Quadratus Lumborum Syndrome

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Introduction[edit | edit source]

Quadratus Lumborum is the deepest muscle of the lumbar region. Extends from pelvis to last rib. It contracts while sitting, walking and standing and is therefore very susceptible to pain formation.Pain is usually caused by overuse, but can sometimes be caused by weakness and tension. Constantly standing in the same position will reduce blood flow and thus pave the way for pain. At the same time, the weakness of the back extensor muscles can also form the basis of the pain as it will put a load on the Quadratus Lumborum.

Symptoms[edit | edit source]

Myofascial pain syndrome (MPS) of the spinal stabilizer muscles is one of the most frequent causes of chronic low back pain. However, MPS is often overlooked. Among the spinal stabilizer muscles, the quadratus lumborum (QL) is frequently a trigger point and location of referred low back pain Overuse and strain of the QL is one of the major causes of chronic pain in the lower back.

MPS is characterized by symptoms that include localized muscular tenderness, myofascial trigger points, a palpable intramuscular taut band, and a muscular twitching response. MPS is a common cause of pain and dysfunction in the musculoskeletal system and accounts for 20% to 95% of cases with musculoskeletal pain presenting at outpatient clinics and pain management centers. The primary goal of managing MPS is to break the vicious cycle of pain through the elimination of trigger points. There are various treatments for the elimination of myofascial trigger points, including trigger point injection (TPI), ischemic compression, stretching, massage, and treatment modalities, including ultrasound and transcutaneous electrical nerve stimulation. A variety of treatments exist, but the most effective treatment for MPS is still under debate.[1]

It is characterized by pain and tension in the lumbar region.

The type and severity of pain can vary. Low back pain is often described as a deep ache, but it can also be felt as sharp and acute depending on the cause. Although the discomfort usually occurs at rest, it can get worse with movement. Lying, walking, standing, and rolling may aggravate the pain. Sharp pain may also be felt when sneezing or coughing. Quadratus lumborum pain can even interfere with daily activities such as walking and sitting.

Quadratus lumborum pain can become chronic. Long-term pain often impairs a person's quality of life and well-being, and also affects them physically. People with chronic low back pain are more likely to experience anxiety and depression than those without chronic pain.

Also, if one part of the body is causing pain, other parts try to support the painful area. For example, if the quadratus lumborum is tight and painful, we may find that the person begins to twist or change their gait by changing their body posture. This changing posture can place an additional load on other parts of the body, such as the hips, further increasing the pain.[2]

Trigger Points[edit | edit source]

A trigger point is a sensitive area of ​​muscle or connective tissue that hurts when stimulated or pressed. Trigger points are also often described as small knots. Pressing a trigger point can also cause directed or radiating pain. Radiating pain is the discomfort felt more in a different part of the body when the sensitive point is pressed. Quadratus lumborum trigger points can cause pain in the lower back, pelvis, and hips.[3]

Quadratus lumborum trigger points can cause deep pain in the lower back or a stabbing sensation in the hips or pelvis. It can also cause a sharp pain when the QL shortens when coughing or sneezing.[4]

Causes[edit | edit source]

  • Sitting for too long: Sitting for a long time causes the quadratus lumborum muscle to contract continuously. Continuous contraction can cause muscle building. If blood is added to the muscles, it can become stiff and painful.
  • Situation: Standing or poor prognosis may place additional strain on the quadus lumborum and cause pain. It can cause sagging, a build-up, or a lack of growth in the back, and soreness of the muscle.
  • Weak muscles: If the quadratus lumborum muscles are weak, it can cause more of the other muscles than necessary. Having weak muscles in the back and pelvic area, the quad must work harder for support. Eventually, the quadratus lumborum muscles may become tense.
  • Not tall: Being happy to be taller, quad taller will put an additional strain on your happy muscles. If one hand is shorter than the other, the pelvis may be higher next to the longer one. Tilting the pelvis can also lead to shortening of the quadratus lumborum, which can strain the muscles.
  • Trauma: like a muscle, the quadratus lumborum can be injured. From a car accident or sports children to muscular cassavarumna may be small. It can be spread in the wrong way. For example, it can force air or the lumborum quadrate.[5]

Treatment[edit | edit source]

Depending on the severity of the pain, the following treatments may be applied:

  • Yoga: It includes a series of movements that can be helpful in reducing quadratus lumborum pain. Along with improving physical function, yoga can also improve mental well-being in people with ongoing back pain.
  • Medications: Medications such as muscle relaxants and pain medications can help reduce quadratus lumborum pain.
  • Trigger point injections: A trigger point injection involves administering the drug directly to the trigger point under ultrasound guidance to reduce sensitivity. The injection may be an anesthetic that numbs the area. In some cases, a steroid is injected to reduce inflammation. Trigger point injections can be effective for reducing muscle spasm and quadratus lumborum pain.
  • Massage therapy: Massage therapy can be helpful for treating quadratus lumborum pain. Massage can reduce muscle tension and increase blood flow to the area.
  • Heat or ice: Applying ice to the area can reduce inflammation, and heat can increase blood flow and reduce pain. A person can try alternating between heat and ice packs to relieve back pain. A warm bath can also help.[6]
  • Streching QL.

References[edit | edit source]