Psoas Pain Or Tight Flexors? When To See An Orthopedic Surgeon

Determining The Cause of Lower Back Pain

There are countless reasons for a person to experience lower back pain. Common causes can be overexertion, overextension, or even using pore posture when sitting or standing for extended periods. Even arthritis can be a primary cause of discomfort in this area. But sometimes, disruption to the muscles in the back and lower part of the body can also be the culprit. Specifically, the psoas and flexor muscles are often the source of back problems.

Psoas vs flexor muscles

The psoas muscle isn’t an often talked about body part. However, the tissue stretch is long, ribbon shaped and located in the lower back. The muscle is responsible for supporting the body’s abdominal core. By contrast, most individuals are familiar with flexor muscles which are a group of five individual muscles located in the hip that control lifting the leg toward the body and even basic walking.

Is the pain different?

While the psoas and flexor muscles can cause lower back pain, the symptoms can sometimes present differently. With flexor-based pain, joint discomfort, changes to posture and gait, and even pain that spreads to the knees and hips are not uncommon. In most cases, the body is attempting to overcompensate for a weak flexor muscle group, leading to more widespread damage. With psoas-based back pain, symptoms can include lower back pain, stiffness in the region, buttocks pain, and discomfort throughout the pelvic, hip, and groin regions. The irritation can spread through the legs or worsen when standing up straight.

Is psoas lower back pain common?

Psoas-linked lower back pain is referred to as psoas syndrome and In the general population, the incidence is somewhat rare. When the condition is observed, the patient group is usually composed of athletes or highly active individuals. In particular, dancers, runners, hockey players, and even high jump or hurdling participants are the types most at risk of developing psoas syndrome. While complications aren’t common, the experience is unpleasant and can make performance difficult.

Diagnosing psoas syndrome

Along with performing a physical examination, a healthcare provider will also ask the patient to perform a series of range of motion movements that rely on the psoas muscle. Likewise, diagnostic imaging tests may be necessary to get a better look at the affected areas. In most cases, a psoas syndrome diagnosis is based on a series of elimination to rule out other possible conditions that could cause the lower back pain. For example hernias, adductor muscle strains, hip labral tears, and even certain kinds of bursitis can create similar symptoms.

Treating psoas-linked back pain

For many individuals with psoas syndrome, rest, activity restrictions, and physical therapy may be sufficient to reverse the damage and boost healing. However, in more serious cases, lower back pain sufferers may need more interventions such as injections or even osteopathic manipulative treatment (OMT). Talk with a specialist if at-home rest doesn’t yield improvement after a week or the pain worsens. Likewise, if physical therapy isn’t offering benefits, don’t be afraid to speak up.

When surgery is necessary

Most patients with a psoas syndrome diagnosis can find relief through non-invasive solutions. However, in some cases, surgery may be the only option. Research suggests that only 12% of such patients need surgery. Sometimes the procedure is done to release tension on the psoas tendon or to even lengthen the muscle. But individuals struggling with lower back pain are urged to seek assistance to get the necessary help and put an end to the discomfort.


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