Pain in low back or pelvic area?

 The quadratus lumborum muscle (QL) is sometimes a key player in the causes of lower back and pelvic pain, especially chronic pain without a clear structural cause.

From a psychosomatic point of view, the quadratus lumborum is the muscle of support, stability, and unbearable burden.

This muscle connects the pelvis to the lowest ribs at the back, deep inside, attaching to the vertebrae.

The pain referral area is shown in red in the photos.

Main psychosomatic meanings:

1.  Carrying an unbearable burden.
    The muscle tenses when a person feels that too much responsibility has been piled upon them—financial, emotional, family, work-related—which they are forced to bear alone. Or they themselves have shouldered it out of unconscious loyalty to their family, inherited patterns, or society pressure.
    This could be caring for a sick relative, the need to be the sole support of the family, or excessive demands at work without support.
    Pain in the QL is the body's cry: "I can't take it anymore!"
    Triggers in the QL can sometimes compensate for trigger points in the gluteal muscles.

2.  Lack of support and a solid foundation.
    The QL stabilizes the lower back when we stand or sit.
    Psychosomatically, this translates into a feeling that "there's no one to lean on," "no backup," "I'm alone in this world." A person may be outwardly successful but internally feel they have no one to trust with their weaknesses or problems.

3. Fear of falling (not just physically, but also socially, financially).
    The muscle is constantly tense, ready to "catch" the body in case of losing balance. So it is in life: chronic worry about the future, about stability, about the idea that "everything could collapse at any moment" leads to chronic tension in the QL.

4.  Repressed anger and irritation.
    Often, the burden a person carries causes hidden resentment: "Why me? When will this end? This is unfair!" But since they don't express these feelings (due to a sense of duty, guilt, or fear), they accumulate as muscle spasms. The QL is the perfect place for this: a deep, "quiet" muscle.

5.  Conflict between "have to" and "want to."
    The muscle attaches on one side to the pelvis (a symbol of movement, desires, "want") and on the other to the ribs and vertebrae (a symbol of structure, rules, "have to"). Chronic spasm can reflect an internal conflict between the necessity to fulfill duties and the desire to live for oneself, to relax, to "lay down the burden."

6.  "Freezing" emotions and the need to keep up appearances.
    The QL helps maintain an upright posture.
    Psychosomatically, this can be linked to situations where one needs to "take the hit, not show weakness, keep face" in the face of difficulties ("back straight, chin up"). The body pays for this armor with muscle pain.

Psychological profile of a person with a chronically spasmed quadratus lumborum muscle:

- Responsible to the point of perfectionism. Often the "pillar" of the family or at work.
- Has difficulty with delegation and asking for help ("I can handle it myself").
- Suppresses "inconvenient" emotions (anger, resentment, fatigue), considering them a sign of weakness.
- Lives in a state of chronic stress and anxiety about the future.
- May feel "stuck" in a job they dislike or burdensome relationships due to a sense of duty.

❤ What to do?
Ways to work with the psychosomatics of the quadratus lumborum muscle:

1. Awareness.
The first step is to honestly answer these questions:
- What  heavy burden am I carrying right now?
- Whose burden is this really? Am I carrying someone else's responsibility?
- Who can I lean on? Who can I trust?
- What unexpressed emotions (anger, resentment, fear) might be "stored" in my lower back?
- What in my life is unstable, and do I live in fear that it will collapse?

2. Physical release (as a symbol of psychological release):
💙 Massage and myofascial release.
For example, working on the trigger points marked with x in the photos using a tennis ball or a lacrosse ball. Position the ball at a 25-degree angle to the wall for points closer to the spine (medial) and at a 45-degree angle for points further from the spine (lateral).
    Physical relaxation of the muscle sends a signal to the nervous system: "The danger has passed, you can relax."

💚 QL stretching exercises after working on trigger points: "Pigeon Pose lying on your back"; 

slow side bends, very slowly.

  💛 Breathing. Gentle diaphragmatic breathing, directed into the lower back area, helps relieve spasm.

3. Psychological work
- Learn to ask for help and delegate. Start small.
- Give yourself permission to express emotions in an eco-friendly way: through conversation, writing, physical activity.
- Re-evaluate your obligations. Which of these are truly MINE and important to ME? What can I let go of without guilt?
- Practice the feeling of internal support: meditations, visualizations, working with a therapist on self-worth.
- Create a "taking off the burden" ritual: for example, visualize taking off a heavy backpack from your shoulders, or literally shake off tension through movement.

If an MRI shows protrusions, but the pain is clearly linked to stress and emotional state, working on the psychosomatic aspect of the QL can be the key to recovery. Plus work on trigger points might help to release tension sooner.

Ultimately, relaxing the quadratus lumborum is not just a matter of massage, but an internal permission to shed the unbearable burden, find support, and stop holding up the world on your shoulders alone.

If you need psychological help, feel free to message me olesyafursova@yahoo.com