Monday 19th February, 2024

The most important muscles to massage for back pain

Back massage
Back massage cannot reach the important muscles deep around your spine

The following muscles can cause back pain. They are all very important for your spine to function normally, and can all have trigger points that produce back pain.

The muscles that can cause back pain

  1. The intrinsic spinal muscles
  2. Erector spinae
  3. Quadratus Lumborum
  4. Gluteus maximus
  5. Gluteus medius and mimimus
  6. Iliopsoas
  7. Piriformis and the other deep hip muscles.

However, almost every therapist misses the first ones because they sit deep around your spine where most therapies cannot reach. Because of this they are usually left un-treated, so you either won’t get better or any relief will only be short lived. We already have an excellent guide that covers each of the muscles listed , with recommended massage and self therapy techniques, so in this guide we will discuss these muscles that are missed, including why they are so important and the self massage techniques you can do that actually effectively treat them.


The muscles
Why they are so important
Why massage therapists cannot examine or treat them
How to treat them (including self therapy)

The muscles

The intrinsic muscles of your spine
The intrinsic muscles of your spine sit deep where conventional massage cannot reach

This picture shows the muscles that are too deep and hard to get to for massage therapists to treat. They sit close to the spine and run between adjoining vertebrae. There are actually many different muscles named according to what part of the vertebrae they attach to and what they do, but we collectively call them the intrinsic muscles of the spine.

Why are they so important

As you can see by where they are and where they attach the intrinsic muscle of your spine:

  • control the movement of each individual spinal joint, and
  • if they are tight they restrict the movement of those joints.

Why massage therapists cannot examine or treat these muscles

Massage therapists examine muscles by feeling them: looking for tightness, feeling ropy, and tender lumps. The intrinsic muscles of the spine are too deep, very short, and sit between levers that jut from the vertebrae. It is impossible for massage therapist to effectively feel them. Likewise they are too deep and hard to get at for conventional massage techniques to have any worthwhile effects.

The trigger point manual
The benchmark two volume guide to muscles and trigger points does not even have a chapter on the intrinsic muscles

Because therapists cannot examine ot treat them these muscles are ignored

The “bible” for massage therapists is the two volume trigger point manual. Each muscle has it’s own chapter with diagrams and a host of clinical and treatment information, only the intrinsic spinal muscles don’t have a chapter or are even listed in the index. Despite being so important they only get a couple of insignificant mentions.

How to examine and treat the intrinsic muscles of your spine

Indirect examination of the intrinsic muscles

The intrinsic muscles of your spine are too deep and hard to get at to examine directly, but properly trained professionals are able to examine them indirectly by examining their effect on joint movement. When the intrinsic muscles are tight (usually containing (myofascial) trigger points ) they restrict the movement of one vertebrae relative to another.

How intrinsic muscles can be treated

The intrinsic muscles are too deep and hard to get to with conventional massage pressure. Needles would not be an option because the bony levers would get in the road and there would be a very high risk of piercing nerve roots, blood vessels or the spinal cord. However, they can be easily reached using vibration massage. We will demonstrate how this is done in this short video.

Video demonstration

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Dr Graeme

About Dr Graeme

Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more

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