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Dr. Tim Esguerra, DC

Low Back Pain: Quadratus Lumborum Patterns, Symptoms and Solutions.

What causes a tight quadratus lumborum?

Do you experience lower back discomfort that is dull, aching, or both? Your quadratus lumborum (QL) muscle may be tight as a result of poor posture when performing certain tasks, which may be causing your pain. Or if in an athletic scenario, a deep low back stabilizer muscle strain can occur as a result of either an acute traumatic event or repetitive microtraumas (overuse injury).


What does the QL muscle do?

The quadratus lumborum is a muscle on either side of your lumbar spine that functions like a series of guide wires holding up a mast. It is unknown what the QL does exactly. According to numerous studies, it stabilizes the spine, particularly during flexion, by attaching to the transverse processes of each segment and acting as an agonist muscle during trunk extension and lateral flexion. Comparatively to the psoas muscle, the QL stabilizes the body more, particularly when spinal compression occurs. Additionally, it is capable of acting as an inspiratory accessory muscle since it has attachment points at the 12th rib.



What does QL pain feel like?

Trigger Point Areas of Referred Pain from superficial QL muscle area
Trigger Point Areas of Referred Pain from superficial QL muscle area

Pathologies of the lumbar spine, such as bulging discs and facet joint hypertrophy brought on by chronic inflammation, may interfere with nerve conduction and reaction to the QL and Iliopsoas, leading to poor stabilization of the muscles and mechanical stress from chronic contracture. Acute low back pain complaints nearly often involve trigger points in the QL, particularly when the pain is so bad that the patient is unable to stand. QL trigger points are frequently linked to hip discomfort and sciatica-like symptoms. Several “zones” of pain at: lower abdomen, sacroiliac joint (upper pole), lower buttock, upper hip, and greater trochanter.


How do I treat QL pain?

It is important to get your back pain assessed as soon as possible to determine the cause of pain. For QL pain there are a few things that can be helpful.

  • Heat: Apply heat pack on the area of about 10-15 minutes. This will improve the elasticity of tissue and provide some short-term pain relief.

  • Light movement: Movement is key to prevent QL pain from progressing. If working at a desk, take regular breaks from sitting every 30 minutes and avoid slouching into postures. Light hip mobility work can go a long way to help relieve low back pain when moving.

  • Strengthening: Strength work is essential to prevent recurrence of QL pain. Seek professional guidance to strengthen core, lower back, and hips.


Eager to learn more? The article below is the earliest account of a quadratus lumborum muscle strain brought on during athletic competition.


Tanaka, K., Funasaki, H., Kubota, D., Murayama, Y., Saito, M., & Iguchi, Y. (2022). Quadratus lumborum muscle strain in a youth soccer player: a case report. Radiology case reports, 18(2), 499–502. https://doi.org/10.1016/j.radcr.2022.10.084

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