Psoas syndrome is a rare and often misdiagnosed condition that happens when the psoas muscle in your back is either tight or in spasm.

The psoas muscle connects your lumbar spine (lower back) to your hip joint. It’s a very long muscle that extends from your lower spine, down through your pelvis to your leg.

You use the psoas muscle every time you walk. Its job is to flex your hip joint and lift your upper leg towards your body.

The Psoas is at the Front So How Can it Cause Back Pain?

The psoas attaches to the facet joints of the lumbar spine (your lower back).

If your psoas muscle is tense, it can put pressure on your facet joints, create shearing forces in your lower spine and stress the lower discs.

A tense psoas muscle can change your posture, which can affect your pelvis and cause pain in your sacroiliac joint.

What Causes Psoas Syndrome?

Psoas dysfunction can occur as a result of chronic back or hip problems. If your core is not stable, your body recruits other muscles such as the psoas to keep you steady. That can overload your psoas muscle.

Psoas syndrome can also come about if you strain the muscle during sports.

Who Gets Psoas Syndrome?

Psoas syndrome can affect anyone but it’s most likely to be a problem for athletes and runners. Bursts of high-energy, high-impact activities like skipping can also trigger psoas syndrome.

Psoas syndrome causes a collection of symptoms. Many of them are quite general and can be related to other conditions. That’s one of the reasons why psoas syndrome is often misdiagnosed.

Symptoms of psoas syndrome include:

• Lower back pain

• Pain when sitting or getting up from a sitting position

• Pain when you try to stand fully upright

• Pain in your buttocks, groin or pelvis

• Pain that spreads down your leg

• Limping or shuffling when you walk.

If you have any of these symptoms, it’s important to see your doctor. Some of these symptoms could indicate other, more serious medical conditions and your doctor may wish to investigate and rule them out before diagnosing psoas syndrome.

Diagnosis is usually made on a clinical basis when your doctor listens to your symptoms and examines your spine, hip and legs. The diagnosis can be confirmed with imaging studies.

Your doctor may order other tests to rule out more worrying conditions.

Psoas syndrome is usually treated by massage, ultrasound and physiotherapy.

Your physio will usually manipulate and stretch your spine, hips and psoas muscle. You may have to do regular exercises at home to stretch and strengthen your psoas muscle.

The underlying cause of the psoas spasm also needs to be addressed. You need to retrain your stabilising muscles (transversus abdominis and pelvic floor) so that you stop overusing the psoas. Your physiotherapist can teach you how to better recruit your core stabilising muscles.

Stubborn psoas muscles may require a psoas sheath injection or dry needling of the muscle.

Will It Get Better?

Usually, yes. With proper diagnosis, treatment and adherence to an exercise program, most people regain a full range of movement and get back to their normal activities.