Can You Stomach the Truth About the Cause of Your Back Pain?

By Dr. Molly Casey

Although all low back pain may feel the same, it is not. Low back pain can be a result of a variety of issues. People often jump to self-diagnose themselves with either sacroiliac (SI) joint problems, hip problems or sciatic issues. While these things can cause low back pain, all low back pain is not a result of these pain generators. An abdominal muscle, quadratus lumborum, is often overlooked but can be a significant cause of low back pain.

Quadratus Lumborum Anatomy

The quadratus lumborum, also called the QL, is the deepest abdominal muscle. Irregular and quadrilateral shaped, it is located on the right and left side of the abdomen. It is often referred to as a low back muscle. The QL originates on the inside wing of the ilium (hip bone) and splays upward, inserting into the transverse process of lumbar vertebrae 1 through 4 and into the bottom border of the 12th rib. The muscles are innervated by nerves T12, L1-L4.

Quadratus Lumborum Dysfunction

Addressing dysfunction requires we first speak of function. The QL function, when working alone on one side, is to raise the pelvis and cause lateral flexion of the vertebral column -- otherwise known as a side bend -- to the same side that the muscle is contracting. When both muscles are firing together (bilaterally) the QL causes depression of the rib cage and some extension of the lumbar spine.

Common quadratus lumborum dysfunction is weak, inhibited musculature. This often results from poor posture, increased kyphotic curve of the thoracic spine (think shoulders rolled forward and a bit of a hunch), and weak core and glutes. This is the common, though not normal, posture these days, especially with prolonged sitting regardless of whether it’s at school, a computer, in the car, or at a desk. As the muscle becomes weaker and becomes more inhibited, it begins to spasm and creates a common pain pattern that can be either a deep, gnarly ache or a sharp, knife-like stab. The pain can be located alongside the spine, irritating the bottom of the gluteal muscles, or the top back portion of the ilium (your pelvis) or even on the side of your hip.

Quadratus Lumborum and Chiropractic

Regular chiropractic adjustments can help the function of the quadratus lumborum in a variety of ways. First and foremost, chiropractic adjustments promote proper nervous system communication. This allows for the brain to communicate properly with the intended structures and for the structures to relay information back to the brain. This includes muscle tension and function. In addition, adjustment addresses motion of the spinal joints. When motion is restored to fixated spinal joints, the muscles that attach to (and move) those joints are able to function at a much higher level. When functioning improves and structures are operating the way they are intended, symptoms tend to decrease. Lastly, chiropractors can assist patients in proper postural corrections, as well as stretching and strengthening exercises, that can assist in proper function, thus preventing further incidents of dysfunction and symptoms.

All low back pain is created equal or from the same sources. Some low back pain is from abdominal muscles. Seeing a chiropractor for regular adjustments helps your nervous system communicate properly and your body function optimally. The QL is no exception.

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