Chronic back pain is now the leading cause of disability nationwide! It is also one of the main reasons people seek out Physical Therapy. Sometimes back pain comes from an acute injury. However, often we just stand up from our desks and feel a deep ache or a sharp twinge and wonder where it came from. There are lots of causes of chronic back pain but we wanted to point out one very likely culprit: The Quadratus Lumborum (QL) muscle. This guy can contribute to so many issues, from chronic back pain to hip pain to even seemingly unrelated symptoms like Irritable Bowel Syndrome!
Chronic Back Pain and the Quadratus Lumborum Muscle (QL)
The Quadratus Lumborum muscle runs from your spine to your hip bone. It is your deepest abdominal muscle. Its job is to stabilize your pelvis and support your core when you are upright. Have you ever had back pain but can’t pinpoint having done anything to hurt your back? Unfortunately just sitting at a desk all day can actually lead to serious back pain! When we sit for long periods, the QL muscle shortens and tightens. This really affects its ability to support the spine. Once the QL is out of whack, the muscles above and below it start straining as well. For this reason, QL issues can actually cause mid and upper back pain as well as low back pain.
Treating Chronic Back Pain from QL Dysfunction
Ok, so my whole back can hurt from this muscle. What can I do to make it better? Well, often times when people seek treatment for upper or lower back pain they start with the area that hurts. This sounds like a good idea, and often is, but if the pain and strain keep returning to that area, or worsen, that is a huge clue that the source of the problem might be elsewhere. And with a short and tight QL muscle from sitting, that is often the case. The QL is not the only muscle that can contribute to back pain of course, but it often is the first to develop problems that then affect other muscles.
At-Home Help for Chronic Back Pain
This is one of the main reasons that a standing or walking desk can be helpful for some workers, or even just setting a reminder to get up and move regularly. For cases of chronic back pain that don’t seem to resolve on their own, a skilled Physical Therapist can assess your posture and functional movement and get you on the road to QL recovery. You may discover that unexpected issues like Irritable Bowel Syndrome improve as well. Read below for more info!
Back Pain and Stomach Issues
This might be surprising, but a tight QL muscle can also contribute to constipation and IBS! A tight and shortened QL muscle will compress the spine in that area, which will actually affect the spinal nerve function in that area. Nerve function plays a huge role in gut motility as nerve signals are what tell the intestine to contract and process food and waste. When those nerve signals are coming too frequently or too rarely, the contents of the intestine spend either too much or too little time in transit and GI problems like IBS occur.
Physical Therapy for Back Pain and IBS
Irritable Bowel Syndrome is given as a diagnosis of exclusion, or what they diagnose when there isn’t another obvious cause for a patient’s bowel issues. This is something to talk about with your own medical provider of course, but if you have chronic back pain and also IBS and sit for most of the day there is a chance that QL muscle function is involved. This is one of the reasons we take a holistic, whole-body approach to PT. Multiple body systems work together to cause symptoms!
One-Sided Pain in the Back of the Hip
So we’ve learned that your QL shortening and locking up can cause back pain all over the back. Sometimes due to how we’re sitting it can shorten in an asymmetrical manner. When the QL muscle gets locked up unevenly, it can lead to even more pain and issues with functional movement. A sharp twinge in the rear hip area (like where your thumb would go if you put your hands on your hip) can often be caused by asymmetrical QL issues.
Chronic Back Pain Affects Daily Life
If the QL is not in its peak form to support your body, muscle spasms and pain will occur as your body tries to protect itself. If you feel like it’s hard to bend down to tie your shoes or pick up a laundry basket, or you get a painful back twinge when lifting things, there is a chance that your QL is playing a part. Feel free to contact Parr PT for a free phone consultation to discuss a customized physical therapy program to treat chronic back pain!
I am dealing with a tight QL –a local PT dx ….that has made my life hell the past 8mo…looking for suggestions for healing.
What to do, what to avoid.
It has affected digestion, just need support.
You’re Welcome! We will be posting more about this condition
More information on how to help chronic digestive and constipation issues please. I’m curious how nerve issues such as sciatica, neuropathy, and spinal problems ( in the thoracic region especially) come into play.
Yes we will be adding these topics in soon, thanks!
My ql has been causing major issues.. I believe on 1 side it’s extremely tight and the other side it’s extremely weak. Heck both sides are prob weak. It is causing bowel, spine, scapula issues. It’s pulling downward on my left scapula which is causing a whole host of things. I am now very asymmetrical, not a little but alot. Have had 5 pts, 5/6 docs which have been of no help. All diff diagnosis. Doing exercises on my own, things now just keep backfiring. This is ruining my body. Any suggestions
Hi, thanks for reaching out! I would recommend checking out this video on how to relieve chronic low back pain: watch video I hope this helps!