Psoas Syndrome: Effective Treatments For This Hidden Cause of Back Pain
- Dr. Jason Hagman
- May 7
- 5 min read
Still struggling with stubborn lower back pain, even after trying everything from rest to physical therapy?
There’s a little-known muscle deep in your core that could be to blame: the psoas major. Often overlooked in traditional treatment, this powerful hip flexor plays a critical role in spinal stability and posture—and when it goes out of balance, the results can be painful and persistent.
In this article, we’ll explore how the psoas works, what causes it to malfunction, and how chiropractic care can bring lasting relief.
What Is the Psoas Muscle and Why Does It Matter?
The psoas major is a deep-seated core muscle that runs from the sides of the lumbar spine (T12 to L5) to the inner thigh (lesser trochanter of the femur). It is one of the primary hip flexors and plays a critical role in spinal stability, pelvic alignment, and core strength. It’s also the only muscle that connects the spine to the legs, making it essential for walking, running, standing, and even sitting.
When the psoas becomes tight, inflamed, or imbalanced, it can disrupt spinal alignment, irritate nerves, and create symptoms that are often misdiagnosed as herniated discs, sciatica, or hip problems.
What Is Psoas Syndrome?
Psoas syndrome refers to dysfunction or chronic shortening of the psoas muscle, leading to lower back pain, postural imbalance, and sometimes pelvic or groin pain. The condition may result from repetitive stress (e.g., prolonged sitting, running), muscular imbalances, or spinal dysfunctions.
According to the Cleveland Clinic, psoas syndrome can cause:
Dull, achy pain in the low back or sacroiliac (SI) area
Discomfort that worsens with standing, walking, or transitioning from sitting to standing
Referred pain into the groin, thigh, or hip
Postural distortion such as a slight forward lean or a twisted pelvis
Why Psoas Syndrome Is Often Misdiagnosed
Due to its deep location and the overlap of symptoms with other lumbar and pelvic conditions, psoas syndrome is frequently underdiagnosed. Patients often go through rounds of conventional treatment—rest, medication, physical therapy—without lasting relief because the root cause (psoas dysfunction) remains untreated.
That’s where chiropractic care excels—by addressing the full kinetic chain and identifying subtle imbalances in structure and function.
How To Diagnose Psoas Syndrome
Use a multi-step evaluation process to accurately assess psoas-related dysfunction:
1. Postural and Functional Assessment
Observation of pelvic tilt, lumbar lordosis, and gait
Functional movement screening (e.g., lunge test, Thomas test)
2. Palpation and Muscle Testing
Hands-on evaluation of psoas tension, tenderness, and fascial restriction
Testing hip flexor strength and flexibility
3. Neurological and Orthopedic Screening
Rule out lumbar disc involvement, sciatica, or sacroiliac joint dysfunction
4. Imaging if Indicated
MRI or diagnostic ultrasound can help visualize psoas inflammation or rule out concurrent disc pathology
Chiropractic Treatment Strategies for Psoas Syndrome
Once psoas syndrome is confirmed, treatment focuses on relieving muscle tension, restoring alignment, and correcting biomechanical dysfunction.
1. Spinal Adjustments
Chiropractic adjustments help reduce nerve interference and correct subluxations (misalignments) in the lumbar spine and pelvis that may be contributing to psoas strain.
2. Manual Myofascial Release
Targeted soft tissue techniques—such as Active Release Technique (ART) and myofascial release—are used to lengthen and decompress the psoas muscle manually. This can help "unlock" the muscle and restore healthy movement.
3. Corrective Exercise Program
We prescribe specific psoas stretches and core stabilization exercises to correct muscular imbalance. These often include:
Supine psoas release stretches
Hip mobility drills
Core and glute strengthening to offload the psoas
4. Postural Re-education and Ergonomic Advice
Education is a key part of care. We coach patients on how to modify workstations, sleep positions, and daily movement habits to prevent chronic psoas shortening.
Why Chiropractic Is Uniquely Effective for Psoas Syndrome
Chiropractic care addresses not just the muscle itself, but the entire neuromusculoskeletal system. This includes the spine, pelvis, joints, and the nervous system—all of which play a role in how the psoas functions.
While medications may dull pain and general physical therapy may stretch the area, chiropractic care works to correct the biomechanical and neurological root cause of psoas syndrome for lasting relief and improved function.
Frequently Asked Questions About Psoas Syndrome
What causes psoas syndrome?
Psoas syndrome is typically caused by repetitive stress, such as prolonged sitting or intense physical activity. It can also result from muscular imbalances, postural issues, or spinal dysfunction that puts strain on the psoas muscle.
Can a chiropractor help with psoas syndrome?
Yes, chiropractors can assess and treat psoas syndrome through spinal adjustments, soft tissue therapy, and corrective exercises. This holistic approach addresses both the muscle tension and the structural imbalances that contribute to the condition.
How do I know if my psoas is causing back pain?
Common signs include deep lower back pain, difficulty standing upright, tight hips, or referred pain into the groin or thigh. A chiropractor can perform specific tests to determine if the psoas is involved.
How long does it take to recover from psoas syndrome?
With targeted chiropractic care, many patients see improvement in a few weeks. Recovery depends on the severity of the dysfunction, lifestyle factors, and how consistently patients follow their treatment plan.
What stretches help release the psoas muscle?
Effective stretches include the kneeling hip flexor stretch, supine psoas release, and gentle lunge-based mobility drills. However, these should be paired with core strengthening for best results.
Conclusion: Don’t Overlook the Psoas Muscle in Chronic Back Pain
If you're struggling with chronic lower back pain, groin discomfort, or poor posture that hasn't improved with conventional treatment, psoas syndrome may be the missing link. Chiropractic care offers a powerful and non-invasive solution by targeting the root cause through precise spinal adjustments, soft tissue work, and functional rehab.
Further Reading and Resources
To schedule a chiropractic appointment or to learn about my practice, please visit www.Springfield-Chiropractic.com
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Springfield Chiropractic Center
454 Morris Ave.
Springfield, NJ 07081
(973) 564-7676
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Wishing you good health.
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