When considering how to make this specific article we’ve ran into some conflict whether we should focus on movements, as was done when explaining the Shoulder Pain or should we focus on the muscles involved and supply examples for the pain they may reflect.
We’ve decided in the end to take the second option, should you have a specific question, using the movement method, please feel free to contact us and we’d do our best to supply with a satisfying answer.
First things first, lower back pain can be caused due to several reason, from spinal condition (i.e. Retrolisthesis, Anterolisthesis, Spina Bifida, etc.) through bulging discs and nerve compressions (Kabeer et al., 2023) and finally with our topic for today, muscles (Seyedhoseinpoor et al., 2022, Matheve, Hodges and Lieven Danneels, 2023).
Make no mistake, lower back pain (LBP), can be caused from either the upper or lower body. It does not have to originate from the lumbar area (the lower segments of the spine), even though it is felt there.
Anatomically, the lower back is the area between the 12th rib and the Iliac Crest. It contains the Lumbar spine [L1 to L5 vertebrae (plural for vertebra)]. It may differ through different books you check, but for this article, that is the area we will focus on when presenting with pain.
When a client complains about LBP, the assessment should consist of range of motion testing, the questions of where is the pain felt exactly; when is the pain felt; and what was the trigger for the pain along with specific tests that might be required. According to the findings, further assessment may take place above the pelvic area or below it, in order to pin point the cause and treat it. It is crucial to remember, the location of the pain might not be the cause of it.
For the sake of the article, we’re going to use the Iliac crest as the border line between the upper and lower muscle groups that can cause LBP.
Superior to Iliac crest
Erector Spinae
Consisting of 3 muscles: Iliocostalis, Longissimus and Spinalis, the Erector Spinae are usually the first to be examined when presenting with LBP.
While following the spine the whole way up to the neck, in our experience, most of the pain they cause is found in the lumbar region.
Releasing the tension from the erectors could be done either by stretching (which would include bending the spine forward), going through some massage work with a qualified practitioner, or training within the limits of pain under the guidance of a qualified trainer who understands your condition and can draw the line so you won’t injure yourself further.
Quadratus Lumborum (QL)
The QL originate from the Iliac crest and grabs a hold on both the lower rib, and the Lumbar Spine. The region the QL is covering is where LBP is usually described.
The QL is the deepest back muscle and is part of the core muscle in charge of posture control. It can work either unilateral (one side is contracting) or bilateral (both sides contracting). When contracting unilateral the QL would help with side bending of the spine, whereas when contracting bilateral the QL would assist with the extension of the spine.
Releasing the tension from the QL can be done through stretching, in which the client would be asked to side bend away from where they feel the pain, and lean forward creating a two dimensional movement in the spine allowing the muscle to stretch.
As with all the muscles we are going to cover, manual therapy with a qualified practitioner is a great way of addressing this muscle.
Psoas Major
Sharing an insertion point with Iliacus (see below), Psoas Major originates from the Lumbar Spine and is the only muscle in the body that attaches to the discs.
Should the Psoas Major be contracted, it would either pool the hip towards the abdomen, or pull the spine towards the hip, shortening the muscle length and causing an anterior tilt of the spine.
Due to it being involved with flexion of the hip, over extending it would supply us with the needed stretch to help relieve the pain. However to make it a sufficient stretch, you might want to suck your stomach in, forcing the pelvic to tilt backwards.
Another way of addressing the pain is receiving manual therapy, however, be warned, it might not be the most comfortable sensation as it is a deep muscle with access only through the belly.
Inferior To Iliac Crest
Iliacus
Sharing insertion point with Psoas Major, it originates on the Iliac Fossa. Shortening of Iliacus would cause the hip to be drown towards the abdomen or create an anterior pelvic tilt which will cause discomfort.
A release to this muscle is tied with the release of Psoas Major,
Gluteus Maximus
Stretching across the Ilium and the Sacrum, the Gluteus Maximus has a strong hold and effect on the lower spine, when contracted it pulls the pelvis into a posterior tilt, which would reposition the spine and remove the natural arch from it. Due to the unnatural new position of the spine, you may feel discomfort in the area.
Releasing the Gluteus can be done by stretching, which would involve placing the heel of the shortened side as close as possible to the contralateral ASIS (the boney area you can feel below you abdomen on the hips) and getting the knee as far away from the body as possible.
This stretch can be done both facing up and facing down, along with standing and using an elevated platform the place the leg. The stretch changes according to your physical abilities.
Tensor Facia Latae (TFL)
Small, yet trouble making. The TFL originates from the Iliac Crest, and inserts into the Iliotibial Band (ITB). Due to it’s insertion, the TFL is in constant clash with the Gluteus Maximus, as both effect the ITB, each towards it’s own side. Any issue in the Gluteus Maximus may cause tension in the TFL and vise versa.
Overall, the TFL would not be triggered alone, and would have a few muscles affected by it, Lumbar pain is one of it’s symptoms but not the worst of them.
Stretching the TFL may prove difficult, and the best suggestion we can give you is go for a manual therapist to have a look and treat it for you. A very common way that people use is the rollers on the ITB, according to Pepper et al. 2021, stretching and foam rolling does not alter the stiffness of either ITB or TFL.
Rectus Femoris (Long head of the Quadriceps)
The long head of the Quadriceps, the only one of the group to connect to the pelvis and have an influence on the hip.
Excessive use of the Quadriceps can lead to a constant pull originating from the Rectus Femoris on the pelvic resulting with the same effects of the Psoas Major and Iliacus when inspecting the pelvic tilt.
However, unlike the the two, to stretch the Rectus Femoris better, other then over extending the hip, you should add a flexion of the knee, for the Quadriceps muscle is the sole extensor of the knee, which would require a flexion if willing to stretch it or parts of it.
Hamstrings
The Hamstrings are a group of 3 muscles (Biceps Femoris, Semitendinosus and Semimembranosus) originating from the Ischial Tuberosity and going over the knee.
Their pull is similar to the pull of the Gluteus Maximus when inspecting the position of the pelvic bone, both would pull the pelvic backwards (into a posterior pelvic tilt position) which would result in the straightening of the spine.
Common stretch for the Hamstrings would be to extend the knee and flex the hip as much as possible, either when lying on the back, or when standing. In both cases you would like to try and reach the toes of the leg your are stretching while maintaining as straight as possible back.
The described above, are the main muscles we think should be looked at, there could be other less commonly known cases that would require further study and understanding, but in general those might be the cause for your pain. In all cases it is best advised to go to a qualified therapist for proper examination and referral if needed. For any issue you may have, let us know through the contact page area. Stay Safe!
Content Last Reviewed & Updated September 2025 – All statistics, references, and therapy recommendations have been reviewed to ensure current best practices.
References
Pepper TM, Brismée JM, Sizer PS Jr, Kapila J, Seeber GH, Huggins CA, Hooper TL. The Immediate Effects of Foam Rolling and Stretching on Iliotibial Band Stiffness: A Randomized Controlled Trial. Int J Sports Phys Ther. 2021
Kabeer, A.S., Osmani, H., Patel, J.J., Robinson, P. and Ahmed, N. (2023). The adult with low back pain: causes, diagnosis, imaging features and management. British journal of hospital medicine, 84(10), pp.1–9. doi:https://doi.org/10.12968/hmed.2023.0063.
Matheve, T., Hodges, P.W. and Lieven Danneels (2023). The Role of Back Muscle Dysfunctions in Chronic Low Back Pain: State-of-the-Art and Clinical Implications. Journal of Clinical Medicine, 12(17), pp.5510–5510. doi:https://doi.org/10.3390/jcm12175510.
Seyedhoseinpoor, T., Taghipour, M., Dadgoo, M., Sanjari, M.A., Takamjani, I.E., Kazemnejad, A., Khoshamooz, Y. and Hides, J. (2022). Alteration of lumbar muscle morphology and composition in relation to low back pain: a systematic review and meta-analysis. The Spine Journal: Official Journal of the North American Spine Society, [online] 22(4), pp.660–676. doi:https://doi.org/10.1016/j.spinee.2021.10.018.
Images taken from Sobotta – Atlas of Human Anatomy, 11th English Edition, Vol. 2