We are sharing another article by Save Yourself, this one on treating trigger points for low back pain. Getting a massage or using a tennis ball are great options, but we have several other tools that may help during this type of treatment. The TheraCane is a wonderful way to give yourself a back massage whenever you want one. This tool has several “nubs” to massage back, neck, IT bands, and trigger points all over the body. Large Spiky Balls work great for larger regions of the body, and the Muscle Release Balls (which are smooth) allow for more body weight to be applied to release knots in different areas.
Massage Therapy for Low Back Pain
Perfect Spot No. 2, in the thoracolumbar corner
by Paul Ingraham, Vancouver, Canada
Trigger points (TrPs), or muscle knots, are a common cause of stubborn and strange aches and pains, and yet they are under-diagnosed. The 13 Perfect Spots are trigger points that are common and yet fairly easy to massage yourself — the most satisfying and useful places to apply pressure to muscle. For tough cases, see the advanced treatment guide.
People usually don’t know about this spot … until it gets massaged! And then it’s like scratching an itch they didn’t even know they had. People say to me, “How could I have not known that was there?” Even when they have low back pain, most people are probably unaware that this spot is the source of so much of it — it often seems too high. But trigger points in this location tend to refer pain downwards, fooling us into thinking our low back pain is lower than it is.
This Perfect Spot lives in the “thoracolumbar corner,” a nook between your lowest rib and your spine — right where the stability of the rib cage gives way to the relative instability of the lumbar spine. Muscle tends to bunch up around this joint between the last of the thoracic vertebrae and the first of the lumbar. The sweet spot consists of trigger points in the upper-central corner of the quadratus (square) lumborum muscle and in the thick column of muscle that braces the spine.
Technically, they are quite different muscles. Practically, trigger points in both will feel like the same spot — Perfect Spot No. 2.
The quadratus lumborum — “QL” for short — is an interesting flat sheet of a muscle, spanning the space between the ribs and the hips. The QL has three major jobs, which is why it often needs work: it acts as a prime mover, a postural muscle, and a respiratory muscle. Some people with back pain also experience significant discomfort when breathing, because a cranky QL resists elevation of the rib cage, and cramps up when pulling it down firmly on exhalation. You can imagine the sense of relief people experience when this is resolved!
The column of paraspinal muscle is not one muscle, but an impressive collection of muscle woven together almost like a thick rope. There is hardly a location anywhere in this muscle group from skull to sacrum that does not have the potential to be someone’s Perfect Spot … but there is almost always a significant trigger point in the thoracolumbar corner.
How does Perfect Spot No. 2 feel?
Sensation in this area can feel hot and burning if the trigger points are severe, and they can also feel breath-taking, so use caution. However, in the majority of people, a blunted or more gentle pressure will still produce the signature sensation of a Perfect Spot: a deep, “sweet” ache.
You just can’t treat this spot on yourself unless you are unusually flexible or have tools like a tennis ball … but it’s easy to find on someone else. Simply locate the bottom rib, and then work your way inwards towards the spine. Between the bottom rib and about an inch away from the spine is a corner or pocket where you can almost push underneath the rib.
Somewhere in there is the centre of Perfect Spot No. 2, but it may not be obvious at first, because this area is usually so densely populated with significant trigger points that pressure nearly anywhere is going to feel worthwhile. But keep exploring. Using thumbs or fingertips if it’s not too sharp, or an elbow or the heel of the hand for a blunter pressure, slowly push into that pocket, and press inwards and upwards. Keep trying different angles and you are likely to find something really attention-grabbing!
The vulnerability of the thoracolumbar junction
The 12th thoracic vertebrae often suffers crush and “burst” fractures. I’m afraid I have personal experience with this: early in 2010, my wife suffered a serious fracture of this type in Thailand. The spot is vulnerable because T12 is the lowest of the non-huge vertebrae, making it the weak link in the chain. The L1 breaks less, because it is more massive. T12 breaks instead because, as the lowest of the thoracics, it carries the most weight.