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Writer's pictureDr. Jill King

Why Your Psoas Can Cause Back Pain




The psoas muscle (pronounced so-as) is a large muscle in the human body that connects the upper body to the lower body. It originates from the vertebral bodies of the lower thoracic and upper lumbar regions of the spine and inserts on the lesser trochanter of the femur bone in the thigh. The psoas muscle is involved in various movements of the trunk, hips, and legs, including hip flexion, spinal stabilizationization, and supporting the torso when standing and walking.


Due to its location and function, tightness or tension in the psoas muscle can cause lower back pain and discomfort, as well as hip and thigh pain. Stretching and strengthening exercises can help maintain flexibility and prevent injury.


A weak psoas muscle can result in decreased hip stability and cause lower back pain. It can also lead to imbalances in the hips and legs, which can contribute to knee pain, hip pain, and difficulty with activities like running and jumping.


A tight psoas muscle, on the other hand, can pull the lower back forward and result in an anterior pelvic tilt, leading to low back pain and discomfort. It can also contribute to hip pain and restricted range of motion in the hips, which can impact activities like walking, sitting and standing.


When the psoas muscle is tight or in spasm, it can cause tension and pull on the lower back, leading to pain. Additionally, the tight or weak psoas can result in imbalances in the hips and legs, which can affect posture and cause strain on the lower back.


Other factors that can contribute to psoas-related back pain include:

  1. Poor posture: Sitting for long periods of time, slouching, and other postural habits can put added stress on the psoas and cause pain in the lower back.

  2. Overuse or injury: Overuse of the psoas muscle from activities such as running or cycling, or an injury to the hip or lower back, can cause pain and spasms in the psoas muscle.

  3. Dehydration: Dehydration can cause the psoas muscle to become stiff and painful.

  4. Stress: Chronic stress can cause the psoas muscle to become tight and result in lower back pain.

It is important to address psoas-related back pain by stretching, strengthening, and addressing any underlying causes, such as poor posture or stress. Stretching the psoas muscle can be an effective way to relieve back pain.


Here are three simple psoas stretches you can do to help alleviate back pain:

  1. Lizard Pose: Start in a high plank position with your hands under your shoulders and your feet hip-width apart. Step your right foot to the outside of your right hand and hold for 30 seconds to 1 minute. Repeat on the other side.

  2. Figure Four Stretch: Lie on your back and cross your right ankle over your left knee. Grasp your left thigh and pull your knee towards your chest until you feel a stretch in your right hip. Hold for 30 seconds to 1 minute and repeat on the other side.

  3. Seated Psoas Stretch: Sit on the edge of a chair with your feet flat on the floor. Cross your right ankle over your left knee and lean forward, keeping your back straight, until you feel a stretch in your right hip. Hold for 30 seconds to 1 minute and repeat on the other side.

Remember to breathe deeply and ease into the stretch slowly. It's important never to push yourself beyond your comfort level. Stretching should be pain-free and gentle. If you feel any discomfort or pain during these stretches, stop immediately and seek the advice of a healthcare professional.


Strengthening the psoas muscle can help to improve hip stability, core strength, and posture. Here are some exercises that can help strengthen the psoas:

  1. Bridging: Lie on your back with your knees bent and feet flat on the floor. Raise your hips toward the ceiling, keeping your core engaged. Lower back down and repeat for 10-15 repetitions.

  2. Clamshells: Lie on your side with your legs bent at a 90-degree angle and your feet together. Keeping your feet touching, lift your top knee as high as you can while keeping your feet together. Lower your knee and repeat for 10-15 repetitions on each side.

  3. Fire hydrants: Start on all fours with your hands under your shoulders and your knees under your hips. Keeping your knee bent, lift your right knee out to the side and then return to starting position. Repeat for 10-15 repetitions on each side.

  4. Leg lifts: Lie on your back with your arms at your sides. Keeping your legs straight, lift one leg up towards the ceiling, then lower it back down. Repeat for 10-15 repetitions on each side.

  5. Lunges: Stand with your feet hip-width apart. Step forward with one leg, lowering your body until both legs form 90-degree angles. Push back up to starting position and repeat for 10-15 repetitions on each side.

It is important to start slowly and progress gradually with these exercises, being mindful of proper form and avoiding pain.


The amount of time it takes to get a stronger and more flexible psoas will vary depending on several factors, including your current fitness level, the severity of any imbalances or pain, and the consistency and intensity of your exercise program.


In general, it is possible to see improvement in psoas strength and flexibility within 4-6 weeks of consistent exercise, but some individuals may require more time, and others may see quicker results. The key to success is to be consistent with your exercise program and to gradually increase the intensity and complexity of the exercises as your strength and flexibility improve.


It's also important to remember that strengthening the psoas is just one part of overall fitness, and a well-rounded program that includes strength training, cardiovascular exercise, and stretching is important for optimal health and well-being.






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