Muscle knots in the Quadratus Lumborum (QL) are located deep in the lower back. These muscle knots often feel like a deep, aching pain in the lower back, especially near the top of the hip or just above the pelvis, and can radiate into the buttocks. These knots can also cause sharp, stabbing sensations when you move, cough, or sneeze, and may radiate into the hips, buttocks, or even the lower abdomen. People often describe the pain as persistent and stiff, making it uncomfortable to sit, stand, or twist for long periods.