Chronic Low Back Pain – Psoas

Psoas major is your primary hip flexor. It can cause a well defined and excruciating pain pattern. The two psoas muscles and ileacus together are called iliopsoas.

Dysfunction on either side will cause you pain on that side in a diffuse spot in the lower back. There are seven primary muscle groups that refer pain into the low back. However, this is one of two found on the front of the body.

The first step in untangling any case of lower back pain is to confirm or eliminate more serious spinal injury or degeneration as a cause. After consultation with trained medical professionals, you can focus on the soft tissue aspects of chronic lower back pain – psoas is just one them.

low back pain psoas trigger points

Trigger points in the psoas muscle cause chronic low back pain. Problems with other muscles often activate iliopsoas secondarily. For instance, a fall or sudden overload can activate psoas simultaneously with these other muscles.

Prolonged flexion can activate iliopsoas trigger points. For example, sitting with the hips flexed for a long time shortens these muscles and promotes myofascial dysfunction and trigger points in the psoas.

In fact, sustained immobility in any seated position will reduce circulation and aggravate iliopsoas trigger points.

Psoas has a helper. The rectus femoris muscle is the only one of the quads that crosses the hip. It assists in hip flexion. Tight bands in this muscle prevent full hip extension and can make trigger points in the iliopsoas worse. See the article on Knee Pain for rectus femoris self care.

What Makes This Type of Low Back Pain Worse?

Some types of skeletal variations can also make myofascial dysfunction of the psoas worse. A trained professional should evaluate these.

A soft mattress that sags in the middle aggravates tension in the low back muscles. There are many types of mattresses available; what you replace it with is a largely a matter of taste but we recommend a firm mattress.

The overload caused by the repetitive vigorous contractions of situps and improperly performed crunches can increase dysfunction of the iliopsoas. Consider the eccentric contraction of slow sit-backs as pictured or some of the many plank variations instead.

Forceful attempts to lengthen the hamstrings by reaching strenuously for the toes can cause sudden overload of iliopsoas. Instead, you can avoid the low back pain that this causes by performing more gentle, passive stretches of the hamstrings.

More importantly, ongoing issues with the iliopsoas can cause distorted posture that overloads back and neck muscles, perpetuating trigger points and dysfunction in them.

How Can I Help Myself With Low Back Pain?

When sitting for prolonged periods, try to modify your seating so that your the angle of your hips is more open. The tilting stool pictured is just one of a variety of ways you can achieve this. This type of seating is a better alternative than standing for many office workers. When driving, cruise control will provide you the opportunity to move a bit over extended distances.

low back pain - psoasIf you sleep on your back a pillow under the knees will provide gentle flexion at the hip and reduce stress on the iliopsoas. When sleeping on the side it is important to avoid sleeping in the fetal position, with the hips sharply flexed.

There are many ways to stretch the iliopsoas. One easy and safe way that requires no equipment is the low lunge. As you can see, for this purpose, the movement of is forward (not “deeper”) to provide gentle extension of at the hip for the trailing leg. Some YouTube videos provide is a good illustration of a safe active psoas stretch with warmup and a deep low lunge.