Introduction: The pain characteristics of myofascial pain syndrome (MPS) are usually described as \"dull,\" \"achy,\" or \"deep.\" However, it is also one of the features of MPS that it can be confused with cervical or lumbar radiculopathy if the patient complains of paresthesia. Though our case of acute exacerbation of low back pain (LBP) with paresthesia, we would like to remind you of MPS, especially quadratus lumborum (QL).
Case: A 46-year-old female outpatient complained low back pain starting when she took off her top a week ago. Her pain described as an electric shock worsened after injection of local anesthetics into painful area at a local clinic, making it hard to sit down and it didn’t improve after six days despite pain medication. She had no medical history except for bulging disc in L5/S1. On her physical examination, there are trigger points on muscle areas specific to quadratus lumborum in her left lumbar para-spinal space. With trigger point injections under real-time ultrasound guidance, her unendurable pain is alleviated.
Conclusions: It should be important to rule out MPS, especially QL syndrome, by confirming active trigger points through palpation in a patient with LBP.