Quadratus Lumborum and Back Pain: What’s the Connection?

Despite being an abdominal muscle, the QL has influence over the lower back.

Quadratus Lumborum and Back Pain Causes

The key piece of the core muscles is the quadratus lumborum (QL). Despite being an abdominal muscle, the QL has influence over the lower back. So, if there is pain felt in the lower back, then it could be connected to the QL. Understanding how the quadratus lumborum works might help prevent as well as alleviate back pain.

What is the Quadratus Lumborum?

As mentioned, the quadratus lumborum is one of the core muscles found in the abdomen. It is one of the muscles that extend far down in the abdomen and is located in the lower back on both sides of the lumbar spine. Pain in the QL is common since this muscle is used for walking, standing, and sitting. Lower back pain is commonly connected to the QL.


Pain in the quadratus lumborum is likely a result of the following causes.

Weak Muscles

When muscles in the pelvis and back are weak, then the QL works harder and may become tense and overworked. This likely results in pain to the QL.

Poor Posture

Sitting or standing in a bad posture can place undue stress on the QL and result in pain. Also, sitting without back support, leaning to one side, and slouching also lead to tight and sore muscles.

Sitting for Extended Periods

Being seated for an extended period causes tightening or continuous contraction of the QL muscle. Such contraction leads to muscle fatigue that then causes pain and stiffness in the area affected.


Trauma like an injury due to sports or a car accident can cause pain to the QL. Other than these, the usual activities performed wrongly may result in an injury. For example, lifting a heavy object in the incorrect stance can cause strain to the QL which, in turn, causes back pain.

Unequal Leg Length

One leg that is shorter than the other leg may place an added strain on the other muscles in the body. This includes the QL. The pelvis is also tilted if there is an unequal leg length which also leads to a strain of the QL.



Severity and type of pain associated with QL vary. The common symptoms, however, involve discomfort and tightness in the lower back. For some people, the pain is deep aching in characteristic while for others it is acute and sharp.

While pain often happens when an individual is at rest, the pain is aggravated with movement such as standing or walking. Sharp and acute pain is also felt when an individual coughs or sneezes.

QL pain is also likely to be chronic or long-lasting. When this happens, the pain interferes with an individual’s activities of daily living. Moreover, studies claim that chronic back pain caused by trauma to the QL may lead to depression and anxiety.

Understanding Trigger Points

A trigger point is referred to as a tender or sensitive area in the connective tissue or muscle when pressed or stimulated. These trigger points are characterized by small knots that when pressed results in radiating or referred pain. Radiating pain refers to the discomfort felt in another area of the body rather than the part touched. For the trigger points in QL, it causes pain in the hips, pelvis, and lower back.


There are numerous treatments to alleviate QL pain, but the methods depend on the severity of pain. In some cases, medical treatments and home care remedies are combined to reduce pain.


Pain medication and muscle relaxants are often prescribed to lessen QL pain. However, some medicines often cause adverse reactions such as fatigue, dry mouth, and drowsiness. This is why it is crucial to stick to the recommended dose that has been prescribed by your healthcare practitioner.


This treatment involves several stretches and poses that prove useful in lessening QL pain. Moreover, studies were done in 2015 claim that yoga reduces disability and discomfort that is associated with low back pain. Plus, yoga improves mental health in individuals who experience chronic lower back pain.

Massage Therapy

Massage helps increase blood flow to the affected area and reduce muscle tightness. Plus, the hand movements used in easing the muscles help alleviate pain.

Ice or Heat Therapy

Ice application to the area lessens inflammation, whereas heat application reduces pain and increases blood flow. Alternate between ice and hot packs to ease back pain.

Trigger Point Injections

In this treatment method, a healthcare practitioner administers medication to the trigger point. This decreases muscle tenderness. The drug injected is either an anesthetic or an asteroid. Usually, steroids are used to decreases the inflammation in the area. These injections to the trigger points are considered the most effective in reducing QL pain and muscle spasms.


Another method of treatment is two types of stretches. These movements prevent tightness in the QL muscles.

Lying Down QL Stretch

In this stretch, you must lie on your back with the arms extended sideways. The knees should be bent, and the right leg is crossed over the left leg. Allow the legs to drop sideways to the right as far as you can. Hold this stance for at least 20 seconds before switching with the other leg.

Overhead Reach

For this stretch, you must stand with the feet at a hip-width apart. Afterward, stretch the left arm upwards and lean to the left side as far as you can. Hold this stance for 20 seconds before switching with the other arm.

Take note, however, that before doing any exercise or stretch that it is best to consult with your caregiver, especially if you have other medical conditions that limit movement.


Apart from the treatment methods mentioned above, there are specific ways to prevent QL pain. Moreover, these steps may also reduce the pain or discomfort if it develops.

  1. Seat or stand with a good posture.
  2. When sitting, use a lumbar support pillow.
  3. Bend the knees when lifting heavy objects.
  4. Maintain the recommended weight for your height and age.
  5. Take breaks when seated for long hours to prevent muscle stiffness.
  6. Avoid sleeping on one side of the body.

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