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Introduction[edit | edit source]


The iliocostalis muscles are the most lateral components of the erector spinae group. This subgroup includes the iliocostalis cervicis, iliocostalis thoracis, and iliocostalis lumborum[1].

  1. Iliocostalis lumborum see link.
  2. The iliocostalis thoracis muscle: starts from the superior aspect of the angles of the lower six ribs and ascends to end on the angles of approximately the upper six ribs and transverse process of the C7 vertebra. This muscle extends and laterally flexes the thoracic spine and is innervated by the lateral branches of the posterior primary divisions (dorsal rami) of the thoracic spinal nerves.
  3. The iliocostalis cervicis muscle: arises from the superior aspect of the angle of the third through sixth ribs and attaches superiorly onto the posterior tubercles of the transverse processes of the C4 to C6 vertebrae. It laterally flexes and extends the lower cervical region and is innervated by the dorsal rami of the upper thoracic and lower cervical spinal nerves.

Function[edit | edit source]

Muscles of the back

Iliocostalis muscles functions include:

  • Work in synergy with the two other erector spinae components (longissimus and spinalis) to produce movements of the vertebral column. When these muscles contract unilaterally, they produce ipsilateral lateral flexion of the spine, while when acting bilaterally, they extend the spine.
  • During forward flexion of the spine, erector spinae muscles eccentrically contract to smoothen the bending of the vertebral column.[2]
  • Global mover of the core muscles.

Physiotherapy Relevance[edit | edit source]

Back Pain

The chief pathology associated with the back muscles is pain. These muscles can develop spasms that can be debilitating. The lower back muscles are a common cause of low back pain.[3]

Assessment[edit | edit source]

Increased Lordosis

It is impossible to isolate one part of the erector spinae muscles for assessment therefore assessing the erector spinae in terms of movement patterns is more relevant in clinical practice. See Lumbar Assessment

Strength: see Manual Muscle Testing: Trunk Extension

Length: Bilateral contracture of low back muscles results in lordosis; Unilateral contracture results in scoliosis with convexity to the opposite side.

Treatment[edit | edit source]

Back Strengthening

Strengthening exercises:

  1. Prone extension exercise: In prone lying, have the patient tuck in the chin and lift the head, thorax of the plinth; To progress further, the patient can vary the arm position. Resistance can be added by using hand-held weights; Patient can further progress by lifting one leg off the mat alternately, and progress to both legs simultaneously; Further progression can be made - spine extension with both upper limbs and lower limbs lifted off the mat.
  2. Prone exercises on a stability ball.
  3. Plank and quadruped exercises to develop control and strength in spinal extensors.
  4. Postural exercises[5].

Below is a 5 and a 1/2 minute video titled Stronger to the Core - Exercises for a Stronger Core Erector Spinae

Stretching exercises:

Trunk lateral bending exercises to the opposite side of tightness and flexion exercises help in stretching the tight muscles.

Below is a less than 3 minute video titled Erector Spinae Muscles Stretches .

References[edit | edit source]

  1. Radiopedia Erector Spinae Available: (accessed 6.2.2022)
  2. Kenhub Iliocostalis Available: (accessed 6.2.2022)
  3. Henson B, Kadiyala B, Edens MA. Anatomy, Back, Muscles.[Updated 2020 Aug 10]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2021. Available: 6.2.2022)
  4. Roldan CJ, Huh BK. Iliocostalis thoracis-lumborum myofascial pain: Reviewing a subgroup of a prospective, randomized, blinded trial. A challenging diagnosis with clinical implications. Pain physician. 2016 Aug 1;19(6):363-72. Available: (accessed 6.2.2022)
  5. Therapeutic Exercise; Third Edition; Kisner & Colby; The Spine: Subacute, Chronic, and Postural Problems; Page No.562