Iliocostalis Pain Treatment


As part of the Erector Spinae muscle group, the iliocostalis is a group of muscles in the back, which, along with the Spinalis thoracis muscles, and the longissmius thoracis muscles, helps provide the support needed for your trunk to maintain proper posture and facilitate movements.

Individually, the Iliocostalis group of muslces is largely responsible for extension, lateral flexion, and rotation of the spine – basically aiding in bending backward and sideways and rotating the spinal column.

The group is made up of three parts. The lower portion, the iliocostalis lumborum, extends from the upper part of the hipbone to the lower ribs. The middle part, also known as the iliocostalis dorsi or thoracis, goes from the lower to the upper ribs. While the upper part, the iliocostalis cervicis, extends from the upper ribs to the neck, more specifically to the transverse processes of the cervical vertebrae.

Quite a few injuries can occur in these muscles given their frequent usage – without any extra or new movements. In fact, your iliocostalis muscles can spasm, cramp and cause pain simply by performing their standard functions. Some of the most common problems associated with the Iliocostalis group of muscles includes the;

  • Iliocostalis Syndrome
  • Iliocostalis thoracis muscle pain
  • Iliocostalis lumborum muscle pain

However, given the close location and functionality of the Iliocostalis group to the quadratus lumborum set of back muscles, often times a iliocostalis dysfunction is misdiagnosed and mistreated as a possible quadratus lumborum concern.

This renders any treatment offered completely ineffective, resulting in prolonged and seemingly unexplained back pain.

Luckily for us – and considering the frequency of Iliocostalis concerns – there are actually a number of pain treatment options available to help relieve the pain.

A look at the muscles in the back.

Iliocostalis syndrome

One of the conditions which affect this group of muscles is the Iliocostalis syndrome.

Caused by the friction created with the lower ribs rubbing against the iliac crest, the curved ridge at the top of the pelvic bone, leading to the irritation of the soft tissues. Otherwise undiagnosed chronic side pain commonly characterizes the condition.

In normal circumstances, however, the distance between the iliac crest and the lower ribs is sufficient to prevent the two bones from coming in contact with one another – even while bending. In Iliocostalis syndrome, the distance between the two is decreased, causing the bones to come in contact with one another to create friction and cause damage to the muscles and tendons in the area.

Iliocostalis syndrome often occurs in people suffering from osteoporosis.

Apart from osteoporosis, the other common causes for the condition include:

  • Disc degeneration
  • Scoliosis
  • Vertebral compression fractures
  • Any other vertebral deformity


Iliocostalis thoracis muscle pain

Iliocostalis muscles are used when bending and twisting. Source:

The iliocostalis dorsi includes the musculus accessorius and the iliocostalis thoracis muscle. Through flattened tendons which arise from the upper border of the angle of the lower six ribs, medially placed to the tendons of insertion of the iliocostalis lumborum convert into muscles and insert at the top border of the upper six ribs efficiently attaching the lower and upper ribs.

The muscles then extend back towards the transverse process of the seventh cervical vertebra in the neck.

In combination with the longissimus and spinalis muscles, the iliocostalis muscles are responsible for straightening the upper back and allowing side to side bending and rotating movements. As such, the iliocostalis thoracis muscle can often be one of the major causes of back, chest and lower abdominal pain.

The main signs and symptoms of Iliocostalis thoracis concerns include:

  • Chest pain
  • Pain which runs in the upper back around the shoulder, concentrated at the edge of the shoulder blade
  • Shooting pains which run from the top shoulder blade down towards the upper hip bone.
  • Strong pain in the abdomen area right beneath the rib cage
  • Concentrated pain around the bottom of the ribs

The discomfort and pain concentration in the bottom of the shoulder blade or the area right below the ribcage, extending towards the sides is considered as a classic sign of iliocostalis thoracis dysfunction.

People with the condition often experience pain when bending and twisting, trying to lift heavy objects and sitting for extended periods in cars or planes.

Conditions in which a person may experience pain in the iliocostalis thoracis region:

  • Lumbar spine hyperlordosis
  • Scoliosis
  • Ankylosing spondylitis
  • Prolapsed disc
  • Degenerative disc disease
  • Herniated disc
  • Rib sublucation
  • Cauda equina syndrome
  • Lumbar spine sprain or strain syndrome

Iliocostalis lumborum muscle pain

The iliocostalis lumborum is a muscle which attaches from the lower six ribs to the lower back via the sacrum and hip bone. The mucle inserts into the inferior border of the angles of the lower seven ribs through six or seven flattened tendons.

It is associated with pain in the lower back, buttocks and occasionally, the lower abdomen. The triggering point, however, for the pain initiating in iliocostalis lumborum muscle is often found in the lower torse.

Symptoms of iliocostalis lumborum dysfunction tend to present during the same activities as those connected with the iliocostalis thoracis. These are whiplash involving the lower back, sitting for long periods in a vehicle, straining while lifting heavy objects as well as bending and twisting.

Common symptoms of the pain association with iliocostalis lumborum dysfunction include:

  • Sharp pains such as those experienced in appendicitis
  • Nausea
  • Buttock pain
  • Excruciating lower back pain
  • Gluteal pain
  • Lumbar pain
  • Bloating
  • Iliosacral pain

Where pain is likely to occur when caused by the iliocostalis lumborum.

Treatments for iliocostalis pain

Iliocostalis syndrome is usually treated with ice, nonsteroidal anti-inflammatory drugs, and steroid injection if the irritation continues. Massage and exercise may also be recommended along with cortisone shots. It should be noted that while cortisone and anti-inflammatory drugs produce short-term benefits, they can also lead to more chronic pain since the interrupt the natural healing process. Long term use also leads to varying side effects.

An alternative to these treatments is prolotherapy, also known as Non-Surgical Ligament and Tendon Reconstruction and Regenerative Joint Injection. This is an orthopedic procedure that stimulates the body’s healing processes to strengthen and repair injured and painful joints and connective tissue. This is said to be very helpful in eliminating chronic side pain, although patients should still avoid side-bending.

Common iliocostalis pain treatments for muscle pain include hot and cold pain-relieving gels, hot or cold packs, back braces and massage.

Other conservative treatment modalities include:

  • Trigger point therapy
  • Manual therapy
  • Active release technique
  • Graston technique

Chiropractic adjustments are also recommended for the pain mangement and treatment of longterm iliocostalis muscle pain.

A number of basic yoga or Pilates exercises are also highly recommended to help strengthen the Iliocostalis group of muscles to eliminate shooting pains during everyday use. Movements such as the triangle pose, and the side angle pose are particularly beneficial for helping improve your lateral flexion while the sphinx, bridge, and crocodile poses are said to help with the spinal extension.

The standing backbend in the Mountain pose also aids in stablaizing a majority of the region to prevent pain during regular use.

We all want to be able to bend, twist and lift objects without pain and discomfort. Unfortunately, dysfunction in the iliocostalis muscles can make this difficult. While most of the recommended exercises can be done at home without proper supervision, only a licensed medical professional can run the necessary tests for the correct diagnosis, treatment planning, medication and pain management of conditions associated with and affecting the Iliocostalis group of muscles.

Consult your doctor for a diagnosis and proper iliocostalis pain treatment.