I can't stress the importance of mastering lower back trigger points (aka lower back knots) enough. I suffered for 4 years of crippling back pain - and the knowledge in this post is how I got out of pain AND live pain-free today. There is light at the end of the tunnel, do not give up on your lower back before trying trigger point release techniques!
Trigger points are one contributing factor to the mysterious, painful phenomena of muscle pain. When trigger points are present, your muscles constantly pull on your joints, producing a ton of pain in the body - especially in the lower back. Effective trigger point release of a few specific muscles could be the missing link between you and a pain-free lower back.
Lower Back Trigger Points: How They Cause Pain
What is a trigger point? As described by the great Travell and Simons, the trigger point therapy pioneers and authors of Myofascial Pain and Disfunction, a trigger point is:
"a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. This spot is painful on compression and can give rise to characteristic referred pain, referred tenderness, motor dysfunction, and autonomic phenomena" [2].
In layman's terms, this means a trigger point is an angry knot in muscles that can cause pain locally or referred pain elsewhere in the body [1].
There are a few particular muscles (5 are most prevalent) that contribute to lower back pain specifically when trigger points are present. This article describes what they are and how to release them. It may surprise you that of these 5 muscles, only 1 muscle is local to the lower back - the rest refer pain from unsuspecting places.
Lower Back Trigger Points: The Muscles
There are 5 main muscles that can cause lower back pain when ridden with trigger points - Quadratus Lumborum (QL), Psoas, Iliacus, Gluteus Medius, and Piriformis. Each of these can refer pain via a different mechanism to the lower back, but all you need to know is what they are, what their pain patterns look like, and how to release them.
All 5 main muscles can be released at home with the deep tissue massage tool, the QL Claw. I personally created QL Claw to hit all the lower back trigger points and muscles below, eliminating guesswork and effectively massaging difficult-to-reach places.
The 5 Muscles And Their Lower Back Trigger Points
Muscle 1: Quadratus Lumbroum (QL)
Up first we have the only muscle in this post that actually lives in the lower back - Quadratus Lumborum (QL). The QL muscle lies deep in the lower back on both sides of the spine, and it can create the gnarly pain pattern below when trigger points are present. When trigger points are present, deep tissue massage with the QL Claw (named after the QL muscle) is your best bet to relieve tension and eliminate pain.
Quadratus Lumborum Referred Pain Pattern [1]
Muscles 2 & 3: Psoas and Iliacus
Next are the two hip flexor muscles in the front of the body that contribute to a ton of lower back pain when tight - the Psoas and Iliacus (Iliopsoas trigger points). These two muscles are often referred to together as the Iliopsoas complex because they function and cause pain in the same way. Both muscles tend to get chronically tight from excess sitting and can refer a ton of pain to the lower back in the process. In addition, incorrectly doing exercises like sit-ups and leg lifts can hyperactivate Iliopsoas and refer the following pain pattern as well.
Iliopsoas Referred Pain Pattern [1]
Muscle 4: Gluteus Medius
Gluteus Medius is a lesser-known perpetrator of lower back pain via trigger points. Gluteus Medius lies in the upper buttock region and is one that can wreak complete havoc on the lower back when tight. Gluteus Medius tension alone can pull the pelvis into a posterior tilt, which can cause pain by itself.
Deep tissue massage is the best strategy for releasing tension and breaking up rigid muscle fibers that cause lower back pain in Gluteus Medius. This can be done by the hands of a professional, or at home with QL Claw. The pain pattern below illustrates what Gluteus Medius can refer in and around the lower back with its trigger points.
Gluteus Medius Referred Pain Pattern [1]
Muscle 5: Piriformis
The Piriformis muscle is a small deep glute that can cause a lot of pain in the outer glute and tailbone when trigger points are present. The pain caused by Piriformis can feel more like buttock or tailbone pain, but some characterize this pain as in the lower back.
Piriformis Referred Pain Pattern [1]
How To Release Lower Back Trigger Points
At this point, you may be overwhelmed by the strange muscles or have no clue what to do next. Look no further, we have taken care of the lower back trigger point fix for you.
Allow me to introduce QL Claw - the only massage therapy tool designed specifically to release all 5 of the lower back pain-inducing muscles in this post. QL Claw is a deep tissue, trigger point release tool that you can use on yourself whenever and wherever you need it. Learn more about QL Claw and its magic on lower back trigger points below!
Lower Back Trigger Points Worked In Action (On The QL Muscle)
Lower Back Trigger Points FAQ:
What Causes Trigger Points In The Lower Back?
Trigger points generally develop from straining a muscle. This can happen during an intense physical activity without a warmup (i.e. lifting a couch), or gradually straining a muscle (i.e. sitting with slumped posture for 10 years).
Trigger points, knots, and constant tension in the muscles in and around the lower back can pull on joints, impinge nerves, and create extreme discomfort.
How To Treat Trigger Points In Lower Back:
Deep tissue massage is the best way to release lower back trigger points. This can be done with the hands of a professional physical therapist, massage therapist, or chiropractor - or at home with a purposefully made tool like QL Claw.
Trigger Points In Lower Back vs. Upper Back:
Trigger points can develop anywhere there is muscle. Upper back trigger points can generally be worked out easier with a foam roller or massage at home, while trigger points in the lower back tend to be more complex. The lower back is a much more complex, busy area muscle-wise.
*Also see: Why Does My Upper Back Hurt When I Breathe
Lower Back Trigger Points - Video Summary
The topic of lower back pain from trigger points in video format. Solving lower back trigger points was how I got out of years of back pain, and potentially how you can too:
Sources/Influences:
[1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.
[2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.