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Quadratus Lumborum/Gluteus Minimus
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By Jonny d
Apr 1, 2012

Three months ago, I started experiencing some left-side-only lower back pain traveling down to the hip joint, primarily when doing leg presses. Seems to have started after a hard climbing day. I've tried just ignoring it and trying to work through it, but the pain has steadily progressed. Finally broke down to see the chiropractor on Friday. She made some adjustments and things felt better when I left the office, but I couldn't walk from the bed to the bedroom door on Saturday morning without having to lie down for a bit on the floor. Same routine this morning. Been reading some trigger point material that suggest issue is related to the QL which quickly involves the GM. ER doc buddy of mine ran me through the lower-back protocol-- no kidney probs, unlikely to be nerve problem; his take is that lower back pain is one of the most-researched and little-understood things in medicine today and that, while everyone has their little "stand-by," docs really don't have much of a clue as to causation/treatment if it's muscular in nature. Anybody else on here ever experience this one? Particularly interested in non-pharmacological pain relief options. Can't even bend over without sharp pain right now. Pain is bad enough in morning that I feel nauseated. Feels OK standing straight up, but movement really kills me. Thanks in advance for any suggestions.


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By Peter Pitocchi
Apr 1, 2012
Pete belays 2nd pitch Little corner

Where is the pain exactly? Is it actuallly in the QL or lower? What actions worsen or relieve it? Sacroiliitis commonly cause pain a couple inches from midline, 4 to 5 inches below the iliac crest and can radiate to the groin. Affects atletes in their late thirties to late forties. Temporarily relieved with rest and much worse with arising from a bent, seated or stooped position. I had this and got relief from several weeks of avoiding exacerbating movements and stopping yoga style pelvis and back stretching. Eventually the joint fuses with age and I think mine was trying to fuse and my activties were preventing it. I am 48. Really need to know the exact location and start googling. I have gotten good info on yoga type websites. There are autoimmune causes of some cases but yours started with leg presses so probably you strained either the SI joint or a muscle. In either case it will probaly get better with reduced activity then eventually good as new.


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By Reed Fee
From White Salmon WA
Apr 1, 2012
Part of an anchor on Pingora.

My herniated L5 disk started with similar symptoms. Don't wanna scare you just saying.


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By Jonny d
Apr 2, 2012

Thanks Peter/Reed. Pain is in two places: (1) a 2-3 inch square of pain starting even with the iliac crest up against the vertebrae and out and up to the left; and (2) directly below and posterior of the left hip socket. Arising from bed or sitting feels pretty bad. Bending over is pretty much impossible. No radiation of pain to the groin.
-- Jonny


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By jody
Apr 7, 2012

I have had something similar sounding- well in a similar location with some of the same symptoms.

The first time it happened, I went to a doc, and he told me to get an mri. I didn't have good health insurance at the time; so, I looked on line and tried some stretching...

It got worse, so I went to a see a physical therapist. He put my legs in different positions and had me pull against his resistance. I felt something pop and felt immediate relief. I was sore the next day and progressively less so for the next week, as my muscles stopped spasming. I then was prescribed a series of stretching exercises that I did, and I my back was better until recently...

For me, the physical therapist was the best move.

Jody


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By Jonny d
Apr 9, 2012

Thanks, all. Things are slowly feeling better. Muscles started relaxing a little a couple of days ago. Friend of mine put me onto a book by Pete Egoscue called "The Egoscue Method of Health Through Motion." So far, I've been doing the exercises for the acute pain phase. No way I can tell whether the slow improvement is due to the exercises or not, but I'm certainly feeling better. May be worth checking out the Egoscue stuff if you've got back pain-- I kinda' like his theory even though it'd be tough to get empirical evidence on its application. The famous climber Jack Nicklaus swears by the Egoscue method. ;)


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By James I.
Apr 10, 2012

Hi Johnny,
Glad to hear things are improving. I am a massage therapist who has worked with some climbers before and lots of people with low back pain. Obviously it's hard to say what might be the cause without sight, but here are my thoughts. I think you're right with the QL and Glutes being a part of the problem. Sacroiliac dysfunction is usually quite point specific right at the confluence of the sacrum and the ilium (your pelvic bone) in the low back, yours seems to be a bit more diffuse.
It sounds like Jody's PT had her doing some psoas release maneuvers which helped her and could be a possibility in your issue. Your psoas and iliacus are two major hip flexor muscles that can cause debilitating low back pain (the I can't stand up straight kind).
In order to cover your bases my recommendation would be to do a glute medius stretch (google should get you something good, but it is essentially taking your left knee to the right shoulder and feeling the stretch in your butt) and a hip flexor stretch (again google but it is having your left knee on the ground your right foot out in front of you and moving forward slightly to feel the stretch in your left quad or higher).
Strengthening sounds like it is helping, a massage to these specific muscles may also provide some serious relief (the trick is finding a therapist who can treat them specifically and effectively). Let me know if that helps.

James


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