12. Quadratus Lumborum

Origin: Anterior lip of the iliac crest and the iliolumbar ligament

Insertion: Medial half of the lower border of the 12th rib and the tips of the lumbar TVPs

Action:

  • Unilaterally: Lateral flexion of the vertebral column or elevates the same innominate
  • Bilaterally: Assists in lumbar stabilization and depresses 12th rib

Innervation: Subcostal nerve (T12) and ventral rami of L1-4

Quadratus lumborum muscle.
Figure 2.28 Quadratus lumborum, adapted by Uwe Gille from the original image by Henry Gray and Henry Vandyke Carter (Public domain).

Needling

Position: Prone or side lying

Palpation: Can palpate this muscle just lateral to the erector spinae group

Technique:

    • Prone: Needle in a cranial to caudal direction aiming towards the superior aspect of the iliac crest
    • Side Lie: Ensure you can palpate the quadratus lumborum and bracket it with your fingers – Needle in lateral to medial direction

Caution: High – the abdominal viscera and kidney lie directly anterior to this muscle – Ensure you do not needle in an anterior direction

Needling of quadratus lumborum.
Figure 2.29 Needling of quadratus lumborum, original image by Nadine Crocker, CC BY-NC 4.0.

Video 2.12 Needling of quadratus lumborum, original video by Nadine Crocker, CC BY-NC 4.0.

Video 2.13 Needling of quadratus lumborum, original video by Nadine Crocker, CC BY-NC 4.0.

License

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Sinew Channel Needling Copyright © 2026 by Nadine Crocker is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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