Thoracolumbar Fascia Basics

Back depiction including muscles and thoracolumbar fascia
Back depiction including muscles and thoracolumbar fascia. National Library of Medicine/Stocktrek Images / Getty Images

What The Thoracolumbar Fascia Is:

The thoracolumbar fascia is located behind the bony spine at the thoracic and lumbar levels. The term "fascia" refers to thick connective tissue found in different parts of the body. 

From a back view, the thoracolumbar fascia makes a diamond shape. Because of its shape, and its fairly central location on the back, the thoracolumbar fascia is in a position to help unify the movements of the upper body with that of the lower.

Why the Thoracolumbar Fascia Is Unique:

The thoracolumbar fascia is unique because both it supports the back muscles and contributes to their ability to move your body. This is because the fibers that make up fascia are very strong. But fascial tissue also has a degree of flexibility, which enables the thoracolumbar fascia to assist in transmitting forces of movement as the back muscles contract and relax.

The thoracolumbar fascia is key for contralateral motions like walking.

The Three Layers of the Thoracolumbar Fascia:

There are three layers to the thoracolumbar fascia: the back layer (called the posterior layer), the middle layer, and the front layer (called the anterior layer).

Muscles and Their Relation to The Thoracolumbar Fascia:

Many back muscles attach to the thoracolumbar fascia. For example, the erector spinae, a muscle group also known as the paraspinals, run longitudinally down the spine.

The paraspinals are attached to the thoracolumbar fascia, as well as to the bony spine.

The lumbar part of the posterior layer of the thoracolumbar fascia extends from the 12th (lowest) rib down to the top of your hip bone (called the iliac crest). Along the way, it connects with the internal oblique abdominal muscle and the transverse abdominal muscle.

Because of these connections, the thoracolumbar fascia helps bridge the muscles of the back to the muscles of the abdominal wall.

The latissimus dorsi, a large, superficially located back muscle that plays a major role in bearing and moving the weight of the body with the arms and shoulders, originates from the thoracolumbar fascia. (The fibers of the lats, as this muscle is often called, extend outward from the fascia.)

The front part of the thoracolumbar fascia (the anterior layer) covers a muscle called the quadratus lumborum. The quadratus lumborum bends the trunk to the side and helps maintain a healthy upright posture. The quadratus, as it is sometimes called for short, is often implicated in muscle-related low back pain.

 

Related:  All About The Latissimus Dorsi Muscle

The Strength of the Thoracolumbar Fascia:

The thoracolumbar fascia is particularly strong in the lumbar area of the back. That strength is reinforced by the fact that it attaches to the spinal bones.

Dysfunction in the Thoracolumbar Fascia

Chiropractor Perry Nicholston says in his article entitled "Thoracolumbar Fascia: The Chronic Pain Linchpin" and published in Dynamic Chiropractic, that if you have a lot of tension or muscle spams in your lower thoracic area in back, this may indicate some dysfunction in the thoracolumbar fascia.

Other symptoms include (but are not limited to) excess lumbar lordosis (spinal curve) in your low back area with accompanying pain, locking at your sacroilic joint, limited ability to twist your spine in the thoracic area and painful and/or tight hips.  Thoracolumbar fascial dysfunction can even cause shoulder pain, headaches and foot pain, Nicholston says.

So what can you do for problems with your thoracolumbar fascia?  Nicholston suggests getting some manual therapy.  This may mean going to a physical therapist who specializes in manual therapy, or a massage therapist with skills in myofascial release.  

Nicholston also suggests seeing a chiropractor or physical therapist who uses modalities such as low level laser therapy, ultrasound and/or electrical stimulation.

Related: Massage Therapy and How To Choose A Qualified Massage Therapist

Sources:

Loukas M, Shoja MM, Thurston T, Jones VL, Linganna S, Tubbs RS. "Anatomy and biomechanics of the vertebral aponeurosis part of the posterior layer of the thoracolumbar fascia." Surg Radiol Anat. 2008 Mar;30(2):125-9. Epub 2007 Dec 18. http://www.ncbi.nlm.nih.gov/pubmed/18087664

Moore, K., Dalley, A. Clinically Oriented Anatomy. Fifth. Edition. Lippincott,Williams & Wilkins. 2006. Baltimore.

Nickelston, P., D.C., Thoracolumbar Fascia: The Chronic Pain Linchpin. Dynamic Chioropractic. November 2013. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56728

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