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Myofascial pain patterns of the quadratus lumborum muscle

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Myofascial trigger points (x's) in the quadratus lumborum are one of the most common sources of low back pain and the "failed surgical back syndrome." Symptoms include persistent, deep aching pain at rest that is most severe in the unsupported upright position. Myofascial trigger points typically restrict forward bending, turning, and leaning to the opposite side. Essential (solid red) and spillover (stippled red) referred pain commonly projects to the crest of the ilium, the sacroiliac joint, and the greater trochanter, often extending to the groin, inner thigh, and abdomen. (From Travell JG, Simon DG. Myofascial origins of low back pain. Volume 2. Torso muscles. Postgrad Med 1992;73:188, with permission.)