The quadratus lumborum attaches inferiorly to the iliolumbar ligament and iliac crest via a broad tendinous layer, and superiorly to the inferior border of the 12th rib and transverse processes of L1-L4. The iliac attachment forms the thickest tendinous component and is the primary site of pathology.
Quadratus lumborum tendinopathy is an underdiagnosed cause of lateral low back pain, often presenting as pain worse with lateral trunk flexion and sustained sitting. It is distinguishable from facet joint pain by its more lateral localisation and response to side-lying manual therapy. Trigger points within the musculotendinous junction can refer to the groin.
Degenerative or inflammatory change at the iliac or 12th rib insertion producing lateral low back pain with trunk side flexion, commonly mistaken for facet joint syndrome.
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