Guidance to trigger point injection for treating myofascial pain syndrome: Intramuscular neural distribution of the quadratus lumborum

Kyu Ho Yi, Kyu Lim Lee, Ji Hyun Lee, Hye Won Hu, Hee Jin Kim

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Postural habits and repetitive motion contribute toward the progress of myofascial pain by affecting overload on specific muscles, the quadratus lumborum (QL) muscle being the most frequently involved. The therapy of myofascial pain syndrome includes the release of myofascial pain syndrome using injective agents such as botulinum neurotoxin, lidocaine, steroids, and normal saline. However, an optimal injection point has not been established for the QL muscle. This study aimed to propose an optimal injection point for this muscle by studying its intramuscular neural distribution using the whole mount staining method. A modified Sihler's procedure was completed on 15 QL muscles to visualize the intramuscular arborization areas in terms of the inferior border of the 12th rib, the transverse processes of L1–L4, and the iliac crest. The intramuscular neural distribution of the QL had the densely arborized areas in the three lateral portions of L3–L4 and L4–L5 and the medial portion between L4 and L5.

Original languageEnglish
Pages (from-to)1100-1106
Number of pages7
JournalClinical Anatomy
Issue number8
Publication statusPublished - 2022 Nov

Bibliographical note

Funding Information:
The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude. This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (Project Number: 1711138194, KMDF_PR_20200901_0109‐01).

Publisher Copyright:
© 2022 American Association of Clinical Anatomists and British Association of Clinical Anatomists.

All Science Journal Classification (ASJC) codes

  • Anatomy
  • Histology


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