts of time to heal. Grade 1 strains could be gone in a week or two. Grade 2 strains might last anywhere from four days to three months.

Which nerves in the quadratus lumborum are blocked?

When employing a similar volume of local anesthetic (T6-L1 for QL block vs. T10-T12 for TAP block), QL blocks produce a wider sensory blockage than TAP blocks. The lateral cutaneous branches of the thoracoabdominal nerves (T6 to L1) are presumably equally susceptible to QL inhibition.

The QL walk: what is it?

Other exercises that I might not have mentioned here include the well-known QL walk, which involves sitting with your legs straight out in front of you and scooting back and forth while holding weight in your hands.

How can QL pain be relieved?

There are several methods for treating QL pain. Heat: Apply heat for ten to fifteen minutes. This will provide you with some temporary pain relief and assist increase the muscle’s flexibility. Stretches: You can get temporary pain relief by using stretches that target the QL muscle.

What is the unique quadratus lumborum test?

The QL endurance test involves the subject lying on his or her side with the arm supporting them and the forearm at a 90-degree angle to the torso. That foot is in front of the lower leg foot when the upper leg is crossed in front of the lower.

What is the quadratus lumborum’s primary purpose?

the quadratus lumborum aids with the mobility and stability of the pelvis and spine. The lumbar spinal column extends as a result of bilateral contraction. The trunk bends in that direction (lateral flexion) when only one side of the muscle is contracted.

How can someone with QL pain sit?

Your back will tend to round out if you sit on a soft couch or chair that doesn’t maintain its natural curve. Adjust your workstation and chair height at work so that you may tilt your work up at you and sit near it.

Which exercises are effective for the quadratus lumborum?

This traditional workout works the hamstrings, glutes, and QL. Keeping your back straight, begin by standing with your feet hip-width apart. Then, stoop to grasp the barbell with an overhand grip and raise the weight towards your hips.

How is the quadratus lumborum massaged?

Accessible just to the side of the long spinal erectors, the QL muscle is somewhat deep. Because of the numerous attachments on the spine, pelvis, and ribs, it’s critical to use upward and downward QL massage glides in addition to directly compressing the attachment sites to fully cover the muscle.

For tight QL, is walking beneficial?

Movement might exacerbate the pain, even though it normally happens at rest. Rolling, standing, walking, and lying down can all make the pain worse.

How can someone who has quadratus lumborum ache sleep?

For lower back pain, lying on your side with your knees slightly bent is the ideal position. See the Source. Maintaining a bent knee position eases pressure on the lumbar spine and aids with body balance. To make this position more comfortable, many people find that placing a tiny pillow between their knees is beneficial.

How is the tightness of the quadratus lumborum measured?

Assessing QL Spasm
Ask your client to sit and do lateral flexion as a test for QL spasms. Look for a ‘hinge’ in the lumbar region, which signifies a spasm, and a smooth curvature in the spine, which is typical.

What is the duration of quadratus lumborum pain?

The severity of the problem and how it is treated can affect how long Quadratus Lumborum (QL) Pain Syndrome lasts. Abrupt strain or overuse is the cause of acute instances. In this case, the pain usually subsides within a few days to a few weeks.

Why does the quadratus lumborum hurt?

When muscles are weak or overly taut, they can occasionally produce pain and stiffness. Sitting for extended periods is one activity that might lower blood flow, particularly in the QL and surrounding areas. Weak back muscles and repetitive activities can also cause pain, contributing to bad posture.

References

De Pietro Crt, M. (2018, January 3). Quadratus lumborum pain: Treatment and stretches. https://www.medicalnewstoday.com/articles/320497
Cronkleton, E. (2017, June 2). Identifying the cause of quadratus lumborum pain. Healthline. https://www.healthline.com/health/quadratus-lumborum-pain
Cronkleton, E. (2023, April 24). 10 QL stretches to relax your spine. Healthline. https://www.healthline.com/health/quadratus-lumborum-stretch