Muscles
Quadratus Lumborum Trigger Points
Symptom Area: Lower Torso
Quadratus Lumborum Trigger Points are explored here through their location and referred pain pattern. Muscle knots is an everyday term used for tender muscular spots; myofascial pain describes pain involving muscle and its surrounding connective tissue. One of the most common muscular sources of low back pain — deep, hard-to-localize pain that worsens with standing.
Where you feel it
When the Quadratus Lumborum holds active trigger points, you usually notice it as bloating/nausea/abdominal cramps, buttock pain, lateral thigh & hip pain, low back pain and si joint pain (base of the spine). Where the pain spreads: Iliac crest, sacroiliac joint area, greater trochanter, sometimes lower abdominal pain. What often sets it off: Leg length discrepancy, asymmetric loading, sustained sitting in a twisted position, lifting with rotation.
Overview
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.
Trigger point locations
Superficial points along the iliac crest and 12th rib attachment, plus deeper points medially along the lumbar transverse processes.
Referred pain pattern
Iliac crest, sacroiliac joint area, greater trochanter, sometimes lower abdominal pain. Often described as a deep, dull lumbar ache.
Palpation & testing
Side-lying with the upper arm overhead to open the flank. Palpate between the 12th rib and the iliac crest, lateral to the paraspinals.
Common causes
Leg length discrepancy, asymmetric loading, sustained sitting in a twisted position, lifting with rotation.
Self-care & clinical treatment
Side-bend stretches over a foam roller, address pelvic asymmetry, diaphragmatic breathing. Clinically: needling, lateral decubitus manual release.
Treatment protocol
For Quadratus Lumborum, the general protocol applies: sustained pressure release on the taut band, then stretch and active movement in the newly gained range.
Position and palpation: Side-lying with the upper arm overhead to open the flank.
Regional precaution for clinicians: In the flank and abdominal wall the kidney (behind the twelfth rib and the quadratus lumborum), the abdominal viscera and the lower lung fields are the structures at risk.
Primary Symptoms
Secondary Symptoms
Often confused with
These muscles cause the same primary symptoms, so they are checked together:
Related muscles in this region
Related articles
- Your MRI is not a diagnosis: what scans show in people without pain
- Self-treating a trigger point: pressure, heat and movement
- Referred pain: why the spot that hurts is rarely the spot that needs treatment
- Why pain spreads: satellite trigger points, and whether deactivating one quiets its neighbours
- The piriformis: the muscle that imitates sciatica from deep in the buttock
- Do stretching and exercise actually change a trigger point? What the trials show
References
- • Travell & Simons, Vol. 2
- • 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
- • 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
- • Effectiveness of trigger point dry needling for multiple body regions: a systematic review — J Man Manip Ther 2015;23(5):276-93
- • 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
- • Physiologic effects of dry needling — Curr Pain Headache Rep 2013;17(8):348
- • 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
- • Myofascial trigger points then and now: a historical and scientific perspective — PM R 2015;7(7):746-61
- • Pertinent dry needling considerations for minimizing adverse effects — Int J Sports Phys Ther 2016;11(5):651-62
- • Adverse events associated with therapeutic dry needling — Int J Sports Phys Ther 2020;15(1):103-13
- • 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
- • Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.) — Williams & Wilkins, Baltimore
Medically reviewed by: Marco Aruffo — physiotherapist since 2006, specialised in myofascial pain · Last reviewed:
