The Psoas Muscle

Back pain is the most common condition that motivates people to reach out to their medical provider. Specifically, patients who have tried ‘everything’ but still have back pain often reach out for acupuncture, massage, physical therapy.

One of the most common muscles that is tight or injured, contributing to low back pain, especially low back pain that feels as though it is coming from the center of the low back, along the spine, is the psoas, pronounced ‘so-as’.

Below you can see why... the psoas originated at the spinous processes of the lumbar vertebrae, it then crosses the waste (only muscle to do so) and inserts into the lessor trochanter of the femur (up in the groin near the sits bone). It’s action is to flex at the waste (bending forward or lifting the knee upward). Because of this, we use it to bend over and pick things up. We can also injure or overwork this muscle during workouts (swinging weight, abdominal workouts, etc).

There is something else very interesting about the psoas muscle, when we flex the psoas we are using some of the same actions and motions that we use when attempting to protect our genitals, abdomen and other soft areas on the front of the body. Because of this fact, the psoas can become injured causing low back pain after a trauma, sexual or otherwise. This means that for some, even without trauma, an emotional response can also occur, either with the onset of pain, during the treatment session to release the tension, or both.

Stretching, strengthening and rehabilitating this muscle can resolve back pain in many cases. To do so, follow the images below, complete these exercises and stretches 1-3 times daily. Never continue with an exercise that increases your pain by 35% or more during or after the exercise.

By using trigger point acupuncture (also known as dry needling) at the psoas, relief and healing can begin. In minor, acute cases, one treatment can be enough. However, when the psoas is badly injured or the situation has become chronic it can take a few sessions to remedy. Also, due to the nature and location, these treatments are very effective without needle retention. This can be very helpful since many patients experience overall tension and tightening in the low back muscles during an injury. Because we can see relief without retention, it can be possible to release the psoas and then treat the rest of the low back muscles directly, retaining those needles for about 25 minutes of rest and relaxation.

For many of us, some level of homework is needed in order to heal and/ or continue to be pain-free after an injury to the psoas, below is a link to a very helpful site that includes visual aids for stretching and strengthening this and surrounding muscles in order to assist with and prevent future low back pain.