If you’re reading this, you’re likely dealing with pain in the lower left abdomen and back and have no idea what it means or what to do next. After a few Google searches, you’ve probably seen a long list of possible diagnoses. Before you panic, let’s talk about the most common—but often ignored—musculoskeletal cause of this pain and, more importantly, what you can do to treat it. This blog focuses on the muscle-skeletal issues behind pain in the lower left abdomen and back.
What Is Pain In the Lower Left Abdomen and Back?
Many different issues can cause pain in the lower left back, but when you feel the discomfort in both your lower back and your lower left abdomen, one structure becomes a prime suspect. If your pain shows up while walking, bending forward, moving from bending to standing, getting out of a chair, or rotating your torso while your pelvis stays still, you’re likely dealing with a musculoskeletal imbalance.
Most people point to the lower abdominal area near the groin when describing pain in the lower left abdomen and back. To understand what’s really happening, we need a quick and simple anatomy lesson.
A strong candidate for your symptoms is a muscle called the psoas (the “p” is silent). This muscle begins at the bottom of the thoracic spine (T12), continues down the entire lumbar spine (L1–L5), travels along the inside of t
Psoas Muscle (Right and Left)
he pelvic bones, crosses the pubic region, and attaches to the femur (thigh bone).
In other words, it’s a long muscle connecting your lower back to the front of your lower abdomen and then to your thigh. The psoas flexes the hip—like when your thigh moves toward your torso during walking—or flexes the torso when your legs stay still.
Because the psoas spans the lower back, hip, and pelvis, anything you do involving these areas directly affects the muscle. It’s one of your major hip flexors, which makes it extremely vulnerable to lifestyle-related dysfunction. I see this problem in a large percentage of my desk-bound patients, and I’ll explain why.
What Causes Pain in the Lower Left Abdomen and Back?
Now that you understand the psoas, let’s go over what makes it painful and what you should avoid. Muscles become problematic when you overuse or underuse them. Overuse makes them short, tight, and tired. Underuse makes them weak. Both scenarios lead to the same end result: dysfunction.
Our lifestyle patterns shape how our body moves. Humans are designed to move the same way—something we know because babies around the world follow the exact same developmental stages. This built-in movement blueprint guides how muscles strengthen, how nerves fire, and how movement patterns form. Problems start when we stray from these innate patterns.
The psoas is no exception. It flexes the hip and torso, both of which happen in walking and sitting. When you sit for long periods, the psoas remains shortened. A chronically shortened muscle becomes weak and dysfunctional. Then, when you stand up or walk, one end of the muscle stays fixed, forcing the other end to compensate. The result? Your torso bends forward and rotates slightly.
You now walk with a bent-forward, twisted torso—exactly the opposite of what your body is designed to do. Over time, your brain rewires itself around this dysfunctional pattern. You unknowingly re-program your entire movement system, affecting everything from muscle coordination to joint stability.
The Missing Link
You feel pain, so you stretch the tight area. But the problem doesn’t exist in isolation. Movement requires multiple muscles to coordinate—much like musicians in an orchestra. Each part has its moment to lead, support, or blend in. When one “musician” loses rhythm, the entire performance suffers.
Your pain started with something simple: sitting. Sitting for long hours, even while working and being productive, still counts as prolonged sitting. Then you decide to play basketball, go for a run, hit the gym, or hop on a bike. How can a weak, overworked muscle keep up?
You end up with an even weaker, more exhausted psoas. You go back to sitting. And the cycle repeats.
At this point, it’s no surprise you’re in pain. Pain medication numbs the sensation, but it doesn’t fix the cause. Physical therapy focused only on the painful area helps temporarily, but the pain returns because the movement pattern never changed. The brain still uses dysfunctional shortcuts it created to compensate for the weak psoas and surrounding areas.
Just strengthening the psoas or working on the lower back won’t correct the faulty movement blueprint.
If you are wondering if there is even a right treatment for these types of problems out there, thankfully the answer is yes.
The Most Effective Treatment for the Lower Left Abdomen and Back Pain?
The first step in treating any musculoskeletal problem is to stop whatever is feeding it. That’s why you NEED to use my Free Ergonomic Checklist. If you continue to sit the same way and set up your workstation the same way, no treatment will stick. You can also read my Ergonomic Fix Blog for more detail.
Next, you need a Postural Neurology Exam. This assessment identifies how your brain has changed its control of movement, sensation, and posture as a result of your dysfunction. We’re looking at function—not just pain.
Once ergonomics are corrected, we still have to address the existing damage. Many patients need targeted functional rehab such as Active Release Technique (ART). ART helps clean up soft-tissue restrictions, reduce joint adhesions, and activate exhausted or underused muscles.
To correct the dysfunctional movement patterns caused by psoas imbalance, I rely on Dynamic Neuromuscular Stabilization (DNS), also known as Developmental Kinesiology. The principles come from observing how babies develop perfect movement without equipment, gyms, or bands. Their patterns reflect a pure, innate blueprint that adults must return to when something breaks down.
DNS helps restore proper muscle sequencing, joint stability, and postural control. It retrains the body the way it originally learned to move.
If you want to learn more about functional movement, how Postural Neurology and DNS can help and all other services we utilize in treating our patients, make sure to visit my website and contact the office if you need help.
Dr.Shakib