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Quadratus lumborum muscle

Contents

Anatomy and supply

The quadratus lumborum muscle is a muscle of the posterior abdominal wall lying deep inside the abdomen and dorsal to the iliopsoas. In order to palpate the muscle one needs place the fingers above the posterior iliac crest at the level of the hip. Starting from the iliac crest of the ilium and from there it runs craniomedially, and attaches to the 12th rib and the transverse processes of the 1st to 4th lumbar vertebrae. All fibers together give the muscle a rectangular appearance. The innervation is supplied by the subcostal nerve and branches of the lumbar plexus.

The quadratus lumborum fills a great amount of space within the abdomen and is therefore in close proximity to many structures. The colon, the kidneys and the diaphragm are located ventrally to the muscle, whereas the intrinsic back muscles lie dorsomedially. Both the iliohypogastric and ilioinguinal nerves course on the ventral surface of the quadratus lumborum after exiting the lumbar plexus and continue towards the lateral abdominal muscles.

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Function

Essentially, the quadratus lumborum contributes to the stabilization and movement of the spine and the pelvis. A bilateral contraction leads to an extension of the lumbar vertebral column. When the muscle is only activated on one side, the trunk is bent towards that direction (lateral flexion). In addition, the muscle fixes the 12th rib during movements of the thoracic cage and this way supports expiration (accessory muscle of expiration).

Pathology

Overuse and strain of the quadratus lumborum are one of the major causes for chronic pain in the lower back. One typical cause is the habit of sitting at the desk using a reclined seat, which releases the intrinsic back muscles and weakens them in the long term. The weak back muscles must now be compensated by the quadratus lumborum leading to painful tension and stiffening of the muscle. Other causes can be direct damage or any type of imbalance of the pelvis or spine which forces the quadratus lumborum to stabilize them. An example of that type of imbalance is unequal leg lengths.

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Show references

References:

  • D. Drenckhahn/J. Waschke: Taschenbuch Anatomie, 1st edition, Urban & Fischer Verlag/Elsevier (2008), p. 145
  • M. Schünke/E. Schulte/U. Schumacher: Prometheus – LernAtlas der Anatomie – Allgemeine Anatomie und Bewegungssystem, 2nd edition, Thieme Verlag (2007), p. 152 G.
  • Fors: Why we hurt – a complete physical and spiritual guide to healing your chronic pain, Llewellyn Publications (2007), p. 135-138

Author:

  • Achudhan Karunaharamoorthy

Illustrators:

  • Quadratus lumborum muscle - Yousun Koh 
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

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