It is estimated that the 70-80% of adults will experience painful symptoms in the lower back at least once in their lifetime. One of the main reasons is dysfunction of the quadratus lumborum muscle.
What is the quadratus lumborum?
The quadratus lumborum is practically the muscle that, bilaterally of the spine, located between the rib cage and the pelvis.
Essentially it contributes to both lumbar movement and stabilization of the spine.
Quadrant lumbosacral pain is usually described as a diffuse dull pain with moments where it becomes stabbing, depending on the movements the patient makes.
There are many times when, although it is simple, diagnosis of its dysfunction eludes therapists.
See below an anatomical illustration of the quadratus lumborum muscle.
Why does the quadratus lumborum muscle cause pain?
There are several causes that cause dysfunction and pain in this anatomical structure.
The first and most common reason is of course the ‘overactivity‘ of the muscle due to poor activation of other muscles in the area or due to poor biomechanical cooperation of the anatomical whole of the lumbar spine.
The next justification has to do with the repetitive movements in everyday life.
When these are combined with poor ergonomics, then the muscle gradually finds itself in a permanent contraction-hyperactivity, resulting in it soon exhausting its structural strength and starting to ‘protest’. Some such repetitive movements are frequent bending or twisting, e.g. in manual work or even in office work with incorrect ergonomic positioning.
In addition to the above, there is a serious possibility that persistent strain will activate some painful myofascial points, also known as trigger points.
Other common reasons are: sedentary life, the asymmetry and of course the injury e.g. in a sport.
When talking about sports, we often have discomfort in the quadratus lumborum muscle due to poor technique of the athlete.
How can I deal with the painful symptoms?
First of all, it is particularly important to make a proper evaluation by a specialist (doctor or physiotherapist). This will determine whether it is indeed a muscle problem and how it is related to the biomechanics of the area and possible accompanying anatomical deviations.
If you are sure that the only problem is quadratus lumborum dysfunction, you can relieve the pain with the following:
- Heat : You can place a Apply a warm compress to the area for 15-20 minutes. The heat will increase blood flow, relax the muscle and restore some of its elasticity, providing short-term relief.
- Stretching: Stretching can also help restore some flexibility and relieve pain. However, it requires the right choice of stretches and perfect technique, otherwise you may have the opposite results than expected. You will need the assistance of an experienced therapist.
- Avoid immobility: Movement is now the preferred therapeutic option. For example, if you work in an office, take a leisurely walk every 30-40 minutes and do some stretching. If you exercise, stopping exercise is not the right choice. Prefer to adapt the exercise and maintain movement in the area. Generally speaking Immobilization and low back pain are incompatible concepts.
- Therapeutic massage: It is simple but always effective. Massage with the right technique and appropriate pressure can be very helpful. The quadratus lumborum will be bloodied, you will generally relax, the pain receptors in the area will stop ‘screaming’. And here you will need the assistance of a specialist therapist
- Acupuncture or dry needling: 2 different techniques that can however provide relief to the area. Whether you are given Western European acupuncture or dry needling, the results are often almost immediate and spectacular. Remember, you will treat the symptoms but you must seek the cause, otherwise the pain will come back.
- Strengthening exercises: Strengthening the area will restore the function of the quadratus lumborum to normal levels since it will no longer bear a disproportionate amount of the ‘weight’ of the function of the lumbar region. In addition, at the end add some exercises to restore the elasticity of the structures and specifically lengthen the possibly inelastic structures. The use of a foam roller may be useful.
- Visit a specialist healthcare professional to find the cause and solve the problem permanently. After your treatments, request a special exercise program from the therapist so that you can maintain your lumbar region in functionally perfect condition yourself.
Morochliadis Stefanos
Physiotherapist Bcs, MT, RT, Formthotics specialist
