Quadratus Lumborum

The Quadratus Lumborum is a muscle of the low back.

Anatomical Attachments:

• Origin: Attaches to the iliolumbar ligaments and the iliac crest.
• Insertion: Attaches to the transverse processes of L1, L2, L3, and L4 vertebrae and also to the inferior margin of the 12th rib.

Action: Acting bilaterally, draws the 12th rib downward; flexes the vertebral column and stabilizes an upright posture. Acting unilaterally, laterally flexes the spine.

Synergist: Erector spinae, Multifidus, Rotatores, Serratus posterior inferior, external and internal abdominal Oblique, Rectus abdominis, Intertransversarii, Psoas major and minor.

Nerve Supply: Branches of T12 and L1 nerves.

Vascular supply: Lumbar branch of the iliolumbar artery.

• Primary: The referred pain varies, from the sharp shooting pain in the low back down to the SI joint or across the ilium into the inguinal region and occasionally into the testicular or groin region. Deep aching pain to the buttocks and trochanter region with a wrap around referral to the side and the front of the leg, pain can be either deep and aching or sharp and electrical, giving the impression of lumbar or sacral nerve compression.
• Satellite or associated triggers: Gluteus medius, Gluteus minimus, Iliopsoas, Erector spinae, Iliocostalis.

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Trigger Point Signs and Symptoms: Low back pain, constant deep aching pain at rest, difficulty in leaning or turning to the opposite side, which frequently prohibits the ability to stand erect.

Trigger Point Activating and Perpetuating Factors: Lower limb length inequality, a small hemipelvis, short upper arms, soft mattress, leaning forward with the upper body unsupported, repetitive or heavy lifting from the waist, stored psychic stress, and trauma.

Differential Diagnosis: Trochanteric bursitis, S1 nerve compression, Degenerative disc disease, (Segmental, Subluxation, Somatic dysfunction) T10 T11 T12 L1 L2 L3 L4 or L5 Radiculopathy, Sciatica, Cauda equina syndrome, Osteoarthritis, Rheumatoid Arthritis, Sprain/Strain low back, Spinal tumors, Myasthenia gravis, Gallstones, Liver disease, intra-abdominal infections, intestinal parasites, Diverticulosis, Colon Cancer, Aortic aneurysm, Iliac Aneurysm-Thrombosis, Intervertebral stenosis, Multiple sclerosis, Ankylosing Spondylitis, Scoliosis, Spontaneous Abortion (Miscarriage), Cervicitis, Endometriosis, Uterine Fibroids, Uterine Prolapse, Menses, Pregnancy, Pelvic Inflammatory Disease, Peripheral Vascular Disease, Bladder Cancer, Cystitis, Kidney Cancer, Kidney Infection, Kidney stones, Urinary tract infection, Obesity, Reiter’s Disease, Paget’s Disease, Prostatitis, Testicular Cancer, Weakened Abdominal Muscles, Eosinophilic fasciitis, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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