How to identify pain originating from QL vs SI?

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Quadratus Lumborum (QL) pain and Sacroiliac (SI) joint pain are two distinct types of pain that can occur in the lower back and pelvic region. While they may have similar symptoms, there are differences in their location and characteristics that can help you distinguish between the two. It’s important to note that accurate diagnosis should be made by a medical professional. Here’s a general guide to help you differentiate between QL pain and SI joint pain:

Quadratus Lumborum (QL) Pain:

  1. Location: QL pain is usually felt on one side of the lower back, just above the hip. It can extend from the lower ribs to the pelvis.
  2. Characteristics: QL pain often feels like a deep, dull ache or tightness on the affected side of the lower back. It may be aggravated by movements such as bending, twisting, or lifting.
  3. Triggers: Activities that involve repetitive movements, poor posture, heavy lifting, or sudden movements can trigger or worsen QL pain.
  4. Radiation: QL pain might radiate down the side of the hip, buttock, or even into the thigh. It’s generally localized to one side of the body.
  5. Muscle Knots: Palpation of the QL muscle may reveal tender or tight areas, commonly referred to as muscle knots or trigger points.

Sacroiliac (SI) Joint Pain:

  1. Location: SI joint pain is typically located lower than QL pain, closer to the sacrum and pelvis. It’s often felt in the buttocks and can extend down the back of the thigh.
  2. Characteristics: SI joint pain can vary from aching to sharp and can be accompanied by a feeling of stiffness in the lower back and hips. It might also cause discomfort during transitions like going from sitting to standing.
  3. Triggers: Activities that involve standing, walking, climbing stairs, or activities that stress the pelvis (such as running) can trigger SI joint pain.
  4. Radiation: SI joint pain might radiate down the back of the thigh but is less likely to extend as high as the QL area on the lower back.
  5. Tenderness at SI Joints: While it’s difficult to palpate the SI joint directly, pressing on the bony prominences near the lower back and buttocks may elicit tenderness.

It’s important to remember that these guidelines are general and individual experiences can vary. If you’re experiencing persistent or severe pain in your lower back or pelvic region, it’s recommended to consult a healthcare professional such as a physician, physical therapist, or orthopedic specialist. They can perform a thorough evaluation, possibly including imaging or diagnostic tests, to accurately diagnose the source of your pain and recommend appropriate treatment.

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