Low Back Pain: which trigger points cause it and how to treat them

Non-specific low back pain — by far the most common presentation — frequently has a meaningful muscular contributor. Quadratus lumborum and gluteus medius referral closely mimics 'lumbar' pain. Identifying these often unlocks progress when generic exercise programs stall.

Quadratus Lumborum — Iliac crest, sacroiliac joint area, greater trochanter, sometimes lower abdominal pain. Often described as a deep, dull lumbar ache.

Longissimus Thoracis — Buttock and lateral lower back pain, mimicking 'sciatica' but staying above the knee.

Iliocostalis Lumborum — Lower back pain along the iliac crest, sometimes wrapping to the lower abdomen.

Iliocostalis Thoracis — Upward referral toward the upper back and shoulder blade, downward referral toward the lumbar region, and wrap-around pain over the lateral chest wall.

Multifidi — Local segmental pain, often felt as a 'spot' the patient can point to.

Rectus Abdominis — Mid-back and lower-back pain, urinary urgency-like sensations, abdominal cramps.

Work the muscles in the order above. Treat one muscle fully — locate the taut band, hold sustained pressure until the ache eases, then take the muscle through its full range once — before moving to the next. Re-test the painful movement after each muscle so you can tell which one is actually driving the pattern: the muscles most often responsible here are Quadratus Lumborum, Longissimus Thoracis and Iliocostalis Lumborum.

If two or three muscles each give partial relief, that is the normal picture in a long-standing pattern; expect to revisit them over several sessions rather than resolving everything in one.

Myofascial referral is a pattern of muscular origin, and it behaves like one: pressure on a specific spot reproduces the familiar pain, the pain moves with load and position, and it eases after release and movement. Findings that do not behave that way belong to a different problem.

Seek assessment rather than self-treating when pain is constant and unchanged by position, wakes you at night without a mechanical trigger, follows a clear dermatome with numbness or weakness, or comes with fever, unexplained weight loss, or a recent significant injury. The same applies when four to six weeks of consistent self-care produces no change at all.