National Associaltion of Myofascial Trigger Point Therapists - Symptom Checker

Quadratus Lumborum
multiple images available Image 1 Image 2
This is the technical name of the muscle being described.  This name may be used to find additional information in any medical resource. Quadratus Lumborum (QL)
A group of muscles generally denotes muscles of the same function and may share a common attachment point. Hip Flexor
Muscle function, in this definition, is what the muscle could do if it was to contract by itself with the body in anatomical position.  This is a general definition of muscle function.  For more information on how muscles work together on the body please refer to a physiology or functional anatomy text.

The QL acts as a hip hiker.  Because of its attachments, it can produce a slight twisting motion on the spine as well as laterally flex the spine from one side to the other.  The QL functions to anchor the spinal column much like guy wires on a telephone pole.

A description of where a Myofascial Trigger Point may produce pain in the body.  This area is generally located away from the trigger point.

Pain is likely to be felt along the crest of the ilium.

Pain may be felt in the groin.

Tenderness may be felt in the greater trochanter.

Sacroiliac joint pain.

Not commonly felt, but noted, is a lightning like sensation down the lateral thigh from the top of the hip (ASIS) to the lateral patella (knee cap).

Pain also may be felt in the testicle and scrotum.

A description of the symptoms a person may experience with trigger points in the muscle being described.

Pain is generally deep, dull, and aching, but may be sharp and lancinating during movement.

Person may have to drop on all fours due to pain from the QL.

Coughing and sneezing can be extremely, and frightfully, painful.

Person may not be able to roll over in bed or stand upright due to pain.

Low back pain.

May cause satellite TrPs in the gluteus minimus and cause it to refer its pain down the leg and mimic sciatica.

May be the cause of non-congenital scoliosis

   

 A list of possible diseases that fit the information derived from examination of a patient.

  1. Other muscles to consider are the longissimus thoracis and multifidi.
  2. Trochanteric bursitis.
  3. S1 radiculopathy.
  4. SI joint dysfunction.
  5. Other diagnosis to consider are spinal tumors, gallstones and liver disease, kidney stones and other urinary tract problems, intra-abdominal infections, intestinal parasites and diverticulitis, aortic aneurysm, and multiple sclerosis

A list of activities or positions that may either CAUSE a trigger point to manifest or PROLONG a pain condition respectively.

  1. Lower limb length inequality (LLLI).
  2. Lifting of large, cumbersome objects.
  3. Quick swooping movements that involve twisting the torso, such as sweeping floor with a vacuum, shoveling snow and twisting to throw it.  For that matter, any shoveling may aggravate TrPs in the QL.
  4. Putting pants on while standing may overload the QL and cause pain.
  5. Motor vehicle accidents.
  6. Introduction of a cast may create an imbalance in the pelvis, which will activate TrPs in the QL.
  7. A sagging bed mattress will aggravate the QL on the “up side” of a person sleeping in the sidelying position.
  8. Short upper arms.  This is when the elbows are not level with the crest of the hip.  In this situation, a person will have to lean to one side or the other to use their arm rest, thus placing the QL in a shortened position.

A corrective action is usually a modification of daily routine which will reduce stress on the affected muscle(s) in a person with myofascial trigger points.

  1. Correct any LLLI (lower limb length inequality or “short leg”).  This may be accomplished by restoring the QL to its normal resting length, thus lowering the affected iliac crest and allowing the lower extremity to return to its normal position.  A heel lift may be necessary depending on certain conditions.
  2. Sit down while putting pants on.
  3. Short upper arm corrections include either having a chair with adjustable armrests or building up the armrests of a chair using material and tape.  The arm rest should be built up to the bent elbow while being careful not to overdo the compensation.
  4. If the person is a side sleeper, a pillow should be placed between the knees to hold the upper thigh in the horizontal position allowing better placement of the pelvis and lumbar spine.
 

References : 
Simons DG, Travell JG, Simons LS, Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1, 2nd Ed. Baltimore: Williams and Wilkins, 1999.

Travell JG, Simons DG, Myofascial Pain and Dysfunction, vol 2. Baltimore: Williams & Wilkins, 1992.


This information is not intended to diagnose, treat, or cure any disease.  A proper diagnosis should be sought from a licensed health care provider.