Muscle deep-dives
Quadratus Lumborum trigger points: referred pain, palpation and release
A clinical deep-dive on Quadratus Lumborum: trigger point locations, the referred pain pattern they produce, palpation landmarks, activating factors and an evidence-based release protocol.
Published:
Why this muscle causes pain
Runs from the 12th rib and lumbar transverse processes to the iliac crest. Side-bends the lumbar spine, hikes the hip, stabilizes the pelvis during breathing. Frequent silent contributor to chronic low back pain.
Where the trigger points sit
Superficial points along the iliac crest and 12th rib attachment, plus deeper points medially along the lumbar transverse processes.
The referred pain pattern
Iliac crest, sacroiliac joint area, greater trochanter, sometimes lower abdominal pain. Often described as a deep, dull lumbar ache.
How to find it by palpation
Side-lying with the upper arm overhead to open the flank. Palpate between the 12th rib and the iliac crest, lateral to the paraspinals.
What sets it off
Leg length discrepancy, asymmetric loading, sustained sitting in a twisted position, lifting with rotation.
Self-care that actually helps
Side-bend stretches over a foam roller, address pelvic asymmetry, diaphragmatic breathing. Clinically: needling, lateral decubitus manual release.
Symptoms this muscle produces
Clinically, this muscle turns up in the workup of abdominal pain, bloating/nausea/abdominal cramps, low back pain, buttock pain, iliosacral pain and lower abdominal pain. Those are the complaints its referral zone overlaps, which is why a patient may present with any of them and never mention the muscle itself.
Muscles covered
Studies cited
Every claim in this article traces back to one of the sources below.
- Kietrys 2013 — Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2013;43(9):620-34 ↗
- Gattie 2017 — The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2017;47(3):133-49 ↗
- Boyles 2015 — Effectiveness of trigger point dry needling for multiple body regions: a systematic review. J Man Manip Ther 2015;23(5):276-93 ↗
- Charles 2019 — A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points. J Bodyw Mov Ther 2019;23(3):539-46 ↗
- Cagnie 2013 — Physiologic effects of dry needling. Curr Pain Headache Rep 2013;17(8):348 ↗
- Fernández-de-las-Peñas 2019 — Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm. J Pain Res 2019;12:1899-911 ↗
- Shah 2015 — Myofascial trigger points then and now: a historical and scientific perspective. PM R 2015;7(7):746-61 ↗
- Halle 2016 — Pertinent dry needling considerations for minimizing adverse effects. Int J Sports Phys Ther 2016;11(5):651-62 ↗
- Boyce 2020 — Adverse events associated with therapeutic dry needling. Int J Sports Phys Ther 2020;15(1):103-13 ↗
- Hong 1994 — Lidocaine injection versus dry needling to myofascial trigger point: the importance of the local twitch response. Am J Phys Med Rehabil 1994;73(4):256-63 ↗
- Simons & Travell — Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.). Williams & Wilkins, Baltimore ↗
