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Quadratus Lumborum Muscle: Trigger Points and How To Relieve Your Pain

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LocationTrigger Point Symptoms | What Causes Trigger Points | Interesting Facts | Treatment  | Healing Time

Quadratus Lumborum Pain

The quadratus lumborum is notorious for pain in the lower back, top of the hip, and buttocks that often extends down into the upper thigh. What is not as commonly known is that trigger points in the muscle can also refer pain in the pelvis, groin and lower abdomen.

Quadratus lumborum strain pain is localized. A strain will cause a specific area in the muscle to be noticeably painful and generalized soreness in the muscle.

Where Is The Quadratus Lumborum Located?

The quadratus lumborum is a low back muscle that connects the hip bone (iliac crest), lower back vertebrae (L1, L2, L3, L4) and to the 12thrib.

The Quadratus Lumborum Muscle

What Movements Does The Quadratus Lumborum Muscle Control?

  • Side bending the trunk
  • Straightening of the spine (standing straight)
  • Stabilizes  low back
  • Helps to raise the hip when you lift your thigh
  • Assists with exhalation (breathing out)

What Are The Signs and Symptoms of Quadratus Lumborum Trigger Point Pain?


Quadratus Lumborum: Trigger Point Referral Pattern

  • Pain in the low back, constant deep aching even at rest
  • Pain in the hips and buttocks
  • Groin pain
  • Pelvic pain
  • Pain down the front  and/or back of the thigh
  • Low abdominal pain
  • Stabbing back and or abdominal pain when coughing or sneezing

Activities Which Contribute To Trigger Point Development In The Quadratus Lumborum

  • Lifting heavy objects
  • Twisting while lifting
  • Sleeping on a mattress that is too soft
  • Horseback riding
  • Golfing
  • Kayaking
  • Leg length discrepancy – one leg shorter than other. This can be the way you were born or due to injury. It is often seen after a leg has been in a cast or splint.
  • The QL muscles are often affected when you slip and or fall

Interesting Facts About The Quadratus Lumborum

  • Known as the ‘hip hiker’ muscle’ because it is the muscle that raises the hip.
  • Pain from the quadratus lumborum can be paralyzing. It brings a sharp stabbing knife-like pain to the lower back area. Turning over in bed and trying to stand from a sitting position can almost bring tears to the eyes.
  • The quadratus lumborum muscle allows separation of movement between the upper body and the lower body.  Two examples are keeping the hips and legs still while moving and twisting the upper body and arms, or moving the legs while keeping the upper body still.
  • People who have one hip noticeably higher than the other are often experiencing problems with the quadratus lumborum.

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

  • Trochanteric bursitis
  • S1 nerve compression
  • Degenerative disc disease
  • Stenosis
  • Sciatica
  • Cauda equina syndrome
  • Ankylosing Spondylitis
  • Scoliosis,
  • Diverticulosis
  • Endometriosis
  • Uterine Fibroids
  • Uterine Prolapse
  • Pelvic Inflammatory Disease
  • Prostatitis
  • Kidney Infection
  • Kidney stones
  • Bladder Pain and Infection
  • Urinary tract infection
  • T10 T11 T12 Radiculopathy
  • L1 L2 L3 L4 or L5 Radiculopathy

Other muscles that should be considered and examined in conjunction with the quadratus lumborum:

Satellite trigger points associated with the quadratus lumborum muscle:

  • Gluteus minimus
  • Gluteus medius
  • Iliopsoas
  • Thoracolumbar paraspinals
  • Piriformis
  • Iliocostalis


How Do I Treat Quadratus Lumborum Trigger Points?

To reduce pain and increase mobility trigger points must be deactivated by applying pressure directly to the trigger point 5-7 seconds several times a day.

Trigger points in the quadratus lumborum are fairly easy to treat once you know the proper technique. If you do not have experience treating trigger points you may want to seek the help of someone trained in trigger point therapy. Many massage therapists, physical therapists, and chiropractors have specified training. Be sure to ask before making an appointment, because not all have the additional training.

If you have previous experience treating trigger points or have time and patience to learn the technique, The Trigger Point Therapy Workbook is an excellent resource. It explains the trigger point phenomenon and includes diagrams to show you where to search for trigger points in each muscle. It is a book that I highly recommend to all my clients and is a book that I reference often.

Because the quadratus lumborum is difficult to reach on your own body, I recommend purchasing the Thera-Cane Massager. The tool is designed to help you reach hard to reach places on the body such as your back, back of the thighs and the bottoms of your feet. It is a tool that I use every day on myself.

Recommended Products

Here are several products that I have used and recommend to help with treatment and that will help relieve your pain.

Hot/Cold Packs

To reduce irritation and help relieve pain I suggest using a cold pack for twenty minutes after treating trigger points. You will be surprised at how good a little cold therapy feels after a treatment!

Alternating cold and warm treatments a few times a day is also helpful. Apply a cold pack after treating the trigger point then wait at least an hour and apply a warm pack for 20-30 minutes. You can do this throughout the day. I also suggest using a warm pack for 15-20 minutes before bedtime. It not only helps relax the problematic muscle but also aid in total body relaxation.

When using hot or cold packs stay within the treatment timeline. Cold treatments longer than 20 minutes may damage the skin and underlying soft tissues. Long treatments with heat can increase inflammation and increase pain.

If you need a hot/cold pack I recommend the Cuerve Hot and Cold Packs. The pack can be put in the freezer for cold treatments and warmed in the microwave for warm treatments. You can use it laying down to relax or use the Velcro straps to secure it in place if you need to be up and moving.

Another hot/cold product that I use and recommend is the Elasto Gel Ice & Hot Wrap. This is a Velcroed wrap that you can comfortably wear while sitting or on the move. The 'tail' can be used not only on the back but also adjusted to the side of the hip and abdomen. It is available in Small/Medium (24-36 inch waist) or Large/X-Large (37-50 inch waist).

Analgesic Creams and Gels 

Analgesic creams and gels help extend the pain and inflammation relief of hot/cold packs. You can also apply these several times a day for pain relief. These are two that I recommend.

Biofreeze Professional Cooling Gel is what I recommend after injuries and treatments. Biofreeze is a cooling gel that works somewhat like ice cooling the area and reducing inflammation. Excellent pain relief that lasts for hours.

Sombra Warming Gel is a warming gel that warms the area without that burning blistering feeling heat of many other heating creams. If you are experiencing muscle pain at night, apply before bed to help muscles relax and help you sleep comfortably. Sombra is an excellent pain reliever and is a client favorite. (not sold in stores)

Do not mix cream or gels or apply one over another as there is a good chance it will blister your skin. If switching products be sure to wash the area thoroughly before applying another cream or gel.

A Back Support That Provides Excellent Abdominal Support

The quadratus lumborum can cause unrelenting low back pain. Providing the proper compression and support to the lower back and abdomen can greatly reduce pain and help you with everyday movements.

I highly recommend The Professional Choice Back Support for low back pain. The brace is wider than most back supports and has a lumbar support for the spine. It is made of neoprene and radiates your body heat back into the muscles which help reduce pain and stiffness. The brace has a Velcro closure with side belts so you can adjust compression to your comfort level.

If your job or hobby requires a lot of bending, twisting, and lifting which contributes to low back pain use this brace during those activities to help alleviate pain and stiffness later.

This brace is not widely known in the medical or therapy communities but in my opinion, is the best brace for lower back and abdominal support on the market. (not sold in stores)

Healing Time

The good thing about trigger points is once they are deactivated pain and stiffness are greatly reduced or eliminated.

If the trigger points are relatively new you should feel improvement within a few treatments. If they have been in the muscle for weeks or even years it may take consistent treatments for a few weeks to completely deactivate the trigger points. The good news is that you will likely notice improvements quickly.

Please take time and read Muscle Trigger Points and How They Contribute To Muscle and Joint Pain to understand why you need to check for satellite trigger points that may be contributing to your pain and stiffness.


Recommended Product For Quadratus Lumborum Trigger Points

These are products that I use personally and recommend to clients


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A too soft or too hard, old lumpy mattress is a major contributor to muscle pain throughout the body, especially the back, lower abdomen, groin/pelvic, and hips. A mattress that is too soft or too firm cannot give the muscles and the body the proper support needed. A lumpy mattress just causes all kinds of pain problems!

The Snuggle-Pedic Mattress
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