A common source of lower back pain is the trigger points in the quadratus lumborum, also known as The Joker.
One of the key functions of this important but relatively small back muscle group is to stabilise the lumbar spine and without it we struggle to stay upright! That’s why quadratus lumborum trigger points can leave you crawling around on your hands and knees — the pain is simply too great to stand up, never mind walk. Pain can also be referred to the sacroiliac joint, hips, buttocks, greater trochanter and thigh.
So what activates these troublesome trigger points? Falls and motor accidents are one cause, but sometimes it can as simple as simultaneously bending down and reaching over to one side to pick up or lift something.
The quadratus lumborum is tricky to treat and you’re not going to be able to deactivate all the trigger points yourself. So your best course of action is to visit a therapist who can use myofascial release and trigger point therapy to get the healing process started and then show you exercises you can do at home.
If you have to wait for an appointment, there are a few things you can do to avoid making matters worse…
- Make Sitting or standing more tolerable by unloading some upper body weight from the lumbar spine — try pushing your arms down against the arms of a chair if sitting, or placing your hands on your hips and pushing downwards when standing
- Avoid twisting sideways when reaching forwards and down
- Try sleeping on the unaffected side, to encourage better relaxation
- Sleep with a pillow between your knees
- Avoid unaccustomed strenuous physical activity
- Stay seated when putting on trousers, pants and socks
- Keep your body warm — heat wraps such as those made by Thermacare can be very effective and allow you to stay on the move while benefiting from heat therapy. You can keep them on for hours at a time, but they are for one use only — as soon as you take them off, the heat is lost.
Once your trigger points have been deactivated and you’re pain-free, try these preventative stretches to help keep you that way…
Standing lateral side stretch
Stand with your feet about shoulder-width apart and look forward. Keep your body upright and slowly bend to the left or right. Reach down your leg with your hand and do not bend forward. Do 10 stretches to each side in time with your breathing. Do not lean forwards or backwards: concentrate on keeping the upper body straight.
This stretch can be enhanced further and performed with a small weight in the hand stretching down, and the other hand placed lightly to the side of the head. Only add in the weight if you require a further stretch. This video show you how to do this stretch correctly.
Standing back rotation stretch
Stand with your feet about shoulder-width apart. Place your hands across your chest while keeping your back and shoulders upright. Slowly rotate your shoulders to one side. Do 10 stretches to each side.
To further extend this stretch, use your hands to pull your upper body further around.
Maintaining a healthy back may also involve you in assessing the condition of your mattress. If it’s past its best but you can’t justify replacing it just yet, consider investing in a memory foam mattress topper instead. Go for one that’s at least 3 inches thick.