Iliopsoas Referred Pain Pattern

Contents of Article

Muscle Location | Trigger Point Symptoms Trigger Points Cause |

Trigger Point PreventionTrigger Point Treatment Interesting Facts  | Similar Pain Patterns

Iliopsoas Muscle: Trigger Point Pain

The iliopsoas is a term used for two muscles located in the lower trunk of the body, the iliacus, and the psoas major. These muscles cause and contribute to pain in the middle and lower back, the hip, buttocks, and thigh. The iliopsoas muscles can also contribute to pain in the lower abdomen, pelvis, and groin.
If you have trigger points in the iliopsoas, you may have trouble rising from sitting. There is pain and you may feel a ‘hitch’ as you straighten to a standing position. Another sign is the tendency to walk with one or both feet turned out, which may give you the appearance of waddling like a duck.


Iliopsoas Muscle Group

Where is the iliopsoas muscle?

The muscles of the iliopsoas are the iliacus and the psoas major.

The iliacus muscle lines the inside of the hip bone (ilium). The psoas major attaches to the low back (lumbar) vertebrae and descends with the iliacus to connect to the top of the thigh bone (femur).

A third muscle, the psoas minor, is often listed in the iliopsoas group. It attaches to the T12 and L1 vertebrae of the spine and travels down to connect to the pubis (pelvis bone) via the pectineal line.

What Movements Does It Control?

  • Picks up the thigh when you raise your thigh toward your stomach (flexion of the thigh at the hip)
  • Assists in straightening (extension) of the spine.

Looking for detailed muscle anatomy? The Iliopsoas Muscles Anatomy Page has origin, insertion, innervation, and blood supply information. It also lists agonists and antagonists for each muscle action.

Iliopsoas Muscles Trigger Points Symptoms:

The iliopsoas is a primary posture muscle that helps the body stand upright. Trigger points in this muscle can cause a wide range of symptoms including pain in the lower abdomen and genitals that are similar to various medical conditions. If there is not a medical condition causing your pain you should check for trigger points.

The symptoms:

  • Low back pain
  • Abdomen pain
  • Groin pain
  • Thigh pain
  • Pelvic pain
  • Difficulty standing from a sitting position
  • Inability or severe pain when doing sit-ups or crunches
  • A tendency to walk with feet turned out
  • Extreme dysfunction in the iliopsoas can cause pain under the shoulder blade that extends down to the top of the hip

Note: If the iliopsoas is affected on one side, the pain runs verticle, up and down the back, hip, and upper leg on the affected side. If both iliopsoas muscles are affected pain runs horizontally across the low back, pelvis, and lower abdomen.

Posture correctorTWD Recommends

If you have rounded shoulder, forward head posture, or have a habit of slouching, correcting your posture will reduce your muscle pain. The HailiCare Posture Corrector fully supports the back and abdominal area while gently pulling your shoulders back which helps retrain muscle memory to maintain proper posture. You will immediately notice a reduction of pain and tension. Start slowly, wearing the brace only 20-30 minutes a day slowly increasing the time you wear it.

What Causes Trigger Points To Develop?

Sitting too much and a slumping posture can have adverse effects on the iliopsoas muscles. Sitting and habitually slumping can cause the muscles to remain in a shortened and tight state which tugs on the bones of the spine, hip, and thigh causing pain and discomfort.

Frequently climbing or running stairs, running, and abdominal exercises can lead to overuse of the muscles and the development of trigger points. When you feel muscle fatigue setting in it is time to rest or stop.

Other causes:

  • Sleeping on your side in the fetal position
  • Being overweight
  • Strenuous running

TWD Recommendation:

A lumpy or too soft mattress wreaks havoc on the body. It can cause pain throughout the body and is especially hard on the lower back.

I have two mattresses that I recommend. The first is the Casper Sleep Essential which is on my bed. This mattress is firm but has enough softness to provide support. I have had this mattress for 3 years and highly recommend it to those who like a firm but not hard mattress.

The Snuggle-Pedic Mattress is a mattress I have slept on several times and I can recommend it. It is not as firm as the Casper, but provides needed support. Recommended for those who need support but prefer a softer feel.

How To Avoid Development of Trigger Points In The Iliopsoas Muscle Group

  • Pay attention when doing targeted abdominal exercises. When you feel fatigued, stop. More is not always better. Don’t overdo it!
  • Alternate sitting and standing throughout the day. Consider a standing desk if you sit at a desk for hours a day. Take time to get up and walk around periodically.
  • We all have a habit of slumping when we sit. A lumbar support cushion will remind you not to slouch and will support your back, which in turn will help with abdominal and low back pain.
  • If you have rounded shoulder posture where your shoulders roll forward, or forward head posture where you carry your head with your head and chin jutted forward, you may want to consider a posture corrector. A corrector will help retrain your muscles and remind you to maintain correct posture. Keeping the spine aligned will help psoas pain.
  • Sleeping on your side can throw your spine, hips, and legs out of alignment, which puts stress on the iliacus and psoas muscles as well as other neck, back, and hip muscles. If it is the only position in which you sleep comfortably, the Moonlight Slumber Full Body Pillow will help keep you in alignment and reduce daily pain and stiffness.
  • Are you a shallow breather? When you inhale, does your chest or abs expand to take in air? It should be the abdominals. Practice inhaling deep into the stomach and exhaling slowly until deep breathing becomes a habit.
  • If you have abdominal scars from surgery, massage is one of the best treatments to treat the restrictions that form in the area of the scar. The build-up of scar tissue affects the psoas muscle. Massage will reduce your pain, tightness, and increase your mobility.

TWD Recommends

Cureve Hot Cold Pack can be used for warm and cold treatments. I recommend using cold packs for 20-minutes after a TrP treatment. Use a warm treatment when the muscle is tight and needs to relax.

Iliopsoas Trigger Point Treatment

The muscles of the iliopsoas are tricky to treat, and if you are unsure of how to apply treatment you can bruise or damage vital organs in the area. Find a massage therapist, physical therapist, sports therapist, or chiropractor trained in trigger point therapy that can show you how to locate and treat the trigger points.

TWD also recommends getting a copy of The Trigger Point Therapy Workbook. The book explains trigger points and provides symptoms and treatment techniques for muscles throughout the body.

Recommended Products


Get Relief From Iliopsoas Muscles Pain By Providing Abdominal Support and Compression

The Pro-Choice Back Support is a go-to for abdominal support and back brace. The lumbar pad provides support without the uncomfortable restriction and poking of metal supports. The band is wide, and it covers the entire lower back. It has an adjustable Velcro front closure along with adjustable Velcro side panels, which can be tightened or loosened to provide support and compression. The brace also reflects your body heat into the muscles, providing warmth to tight, sore muscles. For those with recent injuries or flare-ups, it is comfortable enough to wear all night and will not disrupt your sleep.

The Pro-Choice brace will help relieve your pain and increase mobility. If you have abdominal or back muscle, tendon, or ligament injuries, new or old, this brace is highly recommended.

Sizing: Small and Medium fits waists 22″ – 38″. Large fits waist 24″ – 40″. X-large fits waist 41″ – 50. XX-large fits waist 51″ – 60″.

TWD Recommends
If you have low back pain or need abdominal support, the Professional’s Choice Back Brace will help reduce your pain and stiffness. The waist wrap and 2 side straps are easily adjusted and provide support compression to the low back and abdomen. It is the only low back brace I recommend because it works!

How Long Before I Feel A Reduction In Pain?

Once you learn how to self-treat psoas trigger points, and they are deactivated, your pain and stiffness will be reduced and possibly eliminated.

Relatively new trigger points usually deactivate quickly after a few days of consistent treatment. If they have affected the muscle for months or even years, it may take several weeks to fully deactivate. The good news is that you notice a reduction of pain and stiffness after each treatment.

Interesting facts:

  • The iliopsoas is an important postural muscle and plays a major role in human’s upright stature
  • In approximately 50% of individuals, the psoas minor is absent
  • The psoas major is the strongest hip flexor (brings your leg up toward your stomach).

Iliopsoas muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

  • Quadratus lumborum syndrome
  • Appendicitis
  • Sciatica
  • Stenosis
  • Trochanteric bursitis
  • Crohn’s Disease
  • Irritable bowel syndrome
  • Kidney Stones
  • Kidney infection
  • Bladder Infection
  • Endometriosis
  • Ovarian Cysts
  • Painful menstruation
  • Prolapsed uterus
  • Pelvic inflammatory disease
  • Bladder Disease or Infection
  • Inguinal Hernia
  • Surgical Adhesions
  • L1 L2 L3 L4 or L5 radiculopathy


Other muscles that should be considered and examined:

Satellite trigger points associated with the iliopsoas muscles:

Trigger points in the QL muscle almost guarantee that there will TrPs in the gluteus medius and gluteus minimus muscles which will need to be treated. Other muscles that you should check:

Trigger points in the iliopsoas muscle will cause TrPs to develop in other muscles. These are known as satellite trigger points. You will need to check these muscles for additional TrPs.

  • Quadratus lumborum
  • Rectus abdominis
  • Tensor fascia latae
  • Gluteus maximus
  • Gluteus medius
  • Gluteus minimus
  • Pectineus,
  • Opposite Iliopsoas muscle group

Muscles With Similar Pain Patterns

Quadratus Lumborum

The Oblique Muscles

Rectus Abdominis


Iliopsoas Referred Pain Pattern

Iliocostalis Thoracis


Sombra Warm Therapy Gel  is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)

TWD Recommends:

Biofreeze Professional Gel is what I recommend for the pain and symptoms of muscle strains. It provides excellent pain relief and may help reduce inflammation caused by a strain. Recommended by medical professionals, and athletic, and personal trainers. 

Donna Martin

Massage Therapist Owner: Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.

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