Low back pain is a common side effect from being sick.

It’s that time of year: cold and flu season. Managers scramble to arrange cover for sick employees and sales of nyquil soar. Additionally, massage therapists have their “hands” filled with lumbar treatments. The sneezing, snoozing and low back pain complaints are from a group of muscles called the quadratus lumborum.

The photo below gives us a good idea of what the quadratus lumborum or “QL” looks like. In reality, this muscle group integrates with connective tissue that attaches to the pelvis, lower spine and rib cage. That web of muscle and cartilage contributes to its tremendous endurance and stability.

Sitting, standing, breathing, and bending in every direction requires the cooperation of the quadratus lumborum. As a result, it rarely has the opportunity to relax.

quadratus lumborum and back pain spa rosalia


There is one time it can take a break, and that is when lying down. You would think that a side benefit of being sick is the fact that people spend more time in bed, and it gives the back a chance to rest. However, when a bed is too soft, the QL cannot not relax. Instead, it stays contracted in an attempt to support the lower spine and nerve roots housed there. If it stays that way long enough, constricted muscle tissue, compressed spinal segments and low back pain result.


You can’t inhale without it! This muscle has a strong base in the pelvis and a great grip on the lower rib. As a result, when we take a deep breath, the QL is in a unique position to pull the lower rib down and allow the diaphragm to expand.

The action of an accordion is a good illustration.

Think about what happens during a sneeze or cough. The lungs expand and fill with air just before a forceful exit. Similarly, when operating an accordion air fills the bellows and exits creating sounds. The accordion player keeps one arm fixed while the other moves and allows the bellows to fill. In like fashion, while preparing for a sneeze, the quadratus lumborum stays fixed and is the stable counterpoint for diaphragm expansion. It is just like the fixed and moving arms of an accordion player.

Sneezing and coughing require an active QL. As a result, extended sessions with a box of Kleenex can leave this endurance superstar exhausted and back pain will kick in.

There is another unfortunate thing that can happen when someone is in a bent or twisted position.

Leaning over to turn on a table top lamp is a perfect example. In order to do that, the quadratus lumborum must contract and stabilize the spine. Throw in a sneeze and the next thing you know, a back spasm occurs. There is simply not enough room in a flexed and contorted posture to allow for lung expansion.

What can be done to prevent or fix a sneeze & snooze lower back problem? Face masks are an option, but in the interest of fashion here are a few other ideas:


A strong gluteus medius and paraspinal muscles can prevent QL exhaustion.

Be careful when bending and sneezing


Massage, ice and heat. Even wikipedia recommends it!

Sideways stretches


Anecdotal support from years of full time massage practice.

Muscle description of Quadratus Lumborum