Understanding Lower Back Pain: Could a Tight Iliacus Be the Cause?

Lower back pain is one of the most common complaints I see in my practice. While many people think of the low back muscles or the spine itself as the problem, the root cause often lies deeper — in a small but powerful muscle called the iliacus.

What Is the Iliacus?

The iliacus is a hip flexor muscle that sits deep inside the pelvis. Together with the psoas, it forms the iliopsoas group, which plays a major role in stabilizing your spine and pelvis, supporting posture, and powering movements like walking, climbing stairs, or standing up from a chair.

When the iliacus becomes tight or restricted, it can pull on the pelvis and spine, leading to:

Lower back pain (especially when standing or walking for long periods) Hip discomfort or stiffness Difficulty standing fully upright Compensations in posture that create further tension in the body

Why Does the Iliacus Get Tight?

The iliacus can become shortened or restricted due to:

Sitting for long periods of time Repetitive activities like running or cycling Stress and tension patterns in the body Poor posture or misalignment in the hips and pelvis

Over time, a tight iliacus can create a cycle of discomfort — the muscle stays contracted, the pelvis tilts forward, and the low back muscles are left to pick up the slack.

How Massage and Bodywork Help

Massage therapy can help release the iliacus and surrounding hip flexors by:

Softening muscle tension through deep tissue and myofascial techniques Restoring balance to the pelvis and lower back Improving mobility in the hips and spine Reducing pain and compensations caused by tightness

In sessions, I often integrate iliacus work into a broader plan that addresses not just the symptoms, but the root cause of your discomfort.

A Helpful Resource: Do You Have a Tight Iliacus?

Not sure if this muscle might be behind your lower back pain? This video walks you through simple ways to identify if your iliacus is the issue — and offers helpful stretches for relief:

▶️ Watch on YouTube: Tight Iliacus and Low Back Pain

Takeaway

If you’ve been dealing with persistent lower back pain, don’t overlook the iliacus! This small but mighty muscle could be the hidden culprit behind your discomfort. Massage, stretching, and mindful movement can help bring your body back into alignment — and give your lower back the relief it deserves.