The iliocostal muscle, together with the thorny and the longísimo, it forms the muscular complex called erector spine. The complete muscle complex is located on the posterior and medial aspect of the trunk, on each side of the spinal column. The iliocostalis is the outermost of the three muscles.
Its name comes from the Latin musculus iliocostalis. It is divided into three portions according to the area through which it passes. The muscle begins at the lumbar level and its fibers go up through the dorsal area, finally reaching the cervical region.
Its function is not different from that carried out by the aforementioned muscular complex (the erector spine), as it works synergistically with the spinous and the longis to keep the spine in an upright position and for the lateral movements of the spine..
Frequently, the iliocostal muscle is affected by the appearance of trigger points that generate pain in the lumbar region, causing a condition often called lumbago..
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It is a long, thin, superficial and even muscle. As this muscle encompasses the entire spine, it has been divided into three portions that are: lumbar iliocostal (iliocostalis lumborum), dorsal iliocostalis (iliocostalis dorsi) and cervical iliocostal (iliocostalis cervicis). As described, its fibers are on the rise.
In the lumbar area, the muscle is condensed into a large muscle mass next to the spinous and the very long.
At the level of the dorsal iliocostalis, the muscle is fully individualized, as is the cervical iliocostalis. The latter is located just next to the longis muscle of the neck, forming part of the posterior and medial neck muscles together with it..
It should be noted that the iliocostal muscle, together with the spinous and longis muscle, make up the erector spine muscle..
The antagonist muscle of the iliocostalis and the erector spinae itself is the rectus abdominis.
The portion corresponding to the lumbar area has its origin in three different anatomical areas.
One part arises in the posterior area of the sacral bone (S3), continuing in the posterior third of the iliac crest of the pelvis, touching the sacroiliac joint, and the last one originates from the L4 and L5 lumbar vertebrae, specifically in the thoracolumbar fascia.
The origin of this portion generates 6 muscle fascicles that are used to achieve its posterior insertion.
It originates from the flat tendons in the dorsal area of the last 6 ribs. It has 6 muscle fascicles.
It is born from the third to the sixth rib. It has 4 muscle fascicles.
This portion is inserted posteriorly and laterally from the sixth rib to the 12th rib. Similarly, at the level of the deep layer of the thoraco-lumbar fascia, as well as in the transverse processes from L1 to L2.
In this case, it is inserted from rib number 1 to rib number 6 by its lower edge, and from the second to the seventh cervical vertebra by its upper edge.
Attaches to the processes of cervical vertebrae number 4, 5 and 6, specifically the posterior tubercles.
The posterior branch of the spinal nerves is in charge of innervating the iliocostal muscle (C1-L8).
The arteries responsible for supplying the iliocostal muscle are the intercostals and the lumbar or subcostals..
The iliocostalis muscle acts in conjunction with the longiscus and the spinous, that is, they work as a single muscle (erector spinal complex) to make it possible to tilt the spine from one side or the other, depending on the muscle that is used. active (right or left).
In the same way, it works synergistically with these muscles to maintain the upright position of the spine, that is, in its extension. In this case it is necessary that both muscles are activated, (right and left).
The lumbar and dorsal area of the back in general are areas highly affected by overloads and tensions that can trigger muscle pain at these levels.
Among the muscles that can be affected is the iliocostalis, specifically the dorsal and lumbar area of this. A malfunction of the muscle can lead to the appearance of trigger points.
The most vulnerable areas for the appearance of trigger points are the dorsal region and the lumbar region of the iliocostalis. Usually it does not affect individually, being involved also the longísimo, the latissimus dorsi and the quadratus lumbar.
When the trigger point is located at the upper end of the dorsal iliocostal muscle, the pain produced radiates from the inner part of the shoulder blade to the chest at its lower edge. This pain is easily confused with angina pectoris.
If instead the trigger point is located at the level of the lower end of the same muscle portion, the pain radiates in different directions that are: up, down and to the side.
The trigger point located at the level of the lumbar iliocostalis causes pain in this region, especially it is concentrated towards the side of the hip and it is possible that it extends towards the buttock.
A large part of patients who complain of pain known as lumbago, is due to the presence of trigger points or fibrositis of the iliocostal muscles at the lumbar level..
Sometimes the pain becomes chronic despite having been treated, when this occurs it may be due to a misdiagnosis, since the pain can not only come from the lumbar region, but also from the sacrococcygeal and pelvic area.
That is why some specialists consider that the lumbar spine should not be seen in isolation, but integrated together with the sacral, coccygeal and pelvic areas, which they call the functional unit..
Trigger points can be eliminated with physiotherapy, for this you can use various techniques, for example muscle stretching, massages and isometric contraction and relaxation techniques, among others..
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