Psoas Syndrome: It could be why your back pain won't go away.

More common in runners and athletes, this painful condition is often misdiagnosed.

Back pain that won’t go away? It could be your psoas muscle.


Dealing with back pain that won’t go away can be frustrating. Once you’ve ruled out (and/or treated) most of the possible causes of back pain, you need to start looking a little deeper. If you have not evaluated the psoas muscle, you may be missing a possible cause of the problem.


Pronounced “so as”, each person has two psoas muscles that are located deep in the abdomen. They attach from each side of the spine in your low back to the upper part of your femurs (the bone in your thigh). They are used to help flex your hips, bend your torso sideways, and sit up from a lying position.


What is psoas syndrome?

Although considered rare and often misdiagnosed, psoas syndrome can be a possible cause of refractory low back pain (back pain that doesn’t go away even after treatment). In this syndrome, the psoas muscle can be injured, inflamed, tight, contracted, and/or acting asymmetrically from the psoas on the other side of the spine.


Anyone can get psoas syndrome. There is no known specific cause of the syndrome, but it appears to be more common in runners and athletes that perform a lot of jumping exercise. I also believe that increased tension and shortening of the muscle can occur from months or years of prolonged sitting.


Once the condition occurs, if it is not diagnosed correctly and treated appropriately, it can persist for long periods of time.


What are the symptoms of psoas syndrome?


Low back pain is the most common symptoms associated with psoas syndrome. Other symptoms that can accompany the condition are:


  • Low back pain when going from a seated to standing position

  • Difficulty and/or pain when trying to stand up straight

  • Pain in the buttocks

  • Groin/Pelvic pain

  • Pain radiating into the thighs

  • Back stiffness and/or difficulty when starting to walk


How do you know you have psoas syndrome?


Diagnosing psoas syndrome is not always easy. Many of the symptoms associated with the condition are similar to those of spinal stenosis, piriformis syndrome, hip arthritis, disc herniation, and spinal misalignments. Lumbar facet syndrome can also mimic the symptoms of psoas syndrome. In my article, Back Pain When Standing: It may be lumbar facet syndrome, I address this common condition and how to effectively treat it.


To make matters even more complex, it is also possible to have psoas syndrome along with one of these other low back disorders.


A thorough examination and consultation will be the best way to determine if you have psoas syndrome. Imaging such as x-ray, MRI, CT Scan, diagnostic ultrasound and blood work can also be used to rule out other possible causes of low back pain.


Once the diagnosis of psoas syndrome has been accurately made, treatment that involves correcting the muscular, spinal and possible hip dysfunction will provide the best results. I have found that using specific exercises and stretches for the psoas muscle (as well as other hip and core musculature), correcting any pelvic asymmetries along with spinal manipulation of the lumbar spine yield very good results. If there are other conditions occurring with psoas syndrome, they should be addressed as well.


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Wishing you good health.

Dr. Hagman

DR. JASON HAGMAN

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