Self Care – Multifidi and Quadratus Lumborum

Activities to avoid:

Avoid the teetering exercises listed in the post on this trigger point. This includes things like vacuuming, sweeping, raking, working on a low counter, or doing dishes. Also, avoid exercises where you bend forward like moving boxes or picking up grandkids.

Cycling usually aggravates the low back as well.

Avoid the activities mentioned above until this your back has strengthened and stabilized. An IcyHot patch can help to avoid sharp pain and fatigue from these trigger points.



For temporary relief:

For relief on the go
or getting out of bed.

These topical patches offer a lot of relief for the fragile low back pain from the trigger point referral. They boost your energy during the day and when put on before bed, they can make getting out of bed much easier.

Put them where it is in this picture on the box. Feel for your ribs and hips in the back and center this patch in that area.

They are available. here on Amazon.

To stabilize and reduce inflammation:

Avoid heating pads with this trigger point.
It will feel good when applied but it usually feels worse after a few hours.

Icing helps to reduce pain and inflammation. The larger, longer ice pack below is good for covering the area from the lower ribs and middle of the hips. This will compress and stabilize the lumbar vertebrae.

Many clients have come to me over the years who use a heating pad at night. It makes rising easier, but the condition continues to worsen as the days go on. Consistently, they improve when they stop using heat on their low back. Contrast Therapy is the idea that you will mix ice and heat. It works, if you end with an ice pack. You can read about it in this post on using an ice pack.

I like these 10×13 ice packs to focus the icing on the right area. They have a cloth covering to prevent frostbite when you’re in too much pain to find and position a thin cloth between the pack and your skin. Here is a post with guidelines on using an ice pack. These ice packs are available here on Amazon.

These activities balance and stabilize the low back:

The multifidi of the low back are key in stabilizing the quadratus lumborum. They atrophy significantly in the late 30s and early 40s as the sacroiliac joint is fusing. A common strategy is to loosen the vertebrae with the supine twist and then build balanced muscle with bridges and lunges.


Start with 4 sets of 10 twists on each side
with a set of 10 bridges in between.

variation of a supine twist
by Yoga Journal

The supine twist helps problems like this by mobilizing the binding in lumbar facet joints. This variation, with the legs crossed and twisted away from the top leg, is particularly effective. Twist slowly to one side and back while holding your abdomen in. Hold for about 2 seconds and return to upright. Repeat this 10-12 times. Cross your legs and do the other side, as well. The tender vertebra will often click with a feeling of relief. You’ll find that you can target the spot by moving the foot of the lower leg closer or farther away from your hip.

If you use the IcyHot patches while doing these twists, the low back will loosen more quickly and more completely.

supine twist variation
by YogaBasics.com

Many people prefer this variation on the supine twist.

It often produces little clicks of mobilizing vertebrae that release the trigger points creating immediate relief. Play with the position of the upper leg to target the tight spots.


Bridge Pose by YogaOutlet

This yoga pose is great for returning curve to the low back while balancing tension on the hip flexors and flattening the abdomen.

To make it even better, use the method in Active Isolated Stretching. Do slow repetitions that you take to the point of light tension and hold for 1.5 seconds. Pull your belly button in as you lift your hips. Then, drop your hips back to the mat before you do it again. Do 10 reps.

If you don’t know AIS, here is a post with a brief set of guidelines.


Once you become more stable, walking lunges are a great way to further balance and build the hip and low back. Walking lunges open the pelvis, regulate tension between the hamstrings and quads. They also build spinal erectors. It is important to avoid teetering or allowing the shoulders to lean out over the toe while lunging. Pain in the low back will remind you to stay upright. You may need a trainer or therapist to help with these.

If you are stable enough to do walking lunges,
5 sets of 12 (6 on each leg) are a good way to start.
Do the bridges shown above in between.

  • Step forward so that the front foot is in front of the knee and the back knee is behind your hips.
  • Keep your shoulders back over your hips.
  • Lower your torso until the front is level.
  • Keep your knee behind your toes on the front leg.
  • Widen your stance, turn your front toe in a tiny bit and focus on keeping your hips between your feet if you are unstable.
  • Step forward while minimizing how much your head and front shin lean forward.
  • Do 6-10 reps on each leg.

The low back can be complicated to rehabilitate. If you do not succeed with these simple suggestions, or the exercises don’t lead to quick improvement, see a bodyworker, orthopedist or chiropractor for professional help.

Does another Self-Care post better match your pain?

This Self-Care post is for patterns that create a stiff/fragile low back and hip pain. These patterns are created by the multifidi and quadratus lumborum of the low back.

Check out these other pain patterns for low back pain and hip pain.



This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.


Weekly Featured Post

Is the pain from
degenerative discs or
trigger points in the muscle?

This post discusses the differences in pain from disc problems and pain from trigger points. Who should you see to help with your pain?

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.

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*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read, more accessible, and
to include more patterns with better self-care. In the meanwhile, there will be inconsistency in formatting, content, and readability until we get the old posts updated. Please excuse our mess.