Thigh & Low Back Pain Caused By Trigger Points

Introduction

The posterior section of the lower half of the body consists of the hips, low back, pelvis, legs, and feet, which provide stability to the body while supporting the upper body’s weight. The various muscles surround the lower extremities and make different motions for mobility and functionality by contracting and retracting when the legs and hips are in motion. The various muscles that provide stability to the hips and the legs are the iliopsoas muscles. When normal age or incidents affect the lower body extremities, it can correlate to the development of trigger point pain. Today’s article examines the iliopsoas muscles, how referred trigger pain affects the thighs and low back, and treating trigger point pain on the thighs and low back. We refer patients to certified providers who incorporate multiple techniques in the low back and thigh pain therapies related to trigger points to aid individuals dealing with pain symptoms along the iliopsoas muscle in the lower back, thigh, and near the pelvis. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

What Is The Iliopsoas Muscle?

Have you been dealing with muscle cramps in your thighs? What about feeling muscle stiffness in your lower back when you are stretching? Or do you feel your thigh muscles become heavy after a workout? Many of these issues correlate with the iliopsoas muscle becoming overused and developing trigger points, thus affecting the thighs and lower back. In the lower body extremities, the muscles that help provide stability to the hips are the iliopsoas muscles. The iliopsoas muscles consist of three muscles: iliacus, psoas major, and psoas minor, which can work individually or as a unit. When working individually, the iliacus muscle provides stability to the pelvis, the psoas major muscle helps stabilize the lumbar spine when a person is sitting, and the psoas minor helps with flexion of the trunk and stretch the iliac fascia. As a unit, however, these muscles work together to become the primary flexors of the thighs and allow hip flexion. 

Studies reveal that the iliopsoas is a deep muscle group that anatomically connects the spine to the body’s lower limbs. The iliopsoas muscles have an important function in the body’s lower limbs as primary hip flexors for daily activities, especially for those in sports. However, many impairments and pathologies affect the iliopsoas, which causes significant limitations and challenges since the symptoms mask the pain, causing individuals to think they are dealing with low back and hip pain. 

Referred Trigger Pain On The Thighs & Low Back

Since the iliopsoas muscles provide hip and thigh flexion to the lower body, many impairments and pathologies can affect this muscle group, causing issues in the hips, thighs, and even the lower back. These impairments can cause the iliopsoas muscles to be overused and overstretched, thus potentially developing trigger points along the iliopsoas muscles, causing referred pain on the thighs and low back. Studies reveal that when the iliopsoas muscle becomes overused or traumatic issues affect it, it can lead to problems in hip flexion and impairment in the lower extremities. In “Myofascial Pain and Disorders: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., when trigger points begin to affect the iliopsoas muscles, it is known as the “Hidden Prankster” as normal factors like poor posture can overload the back causing trigger points to form not only on the iliopsoas muscles but the hamstrings, gluteal, thoracolumbar paraspinal, and posterior cervical muscles. Trigger points can mimic other chronic conditions that cause referred pain in different body areas. Trigger point pain in the iliopsoas muscle can lead to back pain, groin pain, snapping hips, and standing up difficult for the individual if it is not treated immediately.

Trigger Point Therapy: Iliopsoas Muscle- Video

Since the iliopsoas muscles provide hip and thigh flexion to the lower body, many impairments and pathologies can affect this muscle group, causing issues in the hips, thighs, and even the lower back. These impairments can cause the iliopsoas muscles to be overused and overstretched, thus potentially developing trigger points along the iliopsoas muscles, causing referred pain in the thighs and low back. Studies reveal that when the iliopsoas muscle becomes overused or traumatic issues affect it, it can lead to problems in hip flexion and impairment in the lower extremities. In “Myofascial Pain and Disorders: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., when trigger points begin to affect the iliopsoas muscles, it is known as the “Hidden Prankster” as normal factors like poor posture can overload the back causing trigger points to form not only on the iliopsoas muscles but the hamstrings, gluteal, thoracolumbar paraspinal, and posterior cervical muscles. Trigger points can mimic other chronic conditions that cause referred pain in different body areas. Trigger point pain in the iliopsoas muscle can lead to back pain, groin pain, snapping hips, and standing up difficult for the individual if it is not treated immediately.

Treating Trigger Point Pain On The Thighs & Low Back

When trigger point pain begins to cause issues in the thighs and low back, the iliopsoas muscles will suffer from muscle spasms, stiffness, and difficulty standing. This is due to nerve entrapment from aggravated iliopsoas muscles caused by trigger points. However, various treatments can manage trigger point pain in the thighs, and low back through multiple techniques that pain specialists utilize can help relieve the pain symptoms from the iliopsoas muscle and manage trigger point pain. Studies reveal that combination treatments like soft tissue manipulation and trigger point therapy can help release the tiny nodules from the affected muscle and reduce the symptoms from re-occurring in the body. Other treatments, like correcting one’s posture, strength exercising, and even stretching, can help lengthen the iliopsoas muscles, stretch and strengthen the surrounding muscles, and prevent pain-like symptoms from affecting the thigh and low back muscles again. These various treatments can even improve hip mobility in the lower body extremities. 

Conclusion

In the lower body extremities, an iliopsoas is a group of deep muscles that provide stability to the lumbar spine and allow hip and thigh flexion. These groups of deep muscles can work individually or together to enable the individual to sit, stand and move around through physical activities; however, when the iliopsoas muscles become overused or suffer from a traumatic event, they can develop trigger points that can cause mobility issues on the thighs, hips, and lower back. Even though trigger points are difficult to diagnose, they are treatable through various treatments. Various treatments, like soft tissue massages, trigger point therapy, strength exercising, or stretching the iliopsoas muscles, can release trigger points from the affected body part and help bring back mobility function to the hips, thighs, and low back.

References

Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Iliopsoas Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 2 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK531508/.

Dydyk, Alexander M, and Amit Sapra. “Psoas Syndrome.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 12 June 2022, www.ncbi.nlm.nih.gov/books/NBK551701/.

Kameda, Masahiro, and Hideyuki Tanimae. “Effectiveness of Active Soft Tissue Release and Trigger Point Block for the Diagnosis and Treatment of Low Back and Leg Pain of Predominantly Gluteus Medius Origin: A Report of 115 Cases.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6382483/.

Lifshitz, Liran, et al. “Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment.” Current Sports Medicine Reports, U.S. National Library of Medicine, June 2020, pubmed.ncbi.nlm.nih.gov/32516195/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

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