The erector spinae, also called the sacrospinalis, comprise three sets of muscles organized in parallel columns. From lateral to medial, they are: iliocostalis, longissimus, and the spinalis group. As a group, these muscles extends and laterally flex the vertebral column (i.e. bending backward and sideways). They also help to maintain correct curvature of spine in the erect and sitting positions. As a whole, the erector spinae steadies the vertebral column on the pelvis during walking. In terms of trigger point referred pain maps, the pain can be divided locally and regionally depending where the trigger point lies. For example, in the thoracic spine—iliocostalis:refers medially toward the spine, and also anteriorly toward the abdomen. In the lumbar spine— the iliocostalis: refers to the mid buttock. In the lower lumbar spine— the iliocostalis: refers to the buttock and sacroiliac area.
A large complex web of muscles, it turns out the erector spinae doesn’t keep the spine erect (that’s the job mainly of the multifidus and spinal ligaments). Trigger points in the erector spinae group are, however, hugely important in patients with back pain. Treating these muscles along with home stretching can have a significant impact on reducing spinal pain, even in discopathic patients.
How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.