Back Clinic Chiropractic. This is a form of alternative treatment that focuses on the diagnosis and treatment of various musculoskeletal injuries and conditions, especially those associated with the spine. Dr. Alex Jimenez discusses how spinal adjustments and manual manipulations regularly can greatly help both improve and eliminate many symptoms that could be causing discomfort to the individual. Chiropractors believe among the main reasons for pain and disease are the vertebrae’s misalignment in the spinal column (this is known as a chiropractic subluxation).
Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors can alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis. From subluxations, or spinal misalignments, to sciatica, a set of symptoms along the sciatic nerve caused by nerve impingement, chiropractic care can gradually restore the individual’s natural state of being. Dr. Jimenez compiles a group of concepts on chiropractic to best educate individuals on the variety of injuries and conditions affecting the human body.
The head has many functions that provide the body with functionality. The head consists of the skull, which protects the brain, the eyes to make the host see, and the jaw, which has teeth and the tongue to taste and chew food. The neck supports the head to ensure that it is stabilized and functions appropriately. Below the eyes, the jaw has muscles and joints that help stabilize the jaw from hyperextending out while providing motor function. To that point, factors that can affect the jaw could potentially affect the surrounding muscles and joints on the head and neck, causing the individual to be in pain. Today’s article looks at the masseter muscles, how myofascial pain affects the masseter muscles, and ways to relieve myofascial pain associated with the masseter muscles. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial pain associated with masseter muscle pain along the jaw. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Masseter Muscle?
Have you been experiencing headaches located near your temples? Does your jaw feel sore throughout the entire day? Or have tooth pain or ear pain seems to bother you constantly? Some of these symptoms may affect your jaw joints, especially in the masseter muscles. The masseter muscles are powerful quadrangular muscles on each side of the jaw with three divisions: superficial, intermediate, and deep. The masseter muscles are also part of the mastication muscles in the jaw which include:
Temporalis
Medial pterygoid
Lateral pterygoid
Masseter muscles
The masseter muscles also help the jaw function properly, as studies reveal that this quadrangular muscle participates in various activities like mastication (chewing), swallowing, and talking. To that point, the masseter muscles have a relationship with the trigeminal nerve, which provides sensory-motor stimulation for the jaw to move. However, when factors (traumatic or ordinary) begin to affect the masseter muscles and the surrounding muscles associated with the neck and head, pain can either slowly or quickly depending on the severity the muscles have endured.
How Myofascial Pain Affects The Masseter Muscle?
Studies reveal that chronic pain in the orofacial region of the body is common worldwide and can cause disorders affecting jaw motor control. When painful symptoms affect the jaw, many individuals begin to feel pain in the top or bottom of their jaws that cause tooth pain and the brows, causing them cluster-like headaches or experiencing tinnitus (ringing in the ears). These symptoms are associated with myofascial pain affecting the masseter muscles in the jaw. Myofascial pain or trigger points are where the muscle fibers in the body become sensitive after being injured or overused. To that point, the muscle fibers developed tiny knots along the taut muscle bands and caused pain throughout the entire muscle. Myofascial pain can be tricky to diagnose due to mimicking other pain symptoms. For trigger pain to affect the masseter muscles, studies reveal that temporomandibular disorders that involve the oral-facial region may be multifactorial while affecting the masticatory muscles and the temporomandibular joints. To that point, myofascial masseter pain could potentially involve ailments like migraines, toothaches, TMJ (temporomandibular joint) dysfunction, and ear pain.
According to Dr. Janet G. Travell, M.D., complex symptoms and overlapping patterns of facial pain might be referred from multiple trigger points in the head and neck muscles, which can be more easily traced back to the individual’s muscles. By finding the root cause of these symptoms, many doctors can develop a clinical process to assess their patients dealing with myofascial trigger pain and develop a plan that caters to their wants and needs.
Stretching The Masseter Muscles-Video
Do headaches seem to be affecting your daily routine? Have you felt that your jaw feels stiff and has a dull ache when you move your mouth open? Or do you feel pain along the sides of your teeth? Many of these symptoms are referred pain associated with myofascial masseter pain. The video above demonstrates stretching the masseter muscles to reduce trigger pain along the muscle structure. Myofascial pain related to the masseter muscles can make it difficult for doctors to diagnose their patients due to the pain traveling to different areas in the body, known as somato-visceral pain. Somato-visceral pain is pain affecting the muscle connected to an affected organ. An example would be jaw pain associated with a toothache while potentially involving the masseter muscles. Thankfully, treatments are available to relieve myofascial pain along the masseter muscle.
Ways To Relieve Myofascial Pain In The Masseter Muscles
Myofascial pain affecting the masseter muscle could cause pain in the surrounding muscles and organs in the oral-facial region. The symptoms caused by myofascial pain associated with masseter muscles may be complex and challenging to diagnose due to the pain affecting different body regions. Fortunately, many doctors refer musculoskeletal specialists like chiropractors, massage therapists, and physiotherapists to relieve myofascial muscle pain associated with the masseter muscles by providing pain relief techniques. Some of the various methods that help ease trigger pain from the masseter muscles include:
Stretch & Spray: Stretching the jaw slowly to the full extent and spraying coolant along the masseter muscle to relieve pain
Jaw Exercising: Yawning, extending, and retracting the masseter muscle to stretch and strengthen the jaw.
A warm compress on the cheek: Helps relax the aggravating muscle and releases any tension causing myofascial pain.
Studies reveal that soft tissue mobilization is one of the various techniques that can help relieve trigger pain in masseter muscles. What soft tissue mobilization does is that it allows musculoskeletal specialists to use a pincer method to lengthen the masseter muscle to an extent and release trigger points in slow downward traction to alleviate the pain from the masseter muscles. Utilizing these various treatments can help many people with myofascial pain associated with masseter muscles feel relief from jaw pain and its related symptoms.
Conclusion
The masseter is a quadrangular muscle that surrounds each side of the jaw and helps stabilize the jaw’s motor function. When injuries or traumatic factors begin to affect the jaw, over time can lead to the development to trigger point pain associated with masseter muscles. When trigger point pain affects the masseter muscles in the oral-facial region, it can cause somato-visceral pain alongside the jaw affecting the teeth, causing tinnitus symptoms and headaches. Fortunately, various treatments are available to help manage trigger pain and relieve the associated symptoms that affect the masseter muscles. This allows many individuals to get back their health by being pain-free.
References
Al Sayegh, Samaa, et al. “Effects of Chronic and Experimental Acute Masseter Pain on Precision Biting Behavior in Humans.” Frontiers in Physiology, Frontiers Media S.A., 29 Oct. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6828929/.
Corcoran, Nicholas M, and Evan M Goldman. “Anatomy, Head and Neck, Masseter Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 June 2022, https://www.ncbi.nlm.nih.gov/books/NBK539869/.
Kuć, Joanna, et al. “Evaluation of Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral.” International Journal of Environmental Research and Public Health, MDPI, 21 Dec. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767373/.
Maini, Kushagra, and Anterpreet Dua. “Temporomandibular Syndrome.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 28 Apr. 2022, https://www.ncbi.nlm.nih.gov/books/NBK551612/.
Widmer, C G, et al. “Developmental and Functional Considerations of Masseter Muscle Partitioning.” Archives of Oral Biology, U.S. National Library of Medicine, Apr. 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861846/.
The neck is vital in keeping the head upright in a casual relationship with the cervical spine. The neck is home to the thyroid organ and the surrounding muscles that help support the neck to the rest of the body. One of the muscles that help support the neck is the sternocleidomastoid muscle. When traumatic forces begin to affect the neck, over time can lead to the development of chronic conditions associated with pain. When individuals start to feel pain affecting their neck, it can cause them to be miserable and find ways to relieve the pain they are experiencing. Today’s article focuses on the sternocleidomastoid muscle, how trigger pain affects this muscle, and ways to relieve SCM pain. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from SCM associated with trigger pain along the neck. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Sternocleidomastoid Muscle?
Have you been experiencing pain along the sides of your neck? What about limited mobility when you turn your neck from side to side? Or do headaches seem to worsen throughout the entire day? Some of these symptoms are associated with pain along the neck and could affect the surrounding muscles that are connected. One of the surrounding muscles that sit behind the thyroid is known as SCM or sternocleidomastoid muscle. The sternocleidomastoid muscle is a long muscle with dual innervation and multiple functions in the neck. The SCM is connected to the trapezius muscle that helps flex the neck, pulling the head forward while bringing the chin down to the chest. The SCM and the trapezius muscle work together to help stabilize and fix the head position while the host is talking or eating. When factors affect the neck over time, the SCM also gets involved.
How Does Trigger Pain Affect The Sternocleidomastoid?
When factors affect SCM associated with the neck, many issues will start to affect the neck and overlap pain near the eyes, ears, sides of the cheeks, and forehead. Studies reveal that SCM may develop myofascial trigger points in the head, causing referred pain. Trigger points are usually formed when traumatic forces affect certain areas in the body. For SCM to be affected by trigger pain, tiny knots along the taut band of the SCM muscle fibers become sensitive to pressure when compressed, and many people often describe the pain as deep and dull. To that point, the symptoms associated with SCM trigger pain may appear in numerous combinations or together depending on how severe the pain is on the person. Some of the symptoms related to SCM trigger pain include:
Headaches (sinus, cluster, or tension)
Sore throat
Ear pain (popping sounds in the ears)
Blurred vision
Vertigo
Dizzyness
Balance issues
Muscle soreness
SCM Pain & Trigger Points- Video
Have you been dealing with headaches throughout the entire day? What about muscle tenderness in certain areas near your neck or shoulders? Or have you been feeling dizzy that it is affecting your daily activities? Many people with these symptoms may be dealing with SCM pain associated with trigger pain. The video above offers an insightful overview of how does trigger pain may be involved with SCM pain. SCM or sternocleidomastoid muscle is a long muscle that surrounds the sides of the neck and is connected to the trapezius muscle. When factors begin to affect the SCM, the muscle is at risk of developing trigger pain along the muscle fibers. Studies reveal that trigger pain along the SCM may affect SCM’s normal muscle functions, like chewing due to hyperactivity. Fortunately, there are ways to relieve SCM pain associated with trigger pain affecting the neck.
Ways To Relieve SCM Pain In The Neck
When it comes to SCM pain associated with trigger pain along the neck, many individuals find ways to relieve the related symptoms that are causing the pain. Some individuals will take over-the-counter medication to relieve their neck, shoulders, and head pain. At the same time, others do stretches to release the tension on their head, neck, and shoulders. However, trigger pain is a bit complex and challenging to diagnose since it mimics other conditions that affect the body. As luck would have it, many doctors will refer musculoskeletal specialists like massage therapists, physical therapists, and chiropractors who can help relieve SCM pain in the neck. Studies reveal that a combination of physiotherapy, classical massages, and stretching exercises can be applied to alleviate SCM pain in the neck. By stretching and massaging the SCM, many individuals can begin to feel pain relief in their neck, increase their range of motion, and have endurance in their neck. Integrating these various treatments for the SCM (sternocleidomastoid muscle) pain in the neck can help revitalize a person’s sense of well-being without being in pain.
Conclusion
The SCM, or sternocleidomastoid muscle, is a long muscle that sits behind the thyroid organ and is connected with the trapezius muscle. This muscle helps stabilize and holds the head position while flexing the neck and bringing the chin down to the chest. When environmental or traumatic factors affect the neck muscles, it can lead to chronic conditions over time, thus inflicting pain and tenderness along the SCM. These are known as trigger points and can be hard to diagnose due to them mimicking other chronic symptoms associated with the neck, head, and shoulders. Thankfully, various treatments like physiotherapy, stretching exercises, and classical massages can help relieve the trigger points along the SCM and relieve the neck and surrounding muscles.
References
Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Head and Neck, Sternocleidomastoid Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 5 Apr. 2022, https://www.ncbi.nlm.nih.gov/books/NBK532881/.
Büyükturan, Buket, et al. “The Effects of Combined Sternocleidomastoid Muscle Stretching and Massage on Pain, Disability, Endurance, Kinesiophobia, and Range of Motion in Individuals with Chronic Neck Pain: A Randomized, Single-Blind Study.” Musculoskeletal Science & Practice, U.S. National Library of Medicine, 12 June 2021, https://pubmed.ncbi.nlm.nih.gov/34147954/.
Kohno, S, et al. “Pain in the Sternocleidomastoid Muscle and Occlusal Interferences.” Journal of Oral Rehabilitation, U.S. National Library of Medicine, July 1988, https://pubmed.ncbi.nlm.nih.gov/3171759/.
Missaghi, Babak. “Sternocleidomastoid Syndrome: A Case Study.” The Journal of the Canadian Chiropractic Association, Canadian Chiropractic Association, Sept. 2004, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769463/.
Sciatica pain can radiate to the knee. Individuals with sciatica do report unique/unusual knee pain that was never there and no past or recent physical injuries. Sciatica is the culprit, as the knee muscles are powered and controlled by nerves in the lower spine. Irritation or compression of these nerves can cause symptoms that can include: random back pain, hamstring tightness, weakness in the hips or quadriceps, the development of bunions, and knee pain and/or weakness. Chiropractic treatment can release the compression, heal the sciatic nerve, and alleviate knee problems.
Sciatica Pain Can Radiate To The Knee
Spine conditions that can cause sciatica include:
Disc herniation – Where the inside of the discs leak out and compress and/or irritate surrounding nerves.
Spinal stenosis – The spinal canal begins to narrow, not allowing enough space for the nerves to rest comfortably, resulting in compressed nerves.
Spondylolisthesis – A condition that occurs when a vertebrae slips forward onto the vertebrae below it.
Any can cause irritation, inflammation, or compression of the sciatic nerve leading to painful sensations that extends from the lower back down through the leg.
Symptoms
Common knee symptoms that may be experienced with sciatica include:
A dull ache, warm sensation, or sharp pain around the knee.
Bunions form from weakened stabilizing muscles that affect walking, running, and standing posture.
As sciatica pain can radiate to the knee, individuals will usually also experience pain in their buttocks, thigh, calf, and/or foot. The nerve sensations and other symptoms in the knee can be felt through a branch of the sciatic nerve known as the peroneal nerve.
Duration
The knee pain will last as long as sciatica does, depending on the type of sciatica, whether it is acute or chronic.
An acute sciatic episode usually resolves after a few weeks, with possible future flare-ups.
Chronic sciatica is a long-term condition that does not resolve independently and necessitates intervention by a specialist.
Chiropractic Treatment Plan
Depending on the diagnosis, a chiropractor will develop a personalized treatment plan to address the root cause and heal the injury. The treatment plan will include therapeutic massage, posture training, and at-home self-care to help heal and prevent future sciatica.
Massage Rehabilitation
Physical therapy and therapeutic massage will loosen and relax the muscles, nerves, tendons, and ligaments.
Heat and ice, exercises, and stretches will prepare the muscles and nerves for chiropractic decompression adjustments.
Posture Training
Training will be provided to maintain the back, hips, knees, and feet in proper alignment.
Training on removing pressure from the lower back and restabilizing the rest of the body.
Training on proper body mechanics, safe lifting techniques, and injury prevention.
Self-Pain Management
Training on self-care habits that include healthy weight, core strengthening exercises and stretches for the back muscles, and proper rest for a full recovery.
An anti-inflammatory diet to reduce/eliminate inflammation and achieve a healthy weight and a nutrition plan to maintain overall health.
Surgery
Surgery is the final option when conservative treatments are not working.
Treating Severe & Complex Sciatica Syndromes
References
Dydyk AM, Khan MZ, Singh P. Radicular Back Pain. [Updated 2021 Nov 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546593/
Hirabayashi, Hiroki, et al. “Characteristics of L3 nerve root radiculopathy.” Surgical neurology vol. 72,1 (2009): 36-40; discussion 40. doi:10.1016/j.surneu.2008.08.073
Jandre Reis, Felipe Jose, and Adriana Ribeiro Macedo. “Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during forwarding Bending.” Asian spine journal vol. 9,4 (2015): 535-40. doi:10.4184/asj.2015.9.4.535
Jeong, Ui-Cheol, et al. “The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain.” Journal of physical therapy science vol. 28,1 (2016): 46-50. doi:10.1589/jpts.28.46
The body incorporates different muscles that have specific jobs to help mobilize the skeletal joints while providing function to the arms, neck, legs, and back. Many individuals use their muscles for everyday uses like lifting and carrying objects, moving from one place to another, and protecting vital organs from damage. To that point, issues like traumatic events, injuries, and environmental factors can affect the body and cause damage to the muscles. When the muscles are affected by these factors, tiny knots can form along the taut muscle band that can cause painful symptoms that affect specific areas in the body. One of the muscles affected by pain is the trapezius muscle, known as the “coat hanger” muscle, which can be associated with chronic symptoms of myofascial pain syndrome. Today’s article examines the trapezius muscle, how myofascial pain affects the trapezius muscle, and how to manage myofascial trapezius pain. We refer patients to certified providers specializing in musculoskeletal treatments to aid individuals suffering from trapezius muscle pain associated with myofascial pain. We also guide our patients by referring them 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. Jimenez DC provides this information as an educational service only. Disclaimer
What Is The Trapezius Muscle?
Have you experienced pain in your neck, shoulders, or mid-upper back? Do you feel headaches occurring near your temples? What about tenderness in certain areas of your body? Some of these symptoms may appear in your trapezius muscles. The trapezius muscle is located across the back that looks like a simple trapezoid with upper, middle, and lower muscle fibers that have different functions for the upper-middle back, shoulders, and neck. While the entire trapezius muscle helps rotates, elevate, and retract the scapula while extending the head and neck, and turning the chin by itself. At the same time, the entire muscle can help with assisting the extension of the cervical and thoracic spine.
Upper Trapezius muscles: allow the shoulders to rise, bend the head and neck, and help support the weight of the upper extremities of the body, including the arms.
Middle Trapezius muscles: assist with flexion and abduction of the arms around the shoulders at a nearly full range.
Lower Trapezius muscles: Helps retract the scapula while rotating the glenoid fossa upwards by decompressing the vertebral borders of the scapula. These fibers help assist the flexion and abduction of the arms.
When traumatic forces or injuries affect the trapezius muscles, painful symptoms begin to affect the muscles, causing them to be tender to the touch and affecting different areas in the body.
How Does Myofascial Pain Affect The Trapezius Muscle?
When traumatic forces or injuries affect the trapezius muscles, certain parts of the shoulders, neck, and upper-mid back will experience pain-related symptoms. When people experience headaches and shoulder and neck pain in their bodies while feeling tenderness in their trapezius muscles, this is known as referred pain associated with myofascial pain. Myofascial pain is when tiny knots along the taut muscle bands begin to make the muscle area tender to the touch. Individuals who suffer from myofascial pain in their trapezius muscles might experience hyperirritable spots that inflict pain and motor dysfunction. Studies reveal that individuals who work in food services may have symptoms of shoulder pain associated with myofascial pain due to repetitive motions on the upper trapezius muscles affecting their upper bodies. Myofascial trigger pain is a bit challenging to diagnose since the pain can be in different locations and mimic various ailments in the body. To that point, when the trapezius muscles are affected by trigger pain may potentially be involved with cervical myofascial pain. Cervical myofascial pain is a disorder that causes pain from muscle overuse or trauma in the neck. When the pain affects the neck muscles, it can travel down to the trapezius muscles causing tenderness and sensitivity in the affected muscle area. Stress, postural mechanics, or repetitive movements can develop myofascial pain syndrome and affect the surrounding muscles.
Trapezius Trigger Points- Video
Have you felt sore around your shoulders, neck, and upper-mid back? What about muscle tenderness in certain areas of your body? Do you feel tension along your neck or near the temples of your head? If you have been dealing with any of these symptoms, then you might be experiencing myofascial trapezius pain. The video above explains how trigger points from traumatic events can affect the trapezius muscle and cause referred pain that overlaps other conditions that may affect the body. Studies reveal that trigger points in the head and neck muscles of many suffering individuals have tension-type headaches. Tension-type headaches are one of the symptoms associated with myofascial trapezius pain. Some of the other symptoms related to myofascial pain affecting the trapezius muscle include:
Deep aching pain
Stiffness
Muscle spasms
Tightness around the shoulder and neck
Tenderness along the shoulders, neck, and upper back
Occipital headaches
How To Manage Myofascial Trapezius Pain
When many individuals suffer from myofascial trapezius pain, many would go to their primary doctor and explain to them that they are experiencing tension headaches constantly. Since myofascial pain is associated with the trapezius muscle is a bit complex and challenging for doctors to diagnose since every person’s pain is different. Many doctors will refer their patients to associated specialists like physical therapists, massage therapists, or chiropractors to determine where the pain is located along the trapezius muscle. Different treatments can help alleviate stiff muscles, and studies reveal that spinal manipulative therapy can help manage chronic pain from myofascial origins. Spinal subluxations or misalignment could potentially involve the corresponding spinal nerve root causing antinociceptive effects to the tender muscle, thus causing pain to the trapezius muscle. Utilizing various treatments to treat myofascial trapezius pain can provide individuals with beneficial relief from their pain along with managing their associated symptoms.
Conclusion
The trapezius muscle is a large superficial trapezoid-shaped muscle located in the back. The upper, middle, and lower muscle fibers have different functions in the head, neck, shoulders, and arms. The trapezius muscle also helps with assisting the extension of the cervical and thoracic spine. When traumatic events or injuries affect the trapezius muscle, it can be developed over time to create trigger points along the taut muscle band of the trapezius muscle and cause referred pain to the upper extremities of the body. Luckily various treatments can help manage the associated pain symptoms from myofascial trapezius pain and can help many individuals get back on their health and wellness journey.
References
Fernández-de-Las-Peñas, César, et al. “Myofascial Trigger Points and Their Relationship to Headache Clinical Parameters in Chronic Tension-Type Headache.” Headache, U.S. National Library of Medicine, Sept. 2006, https://pubmed.ncbi.nlm.nih.gov/16942471/.
Hwang, Ui-Jae, et al. “Predictors of Upper Trapezius Pain with Myofascial Trigger Points in Food Service Workers: The Strobe Study.” Medicine, Wolters Kluwer Health, June 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500039.
Laframboise, Michelle A, et al. “Effect of Two Consecutive Spinal Manipulations in a Single Session on Myofascial Pain Pressure Sensitivity: A Randomized Controlled Trial.” The Journal of the Canadian Chiropractic Association, Canadian Chiropractic Association, June 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915475/.
Ourieff, Jared, et al. “Anatomy, Back, Trapezius – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 26 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK518994/.
Touma, Jeffrey, et al. “Cervical Myofascial Pain – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, https://www.ncbi.nlm.nih.gov/books/NBK507825/.
The neck ensures that the head is upright in the body while providing mobility to rotate, bend, and tilt in various directions. The neck is part of the cervical spine and provides sensory-motor functions from the nerve pathways spread out along the shoulders and upper back. When traumatic events or injuries affect the cervical spine and cause pain to the neck over time, however, if not treated, it can lead to problematic symptoms associated with muscle pain. Neck pain can lead to muscle stiffness and cause myofascial trigger pain associated with referred pain along the rest of the upper body. Today’s article looks at the effects of neck pain, how it is associated with myofascial trigger pain, and ways to manage neck pain associated with myofascial trigger pain. We refer patients to certified providers specializing in musculoskeletal treatments to aid individuals suffering from neck pain associated with myofascial trigger pain. We also guide our patients by referring them 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. Jimenez DC provides this information as an educational service only. Disclaimer
The Effects Of Neck Pain
Have you been feeling muscle stiffness around your neck and shoulders? Do you experience random headaches that affect your day? What about feeling tingling sensations along your arms and hands? These symptoms are associated with neck pain and can affect many individuals if not treated over time. Many people who suffer from neck pain will feel muscle stiffness that affects not only the sides of the neck but around the shoulders and their upper back. Studies reveal that neck pain is a multifactorial musculoskeletal disorder that affects the worldwide population and can become a chronic problem. Risk factors associated with the contributing development of neck pain include:
Stress
Poor posture
Anxiety
Sleep position
Neuromusculoskeletal disorders
Auto accidents
Traumatic events
Many of these risk factors associated with neck pain can cause pain symptoms and cause pain in different locations of the body, making diagnosing the pain source problematic for doctors.
Neck Pain Associated With Myofascial Trigger Pain
Since neck pain is common for many individuals, one of the symptoms associated with muscle stiffness and tenderness is myofascial trigger pain overlapping neck pain. Studies reveal that the formation of trigger points is caused when various physical activities begin to yield repetitive stress or cause micro-tears in the definite muscle groups that can cause tension within the muscle fibers. To that point, knots in the taut band of the muscles become hypersensitive and produce referred pain, tenderness, motor dysfunction, and autonomic phenomena. When the neck suffers from a traumatic event that affects the spine, over time can create trigger points or myofascial pain. It is difficult to diagnose where the pain is located in the body because myofascial trigger pain often mimics other pain conditions. It can confuse many individuals as they think they are suffering from one pain, but it’s a different pain that affects their body. Other studies reveal that individuals with myofascial pain syndrome associated with neck pain have a tender point within the tight muscular band, causing local discomfort. To that point, myofascial pain can cause referral pain in remote areas like cervical spine disorders like herniation can often be confused with myofascial pain when there is referral pain in the upper extremities of the body. Some of the symptoms associated with myofascial trigger pain that affects the neck include:
Deep, aching pain
Headaches
Muscle tenderness in the neck or shoulders
Tingling sensation or numbness down the arms and hands
Muscle stiffness
Neck Pain & Trigger Points- Video
Are you experiencing numbness that is running down your shoulders to your hands? What about muscle stiffness along the sides of the neck or shoulders? Or do headaches seem to pop out of nowhere and affect your day? You could risk suffering from neck pain associated with myofascial trigger pain. The video above explains how neck pain is associated with trigger points and how to trigger pain can be primary or secondary to neck pain. Studies reveal that myofascial pain syndrome is a common muscular pain disorder that is misunderstood and involves referred pain to form minor, tender trigger points within the muscles. To that point, myofascial pain associated with neck pain may be consistent with specific patterns of pain associated with each trigger point, contributing factors like emotional, postural, and behavioral factors that cause tension in the neck and frequently related symptoms from various conditions make diagnosing difficult. Since myofascial trigger points are complex and mimic other conditions that affect a different body part, many believe that different ailments affect their body than the actual ailment itself. Thankfully there are ways to manage neck pain associated with myofascial trigger pain and relieve muscle pain.
Ways To Manage Neck Pain Associated With Myofascial Trigger Pain
Since myofascial trigger pain associated with the neck can be a bit complex and challenging to diagnose, many doctors will refer patients to a physical therapist, a chiropractor, or another spine specialist to examine the trigger points causing neck pain. Various treatments can range from home remedies to severe muscle injections, depending on how severe the injuries are since everyone’s pain is different. Some of the available treatments that can reduce and manage myofascial neck pain include:
Exercising (helps stretch and strengthen neck and upper back muscles)
Massage (helps loosen stiff muscles in the neck and shoulders)
Heat therapy (helps relax and increase blood flow to the affected area)
Chiropractic care (uses spinal manipulation to prevent further pain issues from happening)
Acupuncture (helps to relax the trigger point and relieve pain)
Incorporating these various treatments can provide beneficial relief to those suffering from myofascial neck pain and help manage the symptoms associated with the body.
Conclusion
The neck provides mobility to the head as it can rotate, bend, and tilt in various directions while providing sensory-motor functions to the shoulders and upper back from the nerve roots in the cervical spine. When traumatic forces impact the neck, myofascial trigger pain can lead to neck pain. Myofascial trigger pain associated with neck pain is where tiny knots in the affected neck muscles become tender and stiff, which causes referred pain to different locations in the body. Myofascial neck pain is challenging to diagnose but manageable to treat with various treatments and techniques that can release the knots from the affected muscle and prevent future symptoms from happening. This allows many individuals to feel relief from their neck pain and continue their wellness journey.
References
Alghadir, Ahmad H, et al. “Efficacy of Combination Therapies on Neck Pain and Muscle Tenderness in Male Patients with Upper Trapezius Active Myofascial Trigger Points.” BioMed Research International, Hindawi, 10 Mar. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085833/.
Ezzati, Kamran, et al. “Prevalence of Cervical Myofascial Pain Syndrome and Its Correlation with the Severity of Pain and Disability in Patients with Chronic Non-Specific Neck Pain.” The Archives of Bone and Joint Surgery, Mashhad University of Medical Sciences, Mar. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121028/.
Fricton, J R, et al. “Myofascial Pain Syndrome of the Head and Neck: A Review of Clinical Characteristics of 164 Patients.” Oral Surgery, Oral Medicine, and Oral Pathology, U.S. National Library of Medicine, Dec. 1985, https://pubmed.ncbi.nlm.nih.gov/3865133/.
Kazeminasab, Somaye, et al. “Neck Pain: Global Epidemiology, Trends and Risk Factors.” BMC Musculoskeletal Disorders, BioMed Central, 3 Jan. 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725362/.
The body is a functional machine that consists of muscles, organs, and skeletal joints that play different parts in making the body healthy as possible. Each section has a casual relationship as they work together and do their jobs separately. The muscles provide protection and movement from daily activities. The organs supply hormones, oxygen, and nutrients, so the body’s internal functions work correctly. And finally, the skeletal joints help with mobility and stabilization for the body to stay upright. When environmental factors or traumatic injuries affect the body, many issues over time may cause damage, and the body may develop pain-related symptoms. Today’s article examines how the musculoskeletal system works in the body, how trigger points affect the musculoskeletal system, and how chiropractic care can help alleviate trigger point pain. We refer patients to certified providers specializing in musculoskeletal treatments to aid individuals suffering from muscle pain associated with trigger points. We also guide our patients by referring them 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
How Does The Musculoskeletal System Works?
Have you been experiencing muscle stiffness in specific areas located in your body? Do you feel tenderness in your neck, shoulders, or back? Or do you feel knots along your muscles that are causing you pain? Some of these symptoms are associated with muscle pain in the musculoskeletal system. The musculoskeletal system in the body has muscles, ligaments, and connective tissues surrounding the skeletal joints. Studies reveal that the structure of the musculoskeletal system shows how the surrounding muscles protect the joints and help provide the body functionality. The various muscles in the body offer a range of motion, sensory-motor functions, reflexes, and strength when functioning normally. However, when environmental factors begin to affect the body over time, it can lead to musculoskeletal disorders associated with pain. Studies reveal that when the body succumbs to pain related to musculoskeletal disorders. Musculoskeletal disorders are a common issue that has affected many individuals worldwide and causes various disabilities and symptoms that affect the body. Some of the musculoskeletal disorder symptoms that affect the body include:
Burning sensations
Muscle twitches
Fatigue
Stiffness and aching
Myofascial trigger pain
How Do Trigger Points Affect The Body?
One of the musculoskeletal symptoms associated with muscle pain is trigger points or myofascial pain. Myofascial pain is a common condition involving the muscles and surrounding connective tissues that may be acute or chronic depending on where the pain is located. While trigger points refer to hard palpable nodules in the taut bands of the skeletal muscle that can be active (causes spontaneous pain or abnormal sensory symptoms) or latent (causes no spontaneous pain but shows operational myofascial trigger points characteristics). Studies reveal that myofascial pain can be associated with muscle dysfunction, weakness, and limited range of motion that affects the body. A knot in the muscle in certain body areas can make the muscle hyperirritable, causing painful compression while invoking characteristic referred pain and autonomic phenomena in the body. To that point, it can be difficult for doctors to diagnose since trigger points are caused by traumatic events in the body and can occur in different spots in different people. Trigger points can form all over the body, including:
Neck
Mid-back
Low back
One common characteristic when trigger points affect the body is that they can travel or even spread to the surrounding muscles.
Myofascial Pain Syndrome & Trigger Points- Video
Have you been feeling pain located in your neck, back, or particular areas in your body? What about feeling pain in a different location of your body? Or have you experienced muscle stiffness or tenderness in certain areas of your body? If you have been experiencing these symptoms associated with muscle pain, you could be dealing with trigger point pain or myofascial pain in your musculoskeletal system. The video above explains myofascial pain and trigger points and how they affect the body. Studies reveal that myofascial pain is caused by myofascial trigger points that produce exquisitely tender spots in the taut bands of hardened muscles. To that point, it stimulates local and referred pain amongst other sensory, motor, and autonomic symptoms. Myofascial trigger points can cause stiffness and weakness in the involved muscle, making it difficult to diagnose since it can cause pain in different body areas. Fortunately, there are ways to alleviate trigger point pain associated with myofascial pain syndrome from the body.
How Chiropractic Care Alleviates Trigger Point Pain
Since myofascial trigger point pain can be challenging to diagnose, it can range from neck to low back pain in different locations and mimic other pain conditions that affect the body. It can affect the body to become hypersensitive and hyperirritable while decreasing a person’s overall sense of well-being. Luckily, treatments like chiropractic care can help alleviate trigger point pain and help manage myofascial pain syndrome. Chiropractic care is not just for the skeletal system but can help relieve muscle pain associated with myofascial pain. Since the muscles are layered and interwoven around the joints, they play an integral part in supporting the body. Studies reveal that chiropractors are great at finding trigger points and utilize specific exercises and physical modalities to treat myofascial pain syndrome symptoms. Some of the benefits chiropractic care use include:
Breaking up scar tissue
Applying pressure on the trigger point
Aligning the spine to reduce the spinal subluxation
Ease muscle pain
Conclusion
The body consists of muscles, organs, and joints in a casual relationship that helps function and stabilizes the host. The musculoskeletal system has muscles, tissues, and ligaments that are interwoven and layered, surrounding the skeletal joints to prevent injuries or traumatic events from affecting the body. When the body does suffer from damages caused by traumatic events, it can lead to a musculoskeletal disorder known as myofascial pain or trigger pain. Trigger pain is when the muscles have knots along taut bands of the muscle that can cause muscle stiffness and pain. Trigger point pain can be challenging to diagnose since the pain can travel from one location to another section of the body. This is referred pain, and myofascial trigger pain can mimic other chronic musculoskeletal symptoms. Treatments like chiropractic care can help alleviate myofascial trigger pain through spinal manipulation and trigger point therapy, thus relieving the stiff muscle causing pain. Incorporating treatments like chiropractic care can help loosen stiff muscles, increase joint range of motion and bring a person’s wellness back.
References
Bron, Carel, and Jan D Dommerholt. “Etiology of Myofascial Trigger Points.” Current Pain and Headache Reports, Current Science Inc., Oct. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440564/.
Murphy, Andrew C, et al. “Structure, Function, and Control of the Human Musculoskeletal Network.” PLoS Biology, Public Library of Science, 18 Jan. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773011/.
Shah, Jay P, et al. “Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.” PM & R : the Journal of Injury, Function, and Rehabilitation, U.S. National Library of Medicine, July 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508225/.
The body’s nerves are the communication system that carries messages between the brain and the rest of the body. Some nerves transmit messages from the brain to muscles to make the body move, while others relay pain, pressure, or temperature signals. Tiny fibers bundled inside each nerve carry the messages with an outer layer/sheathing that insulates and protects the nerves. The brachial plexus is a network of nerves that send signals from the spinal cord to the shoulders, arms, and hands. A brachial plexus nerve injury occurs when the nerves are over-stretched, compressed, torn, cut, or ripped from the spinal cord.
Brachial Plexus Nerve Injury
The injury involves the head or neck hitting or getting hit and shifting to one side while the shoulder is stretched/pulled in the opposite direction.
Minor brachial plexus injuries are commonly known as stingers or burners and are common in sports like football, wrestling, hockey, soccer, and basketball.
Severe brachial plexus injuries can cause arm paralysis and usually result from vehicle or motorcycle accidents.
Other conditions like inflammation or tumors can affect the brachial plexus.
Sometimes babies can sustain brachial plexus injuries during birth.
Pressure and stretching injuries do not physically sever the nerve but can disrupt communication.
Cutting injuries vary depending on the severity of the cut and because the nerves are in a protective canal that can also be fractured or broken. If the canal remains intact, the nerve fibers could grow back with time.
However, surgery is necessary to repair the damage if the canal is broken.
Signs and symptoms of a brachial plexus nerve injury can vary, depending on the severity and location of the injury. Usually, only one arm is affected.
Minor Injuries
Minor damage comes from over-stretching or mild compression.
An electric or burning sensation shoots down the arm.
Numbness and weakness in the arm.
Neck pain.
These symptoms usually last for a few seconds or minutes but can linger for days or longer.
Severe Injuries
More-severe symptoms result from injuries that impact, tear, or rupture the nerves.
The most severe injury occurs when the nerve root is torn from the spinal cord.
Symptoms include:
Intense pain.
Writhing neck pain.
Weakness or inability to use specific shoulder, arm, and/or hand muscles.
Complete lack of movement and feeling in the shoulder, arm, and/or hand.
Symptoms in both arms.
Complications
With time, most brachial plexus injuries in children and adults heal with minimal long-term damage. But some injuries can cause long-lasting problems that include:
Joint Stiffness
The joints can stiffen, making movement difficult.
Healthcare providers often recommend ongoing chiropractic and physical rehabilitation during recovery.
Atrophy
Nerves regrow slowly and can take some time to completely heal after the injury.
During that time, lack of use can cause the muscles to break down.
Chronic Pain
Nerve damage can cause pain signals to be constantly firing.
Numbness
It can occur in the arm or hand, increasing the risk of worsening the injury or causing new injuries.
Disability
Recovery from a severe brachial plexus injury depends on age, damage, location, and severity.
Even with surgery, individuals can experience long-term muscle weakness or paralysis.
Chiropractic Treatment and Rehabilitation
Treatment depends on the severity of the damage. Chiropractic can help realign, rehabilitate, stretch, and strengthen the muscles, nerves, tendons, joints, and ligaments to expedite recovery. For less severe injuries:
Muscle strengthening and posture exercises help maintain motion.
Therapeutic massage will stimulate circulation and keep the muscles loose.
For severe injuries:
Surgery
Continued chiropractic and physical rehabilitation to maintain thorough circulation, range of motion, and relaxed muscles.
The Brachial Plexus
References
Brucker, J et al. “Brachial plexus birth injury.” The Journal of neuroscience nursing: Journal of the American Association of Neuroscience Nurses vol. 23,6 (1991): 374-80. doi:10.1097/01376517-199112000-00006
Gutkowska, Olga, et al. “Brachial plexus injury after shoulder dislocation: a literature review.” Neurosurgical review vol. 43,2 (2020): 407-423. doi:10.1007/s10143-018-1001-x
Joyner, Benny, et al. “Brachial plexus injury.” Pediatrics in review vol. 27,6 (2006): 238-9. doi:10.1542/pir.27-6-238
Noland, Shelley S et al. “Adult Traumatic Brachial Plexus Injuries.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,19 (2019): 705-716. doi:10.5435/JAAOS-D-18-00433
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