Back Clinic Chronic Back Pain Team. Chronic back pain has a far-reaching effect on many physiological processes. Dr. Jimenez reveals topics and issues affecting his patients. Understanding the pain is critical to its treatment. So here we begin the process for our patients in the journey of recovery.
Just about everyone feels pain from time to time. When you cut your finger or pull a muscle, pain is your body’s way of telling you something is wrong. Once the injury heals, you stop hurting.
Chronic pain is different. Your body keeps hurting weeks, months, or even years after the injury. Doctors often define chronic pain as any pain that lasts for 3 to 6 months or more.
Chronic back pain can have real effects on your day-to-day life and your mental health. But you and your doctor can work together to treat it.
Do call upon us to help you. We do understand the problem that should never be taken lightly.
When it comes to the torso is surrounded by various muscles that help protect the vital organs known as the gut system and help with stabilizing the spinal column in the body. The abdominal muscles are essential to maintaining good posture and core support for many individuals. When normal activities or chronic issues begin to affect the body, the abdominal muscles can also be affected and can cause referred pain all around the torso area. When the abdominal muscles are dealing with referred pain, it can develop into trigger points that mask other chronic conditions affecting the torso and the thoracolumbar region. Today’s article looks at the abdominal muscles and their function, how trigger points are affecting the abdomen, and how various treatments help manage trigger points associated with abdominal pain. We refer patients to certified providers who provide different techniques in abdominal pain therapies related to trigger points to aid many suffering from pain-like symptoms along the abdominal muscles along the torso. We encourage patients by referring them to our associated medical providers based on their examination when it is appropriate. We designate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Abdominal Muscles & Their Function
Do you have trouble moving around? Have you been dealing with muscle spasms along your abdomen? Does it hurt when you are sneezing, laughing, or coughing constantly? All these actions affecting your abdominal muscles might correlate with trigger points along the muscles and disrupt the torso area. The abdomen in the body has various muscles, a complex organ with many functions that contribute to a person’s quality of life. The abdominal muscles have many important parts, from supporting the trunk, allowing movement like twisting and turning, and holding the organs in the gut system in place through internal abdominal pressure regulation. The abdominal muscles have five main muscles that work together with the back muscles to keep body stability. They are:
Pyramidalis
Rectus Abdominus
External Obliques
Internal Obliques
Transversus Abdominis
Studies reveal that the abdominal muscles can help increase the stability of the lumbar region of the body from the vertebral columns by tending the thoracolumbar fascia and raising the intra-abdominal pressure. This allows the abdominal muscle to bend and flex in different positions without feeling pain. However, overusing the abdominal muscles can lead to unnecessary issues that can affect not only the torso but the surrounding muscles around the torso.
How Trigger Points Are Affecting The Abdomen
The book “Myofascial Pain and Dysfunction,” by Dr. Janet Travell, M.D., mentioned that abdominal symptoms are common and can cause diagnostic confusion for many people. Since the abdominal muscles can provide stability to the body’s trunk when a person overuses the abdominal muscles through various activities like quick and violent twisting of the mid-section, lifting heavy objects with the core instead of the legs, overdoing exercise regimes, or having a persistent cough, these various activities could potentially lead to the development of trigger points in the abdominal muscles causing pain in the abdomen and causing referred pain to the lower back. Studies reveal that trigger points along the abdominal muscles are developed through aggravating factors like prolonged sitting or standing can cause the abdominal muscles to become extremely tender and hyperirritable along the taut muscle bands. When trigger points affect the abdominal muscles, they can produce referred abdominal pain and visceral disorders (somato-visceral effects) that work closely together to mimic visceral diseases. This pertains to many individuals thinking something is wrong in their gut system, but their abdominal muscles are causing issues in their bodies.
Releasing Trigger Points In The Abdominal Muscles-Video
Have you been experiencing abdominal issues around your torso? Does it hurt when you laugh, cough, or sneeze? Do you feel muscle stiffness or tenderness along your abdominals? If you have been dealing with these symptoms throughout your life, you could be experiencing abdominal pain associated with trigger points in your torso. Abdominal pain is common for many individuals and can vary from gut issues or muscle issues that various factors can cause in the torso. Abdominal issues can even cause confusion to doctors when they are diagnosing the issues that are affecting their patients. When various actions cause pain to the abdominals, it can develop referred pain associated with trigger points. Trigger points develop when the muscle has been overused, creating tiny nodules in the taut band. Trigger points can be tricky to pinpoint but are treatable. The video above shows where the trigger points are located in the abdominal muscles and how to release them from the affected abdominal muscles to provide relief and reduce the mimic effects of visceral-somatic pain.
Managing Trigger Points Associated With Abdominal Pain Through Various Treatments
When abdominal pain affects the muscles, the symptoms can develop trigger points. When this happens, it can lead to confusion and often misdiagnosed. All is not lost; there are ways to manage trigger points associated with abdominal pain through various treatments. Studies reveal that various therapies like dry needling combined with palpations can reduce trigger points from causing more referred pain issues in the abdomen. Other ways to prevent trigger points from developing in the future are through exercises that can help strengthen the abdominal muscles. Exercises like abdominal breathing, pelvic tilts, sit-ups, and even laughter can help strengthen weak abdominal muscles and positively affect the body.
Conclusion
The torso has various muscles, known as abdominal muscles, that help protect the vital organs in the gut system, help stabilize the spinal column, and maintain good posture for many individuals. Various factors affecting the abdominal muscles can lead to a confusing diagnosis, as it could be an internal or external issue. When the abdominal muscles are affected by being overused through various activities, it can develop into trigger points in the muscles, causing visceral referred pain to the torso and cause muscle weakness. Luckily multiple treatments can help reduce the effects of trigger points associated with abdominal pain and can help strengthen the core of the body. This allows the individual to feel better and consider what not to do to their abdominals.
References
Balyan, Rohit, et al. “Abdominal Wall Myofascial Pain: Still an Unrecognized Clinical Entity.” The Korean Journal of Pain, The Korean Pain Society, Oct. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5665744/.
Rajkannan, Pandurangan, and Rajagopalan Vijayaraghavan. “Dry Needling in Chronic Abdominal Wall Pain of Uncertain Origin.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, Jan. 2019, pubmed.ncbi.nlm.nih.gov/30691770/.
Seeras, Kevin, et al. “Anatomy, Abdomen and Pelvis, Anterolateral Abdominal Wall.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 July 2022, www.ncbi.nlm.nih.gov/books/NBK525975/.
Tesh, K M, et al. “The Abdominal Muscles and Vertebral Stability.” Spine, U.S. National Library of Medicine, June 1987, pubmed.ncbi.nlm.nih.gov/2957802/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Many individuals don’t realize that the various muscles in their back help provide functionality to the body. The back muscles help move, bend, rotate, and help the individual stand up straight when they are out and about. The back muscles also help protect the cervical, thoracic, and lumbar sections of the spine and work together with the head, neck, shoulders, arms, and legs to provide mobility. When the body begins to wear down with age naturally, it can lead to back issues that can limit a person’s mobility, or normal activities can cause the back muscles to be overused and develop trigger points to invoke back pain or lumbago. Today’s article looks at the thoracolumbar paraspinal muscles in the back, how the lumbago is associated with trigger points, and treatments to relieve the lumbago in the thoracolumbar muscles. We refer patients to certified providers who provide different techniques in thoracic lumbar back pain therapies associated with trigger points to aid many suffering from pain-like symptoms along the thoracolumbar paraspinal muscles along the back, causing lumbago. We encourage patients by referring them to our associated medical providers based on their examination when it is appropriate. We designate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Thoracolumbar Paraspinal Muscles In The Back
Have you been finding it difficult to walk even for a short period? Do you feel aches and soreness when getting out of bed? Are you constantly in pain when bending over to pick up items from the ground? These various actions that you are doing incorporate the thoracolumbar paraspinal muscle in the back, and when issues affect these muscles, it can lead to lumbago associated with trigger points. The thoracolumbar paraspinal in the back is a group of muscles closely surrounded by the thoracolumbar spine, where the thoracic region ends, and the lumbar region begins. The thoracolumbar paraspinal muscles in the back have a casual relationship with the body as it requires contribution from the systems requiring movement. Studies reveal that the thoracolumbar paraspinal muscles are modulated through communication with the three sub-systems, which include:
The passive system: vertebrae, discs, and ligaments
The active system: muscles and tendons
The control system: central nervous system and nerves
Each system provides muscular activities when a person is bending down to pick up an object or doing simple movements. However, when the muscles become overused, it can lead to various issues affecting the back and surrounding muscles.
Lumbago Associated With Trigger Points
Studies reveal that paraspinal muscle integrity plays a very critical role when it comes to the maintenance of spinal alignment in the back. When the thoracolumbar paraspinal muscles become overused from normal activities, it can affect the back by causing back pain symptoms or lumbago associated with trigger points. In Dr. Travell, M.D.’s book “Myofascial Pain and Dysfunction,” trigger points may be activated due to sudden movements or sustained muscular contraction over time that leads to the development of lumbago. Atrophy issues in the paraspinal muscles can contribute to lumbago associated with trigger points that cause deep referred pain in the thoracolumbar regions of the back. Active trigger points in the deep muscle group of the thoracolumbar paraspinal can impair movement between the vertebrae during flexion or side bending.
An Overview Of Lumbago- Video
Lumbago or back pain is one of the most common issues that many individuals, from acute to chronic, depending on how severe the pain is inflicted on the back. Have you been feeling pain in your mid-lower back? Do you feel an electric shock when you run down your leg in a weird position? Or have you felt tenderness in the middle of your back? Experiencing these symptoms could indicate that the thoracolumbar paraspinal muscles are affected by trigger points associated with lumbago. The video explains what lumbago is, the symptoms, and various treatment options to relieve the pain and manage trigger points that are causing the thoracolumbar muscles issues in the back. Many individuals who suffer from lumbago don’t often realize that various factors can affect the surrounding muscles in the thoracolumbar region and mask other previous conditions from which they could suffer. Regarding managing lumbago associated with trigger points, various treatment options can help reduce the pain affecting the thoracolumbar paraspinal muscles while managing trigger points for progressing further in the back.
Treatments To Relieve Lumbago In The Thoracolumbar Muscles
Since lumbago or back pain is a common issue for many people, various treatments can reduce the pain-like symptoms in the thoracolumbar muscles and manage the associated trigger points. Some of the simplest treatments that many individuals can use are to correct how they are standing. Many individuals often lean on one side of their bodies which causes the thoracolumbar paraspinal muscles on the opposite sides to be overloaded. This causes spinal subluxation or misalignment to the thoracolumbar region. Another treatment that many people can incorporate into their daily lives is by going to a chiropractor for a spinal adjustment for the thoracolumbar spine. Studies reveal that chiropractic care combined with physical therapy can relieve the thoracolumbar back while reducing the pain symptoms associated with trigger points by loosening the stiff muscles and causing relief to the back.
Conclusion
The back has various muscles known as the thoracolumbar paraspinal muscles that allow movement and mobility to the body. The back muscles help protect the cervical, thoracic, and lumbar sections of the spine while working with the rest of the body’s components to keep the body stable. When natural aging or actions affect the back muscles, it can lead to various pain issues that can activate trigger points causing lumbago or back pain. Fortunately, some treatments can help alleviate back pain in the thoracolumbar paraspinal muscles while managing trigger points to bring back mobility to the back.
du Rose, Alister, and Alan Breen. “Relationships between Paraspinal Muscle Activity and Lumbar Inter-Vertebral Range of Motion.” Healthcare (Basel, Switzerland), MDPI, 5 Jan. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4934538/.
He, Kevin, et al. “The Implications of Paraspinal Muscle Atrophy in Low Back Pain, Thoracolumbar Pathology, and Clinical Outcomes after Spine Surgery: A Review of the Literature.” Global Spine Journal, SAGE Publications, Aug. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7359686/.
Khodakarami, Nima. “Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation.” Healthcare (Basel, Switzerland), MDPI, 24 Feb. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7151187/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
As the “backbone” of the body, the thoracic region of the back has various muscles that help support the ribcage and protect the heart and lungs from injuries. The thoracic spine’s main function is providing respiration and maintaining good posture. However, various habits can cause issues to the muscles in the thoracic spine, which leads to upper back pain and the development of trigger points. One of the thoracic muscles affected by trigger points is the serratus posterior inferior muscle. Today’s article looks at the serratus posterior inferior muscle, how trigger points affect the thoracic region of the back, and how to manage thoracic back pain associated with trigger points. We refer patients to certified providers who provide different techniques in thoracic back pain therapies associated with trigger points to aid many suffering from pain-like symptoms along the serratus posterior inferior muscle along the back. We encourage patients by referring them to our associated medical providers based on their examination when it is appropriate. We designate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
What Is The Serratus Posterior Inferior Muscle?
Have you felt aches and pain when bending down to pick something up? What about feeling tenderness near your lower back? Or have you experienced muscle stiffness when stretching? Many of these symptoms are associated with back pain that correlates to overusing the thoracic muscles, which includes the serratus inferior posterior muscles. The serratus posterior muscles (superior and inferior) are accessory breathing muscles as part of the extrinsic muscles. The serratus posterior inferior helps with the chest cavity’s expiration, while the superior help with inspiration. Some of the functionalities that the serratus posterior inferior provides are that in a bilateral action, the inferior works with the superior muscles to reduce the extension of the thoracic vertebrae.
In contrast, the unilateral action for the serratus posterior inferior muscle helps rotate the spine to the opposite sides. Studies reveal that based on the attachment of the serratus, the posterior inferior and superior are generally considered insignificant muscles. Since the serratus posterior muscles help aid respiration to the thoracic region, it can be succumbed to trigger points or myofascial pain syndrome that can affect the thoracic part of the back.
How Trigger Points Affect The Thoracic Region?
When the serratus posterior muscles in the thoracic region are affected by myofascial pain syndrome or trigger points, it correlates to the various activities the person has been doing that cause muscle strain along the serratus inferior posterior muscle. The book, “Myofascial Pain & Dysfunction” explains that when individuals feel a nagging ache in the lower thoracic region of the back, it correlates to residual backache associated with trigger points. Studies reveal that trigger points or myofascial pain syndrome are musculoskeletal pain disorder that affects one or multiple muscles in the body. Since back pain is common, trigger points can cause hyperirritability in the muscle’s taut band due to various factors that can cause strain on the affected muscle. When it comes to the serratus posterior inferior muscle developing active trigger points, it’s due to overload strain from combined movements like lifting, turning, and reaching for items that can also affect the surrounding muscles in the thoracic region of the back.
Trigger Point Of The Week: Serratus Posterior Inferior- Video
Have you been dealing with pain in your upper back in the thoracic region? Do you experience tenderness or soreness near your ribcage? Or have you felt a twinge of pain when turning your torso? Most of these symptoms are common signs that the thoracic region is affected by trigger points along the serratus posterior inferior muscle. The video explains where the serratus posterior inferior is located while pinpointing where the trigger points are located in the thoracic region of the back. Trigger points associated with thoracic back pain mimic other chronic conditions that can cause muscle tension and strain on the upper back. Studies reveal that latent and active trigger points affecting the upper thoracic area muscles can make many individuals feel more pain than they can tolerate. This can affect how a person functions and can make them feel inadequate. However, it is possible to incorporate a variety of treatments to reduce the pain and manage trigger points from progressing further in the thoracic region of the back.
Managing Thoracic Back Pain Associated With Trigger Points
Various treatments are available to reduce the pain affecting the thoracic region of the back and even manage trigger points associated with the serratus posterior inferior muscle. Many individuals often go to a chiropractor to relieve their back pain. Chiropractors utilize their hands and various techniques to manipulate the spine and can even pinpoint where the trigger points affect the multiple muscles in the thoracic region. Chiropractors even work with other pain specialists to devise a treatment procedure to reduce the symptoms while managing thoracic back pain associated with trigger points. Studies reveal that by when pain specialists like chiropractors begin identifying proper treatment strategies for managing thoracic back pain associated with trigger points, it might be able to reduce pain and improve function for many people dealing with thoracic back pain.
Conclusion
The thoracic region of the back has various muscles that help support the ribcage and protect vital organs, which include the heart and the lungs. One of the muscles in the thoracic region is the serratus posterior inferior muscle, an accessory breathing muscle that helps with the chest cavity expiration and helps reduce the extension of the thoracic vertebrae. When the inferior muscle becomes overused by various movements, it can develop trigger points along the inferior muscle, causing thoracic back pain. Trigger points along the serratus inferior posterior muscles can mimic other chronic conditions that can cause symptoms of muscle tension and strain on the upper back. Luckily, various treatments have been available to reduce pain symptoms and manage thoracic back pain associated with trigger points. These treatments can bring back mobility to the thoracic region of the back without the individual being in pain.
References
Chen, Chee Kean, and Abd Jalil Nizar. “Myofascial Pain Syndrome in Chronic Back Pain Patients.” The Korean Journal of Pain, The Korean Pain Society, June 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3111556/.
Dor, Adi, et al. “Proximal Myofascial Pain in Patients with Distal Complex Regional Pain Syndrome of the Upper Limb.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, July 2019, pubmed.ncbi.nlm.nih.gov/31563368/.
Mitchell, Brittney, et al. “Anatomy, Back, Extrinsic Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK537216/.
Ortega-Santiago, Ricardo, et al. “Widespread Pressure Pain Sensitivity and Referred Pain from Trigger Points in Patients with Upper Thoracic Spine Pain.” Pain Medicine (Malden, Mass.), U.S. National Library of Medicine, 1 July 2019, pubmed.ncbi.nlm.nih.gov/30821833/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Vilensky , J A, et al. “Serratus Posterior Muscles: Anatomy, Clinical Relevance, and Function.” Clinical Anatomy (New York, N.Y.), U.S. National Library of Medicine, July 2001, pubmed.ncbi.nlm.nih.gov/11424195/.
The upper back is part of the thoracic region of the spine, surrounded by various muscles that protect the thoracic joints and help assist with respiratory functionality for the lungs. The upper back muscles consist of the rhomboids and the trapezoid muscles that provide functionality to the scapula or shoulder blades. Other superficial muscles offer assistance to the thoracic spine. The serratus posterior muscle is one of the superficial muscles that helps the thoracic spine and, like all superficial muscles, can succumb to injuries that can lead to the development of overlapping referred pain symptoms known as trigger points. Today’s article focuses on the serratus posterior muscle function in the back, how trigger points are causing upper back pain, and various techniques to manage trigger points in the upper back. We refer patients to certified providers who are diverse in upper back pain therapies to aid many people suffering from myofascial pain syndrome or trigger points associated with the serratus posterior muscle along the upper back. We advised patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Serratus Posterior Muscle Function In The Back
Have you been dealing with constant upper back pain? Do you feel soreness at the base of your neck? Or are you having difficulty breathing? Most of the symptoms cause pain in the serratus posterior muscles that can lead to the development of myofascial pain syndrome or trigger points along the upper back. The serratus posterior has various roles in the upper back as it is not only part of the extrinsic muscles but also part of the accessory breathing muscle. The serratus posterior muscle helps with inspiration, which causes the chest cavity to expand as it is a superficial muscle attached to the ribs and is less commonly known. Studies show that the serratus posterior muscle is deep within the rhomboid muscles and is superficial. Even though this muscle is superficial when it has been overused through various activities, that can cause hypertrophy in the accessory respiratory muscles. Additional studies reveal that the serratus posterior superior muscle is considered clinically insignificant but has been impaired by myofascial pain syndrome or trigger points that can lead to upper back pain.
Trigger Points Causing Upper Back Pain
As stated earlier, the upper back is part of the thoracic region of the spine, and when various factors begin to affect the body, the back muscles tend to be involved. Studies reveal numerous sources of spinal pain in the thoracic spine. One is a myofascial pain syndrome affecting the serratus posterior muscles causing referred upper back pain. Myofascial pain syndrome or trigger points can be activated when the serratus posterior muscle is overloaded from thoracic respiratory issues like coughing due to pneumonia, asthma, or chronic emphysema. When respiratory problems affect the muscles in the thoracic region of the back, it leads to the development of trigger points, leading to overlapping issues like referred pain, motor dysfunction, and autonomic phenomena. According to Dr. Travell, M.D., in the upper back, trigger points can make the serratus posterior muscle cause overlapping risk profiles along the shoulder blades and have referred pain travel to the hands. This can make many individuals suffer from serious pain-like symptoms, causing them to be miserable.
Releasing Trigger Points Related Tension In The Upper Back-Video
Have you been dealing with respiratory issues causing you to be hunched over constantly? Do you feel soreness or tenderness at the base of your neck? Or are you suffering from upper back pain? These symptoms are associated with trigger points that are affecting the serratus posterior muscles causing upper back pain. Trigger points, or myofascial pain syndrome, is a musculoskeletal disorder that causes tenderness along the affected muscle that causes referred pain to the surrounding muscles in the body. Trigger points associated with the serratus posterior muscles can cause referred pain in the upper back and mimic various chronic conditions. Trigger point pain is difficult to diagnose but can be manageable with treatment. The video above gives examples of how to treat trigger points to relieve tension in the upper back.
Various Techniques To Manage Trigger Points In The Upper Back
When it comes to upper back pain, many individuals will go to pain specialists like massage therapists or chiropractors to relieve any issues affecting the upper back. These pain specialists utilize various techniques like stretching, spinal manipulation, massages, and ischemic compression to alleviate pain and manage trigger points from forming further in the affected muscle. Pain specialists like massage therapists or chiropractors are excellent for locating pain-like symptoms associated with trigger points. Even though treatment can help manage symptoms associated with trigger points, many people can still incorporate these techniques, like deep breathing or correcting their posture, to prevent the upper back muscles from becoming strained and causing more issues than before.
Conclusion
The serratus posterior muscles have various roles in the upper back region of the body. These superficial muscles are extrinsic and accessory breathing muscles that help expand the chest cavity. When multiple issues affect the upper back muscles, like strenuous activities or respiratory problems, it can develop trigger points along the serratus posterior muscles and invoke pain-like symptoms to travel down to the hand, causing mobility issues. Thankfully, various techniques that pain specialists like chiropractors and massage therapists use can help manage trigger points from escalating and can bring upper back mobility to the body once again.
Briggs, Andrew M, et al. “Thoracic Spine Pain in the General Population: Prevalence, Incidence and Associated Factors in Children, Adolescents and Adults. A Systematic Review.” BMC Musculoskeletal Disorders, BioMed Central, 29 June 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2720379/.
Mitchell, Brittney, et al. “Anatomy, Back, Extrinsic Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK537216/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Vilensky, J A, et al. “Serratus Posterior Muscles: Anatomy, Clinical Relevance, and Function.” Clinical Anatomy (New York, N.Y.), U.S. National Library of Medicine, July 2001, pubmed.ncbi.nlm.nih.gov/11424195/.
Spondyloarthritis is a group of inflammatory, immune-mediated diseases that cause chronic low back pain, inflammation, irritating aches, and pains. The conditions mostly affect the spine but can affect joints in the arms, legs, hips, skin, eyes, and intestines. Spondylitis types can significantly affect daily function, physical activity and compromise bone health.
Spondylitis Types
The main types include:
Ankylosing spondylitis
Psoriatic arthritis
Enteropathic arthritis
Reactive arthritis
Juvenile spondylitis
Undifferentiated spondylitis
Axial Spondylitis vs. Peripheral Spondylitis Types
Axial means relating to the body’s central region, as in the trunk and head.
Axial spondyloarthritis is arthritis and inflammation in the hips and spine.
The condition starts before age 45.
The pain typically starts in the low back but can begin in the neck or other regions.
Characterized by back pain, usually in the lower back and/or buttocks.
Morning back stiffness lasting 30 minutes or longer.
Sacroiliac joint inflammation can also present.
The back pain gradually progresses.
Lasts longer than three months.
Improves with physical movement, not with rest.
Peripheral spondyloarthritis is arthritis and inflammatory pain in the peripheral joints and tendons and does not include the spine.
Individuals can have peripheral and axial spondylitis symptoms simultaneously.
Diagnosis depends on whether symptoms are primarily peripheral or axial.
Spondylitis and Spondylosis
Spondylosis and spondylitis are similar in they cause pain and inflammation in the back and hips. The difference is in each condition’s triggers.
Spondylitis is a disease in which the body’s immune system degrades joints, causes inflammation, overproduces bone formation, and causes bone fusion.
Spondylosis is a category of arthritis that presents as the spine ages from normal wear and tear.
It happens during the degeneration of the spine’s discs and joints.
It also presents when bone spurs develop on the spine’s vertebrae.
Ankylosing Spondylitis
Ankylosing spondylitis is the most common form of arthritis affecting the spine, other joints, and body regions. The condition causes spinal joint inflammation causing extreme discomfort and chronic pain. In some cases, the inflammation progresses to ankylosis, where spine sections fuse and become immobile. Other body areas that can trigger inflammation include:
The ribs
Heels
Shoulders
Hips
Small joints of the feet and hands.
Ankylosing spondylitis symptoms vary from person to person. Common early symptoms include:
There is general discomfort, appetite loss, and mild fever early in the condition.
Persistent stiffness and pain in the buttocks and low back, gradually progressing over a couple of weeks or months.
The pain and stiffness can travel into the neck and spine within months or years.
The pain is usually spread out and dull.
The stiffness and pain are worse in the morning and night and improve with light exercise or a warm shower.
The pain typically becomes chronic, lasts for a minimum of 3 months, and can be felt on both sides.
Tenderness and pain in the hips, thighs, shoulder blades, heels, and ribs may also occur.
Treatment approaches include applications of ice and heat to reduce swelling, increase circulation, and decrease joint pain, posture exercises, stretches, physical therapy, and medication.
Psoriatic Arthritis
Psoriatic arthritis causes swelling, pain, and inflammation in the small joints of the hands and feet; however, the joints of the knees, ankles, and wrists can also be affected. Psoriasis is a rash that causes scaly skin patches.
Individuals can develop dactylitis when a finger or toe swells between the surrounding joints.
Spinal stiffness and pain can present.
Typically the ends of the finger joints are most affected and experience pain and inflammation.
Medications frequently utilized to treat ankylosing spondylitis can be used.
Exercise helps preserve the range of motion and maintain strength.
Isometric exercises work muscles without joint motion reducing the risk of further injury to inflamed joints.
Occupational and physical therapy can significantly assist in optimizing arthritic joint function.
Enteropathic Spondylitis
Enteropathic Arthritis is chronic inflammatory arthritis linked to inflammatory bowel disease. The most recognized are Crohn’s and ulcerative colitis.
The peripheral limb joints and sometimes the whole spine are the most prevalent body areas afflicted with enteropathic spondylitis.
The main symptom is intestine inflammation, including bowel and joint pain and/or inflammatory back pain.
Other symptoms can include weight loss, blood in the stool, abdominal pain, and/or chronic diarrhea.
Managing enteropathic arthritis typically means managing the underlying bowel disease.
Juvenile Spondyloarthritis
Juvenile spondyloarthritis is a group of childhood rheumatic diseases that cause arthritis before age 16 and can continue through adulthood. Juvenile spondyloarthritis encompasses:
Enteropathic arthritis
Enthesitis-related arthritis
Undifferentiated spondyloarthritis
Psoriatic arthritis
Reactive arthritis
Juvenile ankylosing spondylitis
Juvenile spondyloarthritis causes inflammation and pain in joints in the lower body, like the ankles, hips, knees, and pelvis. Other body areas that could be affected include:
The bowels
Eyes
Skin
Spine
Lethargy and fatigue can also present. The symptoms can be unpredictable and episodic, appearing and disappearing without a specific cause. The condition cycles between flare-ups and remission. Common treatment approaches include:
Medication
Exercise
Posture training
Physical therapy, medication
Ice and heat to decrease joint pain and relax muscles.
In severe cases, surgery could be recommended.
Reactive Arthritis or Reiter’s Syndrome
Reactive arthritis is arthritis that causes pain and inflammation in the mucous membranes, bladder, skin, joints, eyes, and genitals.
Reactive arthritis is believed to be a reaction to an infection, usually in the gastrointestinal or urinary tract.
Reactive arthritis does not affect the sacroiliac joints and spine in most cases.
Reactive arthritis is typically treated with nonsteroidal anti-inflammatory medications, steroids, and rheumatoid arthritis medications.
A physician could prescribe antibiotics if a bacterial infection brought on reactive arthritis.
Undifferentiated Spondyloarthritis
Undifferentiated spondyloarthritis is where the signs and symptoms of spondylitis don’t meet the criteria for a specific rheumatoid disorder. Individuals diagnosed with undifferentiated spondyloarthritis will have one or more of the symptoms that include:
Fatigue
Back inflammation
Back pain
Buttock pain that alternates or presents on both sides.
Swollen toes or fingers
Heel pain
Arthritis in the small joints.
Arthritis in the large limb joints.
Enthesitis or inflammation where the ligament or tendon connects to the bone.
Eye inflammation
Individuals can also present symptoms of other spondylitis types, like psoriatic or ankylosing.
Treatment approaches include:
Exercise
Physical therapy
Posture training
Ice and heat to decrease joint pain and loosen up muscles.
Spondylitis Types Diagnosis of Spondyloarthritis
References
Carron, Philippe, et al. “Peripheral spondyloarthritis: a neglected entity-state of the art.” RMD open vol. 6,1 (2020): e001136. doi:10.1136/rmdopen-2019-001136
Gill, Tejpal, et al. “The intestinal microbiome in spondyloarthritis.” Current opinion in rheumatology vol. 27,4 (2015): 319-25. doi:10.1097/BOR.0000000000000187
Rosenbaum, James T. “The eye in spondyloarthritis✰.” Seminars in arthritis and rheumatism vol. 49,3S (2019): S29-S31. doi:10.1016/j.semarthrit.2019.09.014
Seo, Mi Ryoung et al. “Delayed diagnosis is linked to worse outcomes and unfavorable treatment responses in patients with axial spondyloarthritis.” Clinical rheumatology vol. 34,8 (2015): 1397-405. doi:10.1007/s10067-014-2768-y
Sharip, Aigul, and Jeannette Kunz. “Understanding the Pathogenesis of Spondyloarthritis.” Biomolecules vol. 10,10 1461. 20 Oct. 2020, doi:10.3390/biom10101461
Many individuals do not realize they are in pain until they begin to feel symptoms of stiffness or tenderness in certain areas of their body. Many people have two most common complaints: back and shoulder pain. The shoulder and the back have a casual relationship that stabilizes the upper body and protects the spine’s thoracic region. When injuries or ordinary factors affect not only the shoulders but the back, it can lead to symptoms of pain and stiffness along the muscles, causing the development of trigger points along the upper back and shoulder muscles. One of the muscles affected by trigger points is the rhomboid muscles located in the upper back behind the scapula (shoulder blades). Today’s article looks at the rhomboid muscle, how superficial backaches and round shoulders can affect the rhomboid muscle, and managing trigger points associated with the rhomboid muscle. We refer patients to certified providers specializing in back pain treatments to aid individuals suffering from trigger points associated with the upper back along the rhomboid muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure that education is a great solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Rhomboid Muscle?
Do muscle stiffness in your shoulders seem to be causing you pain? Have you noticed that your shoulders seem more rounded than usual? What about the unexplainable upper backaches after being in a hunched position for a long period? Many individuals with these pain symptoms could be associated with the rhomboid muscles. The rhomboid muscles are a collective group of muscles important for upper limb movement and stability for the shoulder’s girdle and scapula. The rhomboid muscles consist of two separate muscles: the rhomboid minor and the rhomboid major, deep within the trapezius muscle and behind the scapula (shoulder blades). The functionality of the rhomboid is that they provide stability to the shoulder and when they are active, the upper arms move back and forth while walking.
How Superficial Backaches & Round Shoulders Affect The Rhomboid
While the rhomboid muscles provide stability to the shoulders, they can succumb to pain like any muscles in different body sections. Ordinary factors like a bad sitting posture can cause the upper back and shoulder muscles to contract and strain. Studies reveal that the effects of bad sitting posture can lead to the development of a forwarding head posture with rounded shoulders, causing pain in the rhomboid muscles. When the shoulder muscles, like the rhomboid muscles, experience this sort of change over time, it can increase muscle tone and continuous stress in the neck and shoulders. To that point, it can lead to various symptoms like pain, numbness, loss of functionality in the upper limbs, and nerve root symptoms. Other issues like back pain can also be one of the symptoms that can lead to referred pain in the rhomboid muscles and can potentially lead to the development of trigger points along the shoulders and rhomboid muscles.
Other issues that can affect the rhomboid muscles are trigger points. Trigger points can be latent or active as they are tiny knots formed in the body’s muscle fibers. For the rhomboid muscles according to Dr. Janet G. Travell, M.D., when a person hears snapping and crunching noises during the movement of the shoulder blades, it may be due to the trigger points in the rhomboid muscles. Studies reveal that since trigger points can be either active or latent and elicit local referred pain, that can lead to muscle imbalance, weak and impaired motor function, and expose the joints to suboptimal loading. This means that trigger points in the rhomboid muscles can cause referred pain to the shoulder and mimic other chronic symptoms.
Stretching The Rhomboid Muscle & Managing Trigger Points-Video
Do you hear any snapping or crunching noises when rotating your shoulders? What about muscle stiffness along your shoulders or upper back? Or do you feel muscle aches from being hunched over for a long time? These symptoms could potentially involve trigger points associated with the rhomboid muscles. The rhomboid muscles help stabilize the shoulders and provide movement to the arms. When people overuse their shoulder muscles, it can cause the surrounding muscles to develop trigger points and inflict pain-like symptoms on the shoulders and upper back. Thankfully, all is not lost, as various treatments are available to relieve shoulder and upper back pain associated with trigger points along the rhomboid muscles. The video above explains where the trigger points are located on the rhomboid muscles and how to stretch that muscle to relieve trigger points from causing referred pain to the shoulders.
Managing Trigger Points Associated With The Rhomboid Muscle
Since the rhomboid muscles can become stiff due to overuse and could develop trigger points to inflict pain along the upper back and shoulders, this can cause many symptoms associated with pain and make the individual feel hopeless. Thankfully, various treatments can help manage trigger point pain associated with the rhomboid muscles. Studies reveal that thoracic spinal manipulation can relieve pain pressure sensitivity of the rhomboid muscles. Chiropractors are excellent when finding trigger points along the musculoskeletal system by utilizing spinal manipulation on the thoracic spine to loosen up the stiff muscles along the shoulders and upper back. Another way to manage trigger points associated with the rhomboid muscle is to stretch the shoulder muscles after a hot shower. This allows the muscles to relax and prevent future trigger points from forming along the rhomboid muscles.
Conclusion
The rhomboid muscles are a collective muscle group that has an important function in stabilizing the shoulder’s girdle and scapula (shoulder blades) while providing upper limb movement. The rhomboid muscles consist of two separate muscles: rhomboid minor and rhomboid major, which are behind the shoulder blades and deep within the trapezius muscles. When ordinary factors like poor posture or shoulder injuries affect the rhomboid muscles, it can develop trigger points that can cause stiffness in the rhomboid muscles. Various techniques can alleviate the referred pain along the shoulders, causing trigger points to develop along the rhomboid muscles. When these treatments are utilized on the rhomboid muscles, they can help prevent future shoulder issues.
References
Farrell, Connor, and John Kiel. “Anatomy, Back, Rhomboid Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 May 2022, www.ncbi.nlm.nih.gov/books/NBK534856/.
Haleema, Bibi, and Huma Riaz. “Effects of Thoracic Spine Manipulation on Pressure Pain Sensitivity of Rhomboid Muscle Active Trigger Points: A Randomized Controlled Trial.” JPMA. The Journal of the Pakistan Medical Association, U.S. National Library of Medicine, July 2021, pubmed.ncbi.nlm.nih.gov/34410234/.
Ribeiro, Daniel Cury, et al. “The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature.” BMC Musculoskeletal Disorders, BioMed Central, 25 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6060458/.
Yoo, Won-Gyu. “Effects of Pulling Direction on Upper Trapezius and Rhomboid Muscle Activity.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5468195/.
When many individuals look for ways to relax after a stressful event in their daily lives, many people have an exercise regime that allows them to take their minds off of their hectic lives. When finding the proper exercise, it is best to consider that everybody is different and has different fitness levels. Many individuals could be dealing with chronic issues that affect them drastically and with so much pain in their bodies. When these chronic issues overlap with muscle and joint pain, it can make the body dysfunctional while potentially being involved in environmental factors. Yoga is a low-impact exercise that helps tone muscles, relax tension in the body, and focus on deep breathing. Today’s article looks at the benefits of yoga for the body, how chiropractic care works together with yoga, and different yoga poses can help manage various chronic issues. We refer patients to certified providers specializing in musculoskeletal treatments to help many individuals with musculoskeletal problems affecting their bodies. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer
The Benefits of Yoga For The Body
Have you been dealing with chronic stress affecting your quality of life? Have you been dealing with bladder or gut issues constantly? What about feeling muscle stiffness in your back, neck, shoulders, or pelvic regions? Some of these symptoms are signs that you could risk developing musculoskeletal problems associated with pain. Dealing with musculoskeletal issues related to pain can make a person feel miserable and have stress affecting their bodies. Yoga is a low-impact exercise that doesn’t put pressure on the joints and will provide a full-body workout through strengthening and stretching weak muscles. Yoga has many benefits for many individuals that are dealing with the following:
Studies reveal that environmental factors are involved in non-specified chronic pain in the spine, overlapping musculoskeletal disorders causing many individuals to try to find relief. Many individuals incorporate yoga because it is a safe and effective way to alleviate various forms of back, neck, or pelvic pain causing issues to the body. Yoga utilizes gentle stretching and strengthening of weak, injured muscles while increasing blood circulation to promote healing in the body.
Chiropractic Care & Yoga
When people are dealing with health conditions or injuries that have affected their bodies, it can make them feel frustrated and think their injuries are taking forever to heal. Many individuals don’t realize that incorporating yoga practices provides impressive health benefits while mirroring the similar foundations of chiropractic care. Both chiropractic care and yoga provide many beneficial results to an aching body that needs a good stretch and ready the body to heal itself naturally. Chiropractic care includes spinal manipulation to the spinal joints while reducing inflammation and strengthening weak muscles. Yoga allows the body to increase its flexibility and stamina, reduces stress and blood pressure, and provides a better sense of breathing and balance.
Yoga For Chronic Pain-Video
Have you felt muscle stiffness in your neck, back, or body? Have you felt sluggish or overly stressed from your day-to-day lives? Do you want to improve your balance? If you have been experiencing these issues affecting your quality of life, why not incorporate yoga as part of your exercise regime? The video above shows that yoga poses for chronic pain affect the body, including the neck, back, and pelvic regions. Studies reveal that yoga can help relieve intense neck pain while improving pain-related function disability. Yoga allows the muscles to not only relax but strengthen them as well. Yoga can also help improve the body’s range of motion through deep breathing and give more awareness of how the body holds tension in places a person hasn’t realized they were holding onto.
Yoga Poses For Different Issues
When a person does yoga, they will go through various poses and repeat them constantly as their body begins to get used to the movements. This allows the body to challenge itself and helps the individual focus more on deep breathing. A good example would be an individual taking a yoga class due to experiencing pelvic pain. By going through each yoga pose, many individuals suffering from pelvic pain will reduce the pain intensity while improving their quality of life. Below are some yoga poses that anyone can do to reduce pain associated with their back, neck, or pelvis.
Bridge Pose
Lie on your back
Bend both knees while placing the feet on the floor at hip-width apart
Arm on the sides with palms facing down
Press feet to the floor and lift the hips as you inhale
Engage the legs and buttock
Hold 4-8 breaths and exhale to lower the hips back to the ground slowly
Cobra Pose
Lie on your stomach with hands near the chest just under the shoulders and fingers facing forward
Keep elbows close to sides
Press hands on the floor and slowly lift your head, chest, and shoulders while slightly bending the elbows by inhaling
Exhale to go back down slow and rest your head
Cat-Cow
Be on all fours, hands under the shoulders and knees under hips (Think like a table)
Inhale to lower your core to the floor as your head looks up to the sky
Exhale slowly to lower your chin to the chest as you round your back
Continue fluid motion for a minute
Forward Bend
Be in a standing position, and feet are at a hip distance apart
Lengthen the body as you lean forward while keeping the knees slightly bended
Place hands on either legs, yoga block, or the floor (Whichever makes you comfortable)
Tuck the chin into the chest, letting the neck and head relax
Gently rock your head side to side to relieve tension in the neck and shoulders
Slowly roll up to a standing position allowing the arms and head to be the last to rise
Supine Spinal Twist
Lie on your back while your knees bent and feet flat on the floor
Extend arms out of the side and place palms down on the floor
As you inhale, breathe into the gut and lower limbs
Exhale to lower knees on the left side (Look at the opposite way to slowly stretch the neck and shoulder muscles)
Pay attention to the stretches for 5 breathes as well as the lengthening sensations on the ribs
Return the knees to the middle and repeat on the right side
Child’s Pose
Sit back on the heels with the knees together (For added support, you can use a rolled-up blanket under your knees)
Bend forward and walk hands in front of you
Gently rest your forehead on the floor
Keep arms extended in the front while focusing on relieving tension in the back as the upper body falls to the knees
Stay in that pose for 5 minutes
Conclusion
Incorporating yoga as part of an exercise regime allows the individual to focus on deep breathing while calming the mind. Yoga is a low-impact exercise that helps strengthen weak muscles associated with pain and inflammation. Yoga provides a full-body workout that benefits many people dealing with chronic pain. Utilizing yoga as part of a daily practice might help individuals learn to be calm and practice mindfulness.
Crow, Edith Meszaros, et al. “Effectiveness of Iyengar Yoga in Treating Spinal (Back and Neck) Pain: A Systematic Review.” International Journal of Yoga, Medknow Publications & Media Pvt Ltd, Jan. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4278133/.
Li, Yunxia, et al. “Effects of Yoga on Patients with Chronic Nonspecific Neck Pain: A Prisma Systematic Review and Meta-Analysis.” Medicine, Wolters Kluwer Health, Feb. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6407933/.
Saxena, Rahul, et al. “Effects of Yogic Intervention on Pain Scores and Quality of Life in Females with Chronic Pelvic Pain.” International Journal of Yoga, Medknow Publications & Media Pvt Ltd, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5225749/.
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