Discover the Top 3 Muscle Culprits Behind Your Low Back Pain
- Julian Simpson
- Oct 11, 2025
- 2 min read
Discover the Top 3 Muscle Culprits Behind Your Low Back Pain
Low Back Pain (up to 90%)often lacks an identifiable pathoanatomical cause is classified as non-specific. In such cases, while various lumbar structures, such as intervertebral disks and facet joints, are plausible pain sources, clinical tests cannot reliably attribute pain symptoms to any particular structure
Muscles are a frequent source of symptoms associated with LBP . Myofascial trigger points (MTrPs) are defined as “hyperirritable spots in skeletal muscle, associated with a palpable, hypersensitive nodule within a taut band.
These areas are painful upon manual compression and can generate characteristic referred pain, referred tenderness, motor dysfunction, and autonomic phenomena
How do you get trigger points ?
Trigger Points are classified as active or latent.
Active trigger points are responsible for persistent pain that reproduces YOUR symptoms and, when stimulated, elicit a response the patient recognises as part of their symptomatology.
They are also associated with functional limitations, restricted range of motion, and muscle strength deficits.
Latent trigger points on the other hand, are clinically silent, as they do not cause spontaneous pain
What are the three muscles that are most common to have trigger points with low back pain?
quadratus lumborum,
gluteus medius, and
iliocostalis
What do they do ?
1. Quadratus Lumborum (QL)
Primary Actions:
Lateral flexion of the lumbar spine (side bending of the trunk)
Extension of the lumbar spine (when both sides contract together)
Stabilization of the pelvis and lumbar spine
Elevation of the hip (hip hiking—important in walking)
🟩 2. Gluteus Medius
Primary Actions:
Abduction of the hip (lifting the leg to the side)
Medial (internal) rotation of the hip (anterior fibers)
Lateral (external) rotation of the hip (posterior fibers)
Pelvic stabilization during walking (prevents the opposite hip from dropping—Trendelenburg gait if weak)
🟩 3. Iliocostalis (Part of the erector spinae group)
Primary Actions:
Extension of the spine (when contracting bilaterally)
Lateral flexion of the spine (when contracting unilaterally)
Assists with posture and maintaining spinal alignment
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Monclús-Díez G, Díaz-Arribas MJ, Fernández-de-Las-Peñas C, Kosson D, Kołacz M, Kobylarz MD, Sánchez-Jorge S, Valera-Calero JA. Prevalence of Myofascial Trigger Points in Patients with Radiating and Non-Radiating Low Back Pain: A Systematic Review. Biomedicines. 2025 Jun 12;13(6):1453. doi: 10.3390/biomedicines13061453. PMID: 40564172; PMCID: PMC12190296.
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