The quadratus lumborum is a back muscle that athletes utilize daily for balance and stabilization. The downside of the muscle playing a crucial role in supporting the body is that it can easily be injured. Aching pain in the lower back and tenderness characterizes the diagnosis of quadratus lumborum syndrome. The mechanisms of injury are linked to trauma or repetitive daily activities. The treatment options for the syndrome include ultrasounds, medications, or physical therapy.
What is the Quadratus Lumborum
An article by Krzysztof Kassolik titled “Quadratus Lumborum Syndrome” states the quadratus lumborum is the deepest muscle in the back. The muscle starts on the bony protrusion of a vertebra in the lower back and ends on the pelvic bone.
Photo 1: An article titled “Myofascial Lower Back Pain” by Ryan Ramsook illustrates the quadratus lumborum’s placement on the ribs and pelvic bone.
Diagnosing Quadratus Lumborum Syndrome
Quadratus lumborum syndrome characteristics include the following:
- Muscular tenderness
- Muscular twitching responses
Quadratus lumborum syndrome can cause pain during the following motions or positions:
- Deep aching pain persisting in the lower back in a sitting or standing position
- Sneezing or coughing
- Lying down or walking up stairs
Mechanism of Injury
The mechanism of injury for quadratus lumborum syndrome can be from repeated use or a traumatic injury.
- Traumatic injuries: Traumatic injuries affecting the quadratus lumborum muscle include car accidents or sports injuries.
- Repetitive Daily Activities: Lifting a heavy object can strain the quadratus lumborum.
- Sitting for Long Periods: When an individual is sitting for too long, this often causes continuous contraction and tightening of the quadratus lumborum muscle. When the muscle is continuously contracting, it can lead to fatigue. This sitting position can also lead to decreased blood flow to the muscle, leading to stiffness and pain.
- Weak Back Muscles: Weak muscles around the quadratus lumborum can also cause pain in the muscle. When the surrounding muscles in the back and pelvis areas are too weak, the quadratus lumborum may have to work hard to support the body. Eventually, after working too hard when sitting and standing, the quadratus lumborum may become overworked and tense.
Photo 2: An article by Rick Perry of BQ Personal Training titled “Poor Posture: The Root of Neck & Back Pain” illustrates areas of back pain based on the type of posture an individual has.
Treatment
Quadratus lumborum syndrome can be treated with non-surgical methods or with physical therapy.
- Ultrasound Infiltrations: Ultrasound-guided infiltrations of the quadratus lumborum are an effective procedure to relieve pain in the quadratus lumborum syndrome.
- Medication: Taking non-steroidal anti-inflammatory drugs, opioids, anticonvulsants, antidepressants, and muscle relaxants is a non-surgical treatment option. Anticonvulsants can block the pain coming from the quadratus lumborum by blocking the sodium and calcium channels at a cellular level, suppressing the continuous muscle contractions in the muscles.
- Physical Therapy: Physical therapy can also alleviate the point-tenderness of the quadratus lumborum with the use of exercise treatment plans and manual therapy.
Well done!