Low Back/QL Pain

by Beth C
(Upstate NY, USA)


I am in my early 40s, and I am currently experiencing my second incidence of low back pain. The first occurred about 18 months ago without a clear trigger. (I assumed that I might have caused a strain while exercising--I exercise daily as well as engage in yoga 3-5 times per week.) I was able to recover on my own through yoga and other therapeutic exercises; I also saw a massage therapist for one visit.

My current episode began just after Christmas, and again, there was no clear precipitant. As before, I engaged in gentle yoga & stretching activities, and by the end of the first week, I was seeing some improvement. At the start of the second week, however, I must have re-aggravated something, because I then got worse again.

Now, my condition seems to have plateaued, and my continued exercising doesn't seem to be helping. The problem also seems different from before: I now have a constant, dull ache right in the area of my left QL that will not go away (I've tried self-massage with a foam roller and therapy balls, but this does not help for more than a few minutes). The low back pain is fine when I am sitting or lying, but if I am standing for more than a few minutes, I begin to feel painful pressure in my low back and need to sit down. Although the discomfort in my left QL extends a bit into my left hip, I don't feel any pain extending down into my buttocks and/or my legs.

Any thoughts on this? I read about Maignes Syndrome on your web site--could that be what is going on with me? Do you have any suggestions for how I should proceed? My doctor referred me to PT, but I'm not sure I would get any exercises there that I am not already doing. I was also considering returning to my massage therapist.

Thank you in advance for any help you can provide!

Good morning Beth,
What a pleasure to have a letter written in decent grammar with the problem so succintly set out.

Pain with standing, but not sitting or lying, immediately makes me think of a short leg. In that case, brisk walking is often good, but dawdling also painful, as in windowshopping. Ask someone to stand behind you, place their hands firmly on the iliac crests, and compare the heights of the hips.

Let me know what bending forwards, backwards, and to the side does.

It's a good sign that it's not radiating to the legs, but be careful, one slip on the snow... a heatwave here in sunny South Africa!

Dr B

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Jan 12, 2012
Thank you/follow-up
by: Beth C

Thank you so much for your quick reply!

RE a short leg: wouldn't that have bothered me before now (age 43)? Or is that something that can develop over time/with age? Age I mentioned in my first letter, I do exercise daily (not just yoga but weights & cardio as well), so I believe that I am maintaining good strength/muscle tone for my age.

None of the things you mentioned aggravates the pain I am having. In fact, NO movement at all seems to make it feel worse--movement (through exercise, etc.) generally feels good, whereas just standing seems to hurt.

My own theory (after doing further research yesterday) is that I may be experiencing a spasm in my QL. Therefore, I attempted more prolonged self-massage work in that area, and I THINK it may have helped, as it is feeling a little better today. Time will tell, but I certainly would still be interested if you have any further thoughts.

Thank you again!

Hello again, Beth,
When movement doesn't aggravate the pain, be aware it could be systemic. Kidneys, bladder, ovaries... good health otherwise?

The Leg length inequality is a strange bird. Sometimes it may start to be a factor, but yes, I would have expected it to bother you before. Get a friend to look at the height of your pelvic crests.

Like all conditions, if after a period you know it's not improving, then see someone for advice, diagnosis and treatment.

Try the Maignes syndrome exercises ... type it intot he search this site function at C-h.

Let me know in a month how you are getting on.

Dr B

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