The major ligament to know about in the lumbar area is the iliolumbar ligament that starts at the iliac crest and inserts along the transverse processes of L4 and L5. This ligament will decrease the lower lumbar mobility and often contributes to referred pain in the lumbar area. The spinal cord itself ends at L2 with the cauda equina passing through the canal lower than this. The iliopsoas muscle is important here because several major nerves pass near this muscle. Directly through the psoas major muscle is the genitofemoral nerve, which can lead to anterior thigh or groin pain should there be psoas muscle tension. Another potential problem is pyriformis syndrome, which can lead to sciatica if this muscle is tight or dysfunctional. Figure 5 demonstrates pyriformis syndrome:
Figure 5.
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