Which muscles are involved in low back pain?

The Gluteal muscles

The gluteal muscles are a group of three muscles making up the buttocks: the glutes maximus, gluteus medius and the gluteus minimus. They originate from the back of the pelvic bone ilium and sacrum and end on the thigh (femur).

The largest and the most superficial of the three gluteal muscles is the gluteus maximus. It makes up a large portion of the shape and appearance of the hips. The functions of the muscles are extension, abduction, external and internal rotation of the hip joint.

Gluteus maximus starts from the posterior gluteal line of the inner upper ilium crest, the posterior surface of the lower part of the sacrum and the side of the coccyx, aponeurosis of the erector spinae, sacrotuberous ligament and the fascia covering the gluteus medius. The gluteal maximus go downward and lateralward and insert into iliotibial band and glutealtuberosity. It extends and laterally rotates the hip and extends the trunk. Gluteus maximus injury is a common source of the low back pain. Trigger points are often presents at the originated fibers. The pain can radiate to the thigh, knee, leg and even foot like sciatic pain.

Erector spinae muscles

The erector spinae muscles are a group of muscle and tendons lying along the side of the spine. They arise from the anterior surface of the tendon attached to the medial crest of the sacrum, spinous processes of the lumbar and last two thoracic vertebrae, the supraspinous ligament, the innerpart of the iliac crest and the lateral crest of the sacrum. They extend up through lumbar, thoracic and cervical regions. This group of muscle include iliocostalis, longissimus and spinalis. The erector spinae make the back straight and rotate the back from side to side. Injury, strain chronic inflammation to these muscles may cause back spasm, pain and stiffness.

Others

The quadratus lumborum is a deep muscle at the back that runs from the last ribs and transverse processes of lumbar vertebrae to the top of the pelvis. It is quadrilateral in shape and forms posterior abdominal wall. When one side of the muscle contract, it flexes the spine laterally; when both side of the muscles contract, it extends the spine; it helps expiration and inhalation; and when it contracts on one side, it elevates pelvic bone. If trigger points are present in this muscle, it is a common source of low back pain. This is often caused by overuse, poor posture, stress, strain and tension from twisting, bending or lifting improperly etc.

The psoas major muscles are the deep muscles by the sides of the spinal column. They go downwards to the pelvic bone and end at lesser trochanter of the femur. Illacus muscles start from the interior side of the pelvic bone. The psoas major and the illacus muscles join together and form the iliopsoas. These muscles connect the core and lower limbs and they flex the hip joint, bend the spine forward and laterally and raise the spine from supine position. The pain and trigger points related to iliopsoas is at the low back and upper thigh. Walking and standing upright can be painful, if there are trigger point present in these muscles.

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