Lower back pain is one of the most common complaints people face, whether from long hours at a desk, lifting heavy objects, or simply moving the wrong way. Among the many muscles that can contribute to this discomfort, the quadratus lumborum (QL) often goes underappreciated. When strained, this deep muscle can cause sharp pain, stiffness, and restricted movement that affects everyday life.

Osteopathy, a holistic approach to healthcare that focuses on the body’s structure and function, offers targeted ways to treat and manage a strained QL. By addressing not just the muscle itself, but also the surrounding tissues, joints, and posture, osteopathy helps restore balance and reduce pain.

In this article, we’ll break down what the QL does, how strains happen, what symptoms you might experience, and most importantly, how osteopathic treatment can make a meaningful difference. 

Understanding the Quadratus Lumborum (QL)

The quadratus lumborum is a deep, thick muscle located on both sides of your lower back. It sits between your ribcage and pelvis, attaching from the iliac crest (top of the pelvis) up to the 12th rib and the lumbar vertebrae.

Because of this unique positioning, the QL has several important functions:
  •  Stabilisation: It helps stabilise the spine during movement.
  •  Side bending: It assists in bending the torso sideways.
  •  Breathing: It anchors the 12th rib, playing a role in deep breathing.
  •  Posture: It contributes to upright posture by supporting the lower back.

When healthy, the QL works quietly in the background. But when strained, its role in stabilisation means that pain can radiate across the lower back and even mimic other issues, such as disc problems or hip pain.

Causes of QL Strain

 A strained QL usually results from overuse, poor posture, or sudden movements. Some common causes include:

• Prolonged sitting: Sitting for hours, especially with poor posture, shortens and tightens the QL.
• Heavy lifting: Picking up heavy objects with poor technique puts excessive strain on the muscle.
• Repetitive bending or twisting: Jobs or sports requiring these motions can fatigue the QL.
• Weak core muscles: If abdominal and glute muscles aren’t supporting the spine properly, the QL overcompensates.
• Leg length discrepancy or uneven gait: Imbalances in movement force one side of the QL to work harder than the other.

Symptoms of a Strained QL

The signs of a strained QL can vary but often include:
  •  Localised lower back pain, especially on one side.
  •  Pain that worsens with sitting, standing, or walking for long periods.
  •  Difficulty bending sideways or rotating the torso.
  •  Discomfort when breathing deeply or coughing.
  •  A feeling of tightness or knots in the lower back muscles.

Because the QL is deep, the pain may feel dull and achy, but flare into sharp discomfort with specific movements.

How Osteopathy Helps With QL Strain

Osteopathy takes a whole-body approach. Rather than just treating the site of pain, an osteopath investigates why the QL became strained in the first place. This might involve examining posture, spinal alignment, hip mobility, and even breathing patterns.

Here are the key ways osteopathy can help:

1. Manual Therapy for Pain Relief

Osteopaths use hands-on techniques such as soft tissue massage, stretching, and trigger point therapy to reduce tension in the QL. These methods help:

  •  Improve blood flow to the muscle, promoting healing.
  •  Reduce muscle spasms and tightness.
  •  Relieve referred pain patterns.

By releasing tightness in the QL, pain decreases and movement becomes easier.

2. Restoring Spinal and Pelvic Alignment

A strained QL often coincides with misalignments in the lumbar spine, pelvis, or hips. Osteopaths use gentle joint mobilisations and manipulations to restore proper alignment. This reduces the workload on the QL and helps prevent recurring strain.

3. Addressing Compensations

The body often compensates for a painful QL by recruiting other muscles, which can create secondary problems in the hips, glutes, or even upper back. Osteopaths identify and correct these compensations, ensuring the whole musculoskeletal system works together efficiently.

4. Breathing and Rib Mobility

Because the QL attaches to the 12th rib, restricted breathing can aggravate the muscle. Osteopaths may work on rib mobility and diaphragm function, improving respiratory mechanics and reducing strain on the QL.

5. Posture and Ergonomics

An osteopath doesn’t just treat symptoms—they also guide you on how to prevent future problems. They may analyse your posture, workstation setup, or lifting technique, and provide tailored advice to reduce daily strain on the QL.

6. Rehabilitation and Exercise Prescription

Once pain is under control, strengthening and stretching are key. Osteopaths prescribe specific exercises to:
  •  Stretch a tight QL.
  •  Strengthen core muscles to provide better spinal support.
  •  Improve hip mobility to reduce compensatory stress on the lower back.

This active component ensures long-term recovery rather than just short-term relief.

Example of a Typical Osteopathic Session for QL Strain

A session might look like this:
  1. Assessment: The osteopath takes a full history, then examines your posture, movement, and areas of tenderness.
  2. Treatment: They use gentle massage, stretching, and joint techniques to release tension and restore alignment.
  3. Breathing work: If needed, they mobilise the ribs and diaphragm.
  4. Advice: You may be shown stretches like the “child’s pose side stretch” or core activation exercises.
  5. Follow-up: Depending on severity, a few sessions may be recommended, alongside home exercises.

Self-Care and Prevention Tips

In addition to osteopathic treatment, you can take steps at home to support recovery and prevent recurrence:
  •  Apply heat: A warm compress helps relax tight QL muscles.
  •  Stay active: Gentle walking encourages blood flow and prevents stiffness.
  •  Stretch regularly: Side bends and hip stretches can ease tension.
  •  Strengthen your core: Planks, bridges, and pelvic tilts reduce the burden on the QL.
  •  Mind your posture: Avoid slumping in chairs; sit tall with proper lumbar support.

When to Seek Professional Help

While mild QL strains may ease with rest and self-care, you should consult an osteopath or healthcare professional if you experience:
  •  Persistent or worsening pain.
  •  Pain radiating into the leg, which may suggest nerve involvement.
  •  Difficulty standing upright or walking.
  •  Recurrent lower back issues despite self-care.

An osteopath can differentiate between a simple muscle strain and more complex conditions, ensuring you get the right treatment.

 Conclusion

A strained quadratus lumborum can be frustrating and painful, affecting everything from sitting at your desk to breathing deeply. Because the QL plays such a central role in stabilising the spine and maintaining posture, addressing it properly is essential for lasting relief.

Osteopathy offers a comprehensive solution by combining hands-on treatment, postural correction, breathing work, and exercise prescription. Instead of just targeting symptoms, osteopaths look at the bigger picture—helping not only to ease the immediate pain but also to prevent future strains.

If you’re struggling with lower back discomfort that doesn’t seem to go away, it may be time to consider osteopathy. With a tailored approach, you can restore balance, reduce pain, and get back to moving comfortably in daily life.