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The muscle that straightens the spine and back pain
Last reviewed: 04.07.2025
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The muscle that straightens the spine - m. erector spinae
- M. iliocostalis
- M. iliocostalis lumborum
Beginning: Crista iliaca, Crista sacralis lateralis, Aponeurosis lumbalis
Insertion: angles of the VI-IX underlying ribs
M. iliocostals thoracis
Origin: angles of the XII - VII ribs
Insertion: angles of the V-VI overlying ribs
M. iliocostalis cervicis
Beginning: angles of the VI - III ribs
Attachment: posterior tubercles of the transverse processes of the VI - IV (III) cervical vertebrae
M. Longissimus
- M. longissimus lumborum:
Beginning: Crista sacralis lateralis, Crista iliaca
Insertion: Lateral cords: Procc. costarii of lumbar vertebrae, deep leaflet of Aponeurosis lumbalis, Medial cords: Procc. accessorii of lumbar vertebrae
- M. longissimus thoracis:
Origin: spinous processes of the sacral, lumbar and lower thoracic vertebrae; additional bundles from the transverse processes of the lower 6th or 7th thoracic vertebrae, Proc. mamillaris of the 1st or 2nd lumbar vertebra
Attachment: lateral bundles - angles of the 12th - 2nd ribs; medial bundles - transverse processes of all thoracic vertebrae
- M. longisimus cervicis:
Origin: transverse processes of the upper 4-6 thoracic vertebrae and the lower 1 cervical vertebrae
Attachment: transverse processes of the V - II (I) cervical vertebrae
- M. longissimus capitis:
Origin: transverse processes of the upper thoracic vertebrae and lower cervical vertebrae
Attachment: Proc. mastoideus of the temporal bone
Innervation: from the posterior rami of the spinal nerves of segments C6-L3.
Diagnostics
The patient is placed on the healthy side in a comfortable, relaxed position with a pillow placed under the abdomen.
The back muscles should be moderately stretched, which allows for the detection of tense thickenings containing trigger zones. The degree of their stretching is regulated by pulling the knees to the chest. Superficial palpation reveals areas of pain and often referred pain.
[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ]
Referred pain
The pattern of referred pain from trigger points in the iliocostalis muscle at the mid-thoracic level radiates toward the shoulder and laterally along the chest wall. Trigger points in the iliocostalis muscle at the lower thoracic level may refer pain upward across the scapula and onto the anterior abdominal wall, as well as downward toward the lumbar region. Pain referred anteriorly may be mistaken for visceral pain. Trigger points in the iliocostalis muscle at the upper lumbar level radiate pain clearly downward toward the center of the buttock and posterior thigh. Trigger points in the lower thoracic region of the longissimus dorsi muscle refer pain to the buttock. This distant source of gluteal pain is often ignored.