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.
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
The upper arms allow the individual to move the arms, hands, and fingers, enabling them to do everyday activities without feeling pain or injuries. Different muscles in the upper arms allow precise movements, from threading a needle to throwing a ball across the field. These muscles also work with the shoulders, allowing a full range of motion and flexion. One of the muscles that help the upper arms is the bicep brachii, which provide flexion to the arm. However, like all the muscles in the body, they can succumb to pain caused by trigger points. Today’s article looks at the bicep muscles’ function, how trigger points affect the muscles, and how to manage trigger points associated with the bicep muscles. We refer patients to certified providers who specialize in arm pain treatments to aid individuals suffering from trigger points associated with the bicep brachii muscles along the upper arms. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer
What Are The Bicep Muscles Function?
Have you been dealing with radiating pain down to your elbow? Do your upper arm muscle ache when carrying items from place to place? Or have you experienced muscle spasms in your arms and hands? Many people experiencing these symptoms might risk developing trigger points along their bicep muscles. The bicep brachii is a large, thick muscle that covers the joints and is located in the upper arms. The bicep muscle consists of two attachments: the short head (caput breve) and the ling head (caput longum). It works together with the coracobrachialis muscle to support stability to the shoulders.
Studies reveal that these two muscle bands work together to provide multiple actions between the shoulder and elbow joints by being in conjunction with the other muscles. The main function of the bicep muscles is that it is one of the three muscles that can flex the elbow and shoulders. The biceps also allow flexion and supination or outward rotation of the forearms at 90 degrees. This muscle is very important for athletes that require lifting, carrying, or throwing and can make the individual stronger. To that point, the bicep muscle can also succumb to injuries that can cause pain to the upper arms and shoulders.
How Does Trigger Points Affect The Bicep Muscles?
When the bicep muscles succumb to injuries, it can be due to overusing the long head of the bicep muscles and can lead to bicep tendon rupture. When the bicep muscle succumbs to a tendon rupture, it is due to excessive eccentric force that brings the arms to an extension rather than flexion. Other issues affecting the biceps can correlate to rotator cuff pathology and can be associated with being a common source of shoulder pain. Studies reveal that since the bicep is closely associated with the rotator cuff, tendinopathy can form due to repetitive traction, friction, and rotation of the shoulder joints. To that point, it can lead to the development of trigger points along the bicep muscles. Trigger point pain can be complicated to diagnose since it can mimic other chronic conditions. For trigger points to occur along the bicep muscles, pain-like symptoms are caused when the arm is above the shoulder. To that point, it causes symptoms of aches, stiffness, and muscle weakness in the bicep muscles.
Trigger Points Affecting The Bicep Brachii- Video
Have you experienced muscle aches and stiffness when lifting your arms above your shoulders? Do you find difficulty to bend your elbows? Or have you been experiencing radiating pain along the shoulders, arms, and hands? These pain-like symptoms are associated with trigger points along the bicep muscles and can evoke motor dysfunction in the upper arms. The video above gives an overview how trigger points affect the bicep brachii and cause symptoms like “frozen shoulder” to affect the entire arm. Studies reveal that trigger points are the most frequent causes of chronic musculoskeletal pain that causes the muscle tissue to become hyperirritable. Trigger points can also cause referred pain to the affected muscles, causing limited range of motion to the joints. When the bicep muscles are being affected by trigger points, it can cause stress on the muscle and cause hyper-extension to the arm. According to Dr. Travell, M.D., when trigger points affect the bicep brachii muscles and cause referred pain and tenderness on the ball-and-socket joint, the symptoms associated with trigger points are mistaken as a rheumatic joint disease unless the affected bicep is examined for trigger points. Thankfully, there are ways to manage trigger points associated with the bicep muscles to reduce pain in the upper arms.
Managing Trigger Points Associated With The Bicep Muscles
When individuals are suffering from pain along their bicep muscles, it can cause them to be miserable as they cannot participate in various activities that require their arms; when trigger points are formed along the taut muscle band of the bicep muscles, the radiating pain from the shoulder to the elbow, causing stiffness and muscle aches. Fortunately, various techniques can help manage trigger points associated with the bicep muscles. Studies reveal that many people can manage trigger points related to the bicep muscles to reduce shoulder pain by resting, modifying their activities, and seeking more non-invasive treatments to reduce the pain associated with the bicep muscles. Many people can do various arm and shoulder stretches to reduce the stiffness of the bicep muscles. This allows gentle stretching along the upper arm muscles and releases tension through slow, even breathing and prolonged shortening of the bicep muscles.
Conclusion
The bicep has two attachments that provide mobility and are a large thick muscle that covers the upper arm joints. The bicep muscles also work together with the coracobrachialis muscle to help support the shoulders by making them stable. When the bicep muscles become overused and succumb to injuries, they can develop trigger points along the bicep muscles, causing referred pain to the arms and shoulders. When this happens, the muscles become stiff and can become painful when doing simple actions like lifting their arms or playing a sport. When this happens, many individuals become miserable since they can’t participate. Fortunately, various techniques can help reduce the pain symptoms in the arms and prevent future injuries. Gentle stretching and muscle massages can release the trigger points from the bicep muscles and improve arm mobility to the biceps.
References
Akamatsu, Flávia Emi, et al. “Trigger Points: An Anatomical Substratum.” BioMed Research International, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4355109/.
Landin, Dennis, et al. “Actions of the Biceps Brachii at the Shoulder: A Review.” Journal of Clinical Medicine Research, Elmer Press, Aug. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5505302/.
McDevitt, Amy W, et al. “Physical Therapy Interventions for the Management of Biceps Tendinopathy: An International Delphi Study.” International Journal of Sports Physical Therapy, NASMI, 1 June 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9159730/.
Raney, Elise B, et al. “Pain and the Pathogenesis of Biceps Tendinopathy.” American Journal of Translational Research, e-Century Publishing Corporation, 15 June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5489872/.
Tiwana, Manpreet S, et al. “Anatomy, Shoulder and Upper Limb, Biceps Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK519538/.
Nerve damage is also known as peripheral neuropathy. Peripheral nerves transmit information to and from the brain through the spinal cord to the rest of the body. Nerve damage symptoms are common in the neck, arms, hands, low back, legs, and feet. Communication becomes weakened, interrupted, or no longer transmits sensation signals. Nerve damage can be a complication from conditions like diabetes or present after an injury. Injury Medical Chiropractic and Functional Medicine Clinic recognize the symptoms and can treat the injuries rehabilitating the nerves back to functional health.
Nerve Damage Symptoms
Nerve damage symptoms can happen to a single nerve or a group of nerves that can affect the rest of the body. Damage depends on the severity of the condition or injury.
Partially damaged nerves can heal on their own with minimal treatment to ensure they heal correctly.
The fibers are covered with tissues that are a type of insulation.
Sometimes only the fibers get damaged.
Sometimes a nerve gets stuck or jammed inside a tight space, causing irritation and, over time, scarring.
Severe nerve damage can involve the fibers and tissues and often require surgery.
Symptoms can range from mild to severe and depend on which nerve fibers are damaged. These could be the following:
Motor nerves
These nerves regulate all the muscles under conscious control.
These control motor functions like walking, talking, and grabbing and holding objects.
Damage to these nerves usually causes muscle weakness, cramps, and uncontrollable muscle twitching or spasms.
Sensory nerves
These nerves relay sensory information, including touch, taste, smell, vision, temperature, and pain.
Symptoms can include numbness or tingling.
There can also be difficulties:
Sensing pain
Sensing temperature changes.
Walking
Maintaining balance with your eyes closed.
Working with the hands.
Autonomic nerves
This group of nerves regulates unconscious actions, including breathing, heart and thyroid function, and digestion.
Symptoms include excessive sweating, blood pressure variations, inability to tolerate heat, and gastrointestinal issues.
Various symptoms can be experienced as many peripheral nerve injuries affect more than one type of nerve.
Signs
Improperly functioning nerves can cause uncomfortable or painful sensations because the nerves cannot carry the correct signals from the brain to the spinal cord. The signs of nerve damage include the following:
Feeling like you’re wearing an overly tight glove or sock constricting circulation and movement.
Numbness or tingling.
Pins and needles or what feels like mild electrical sensations.
Specific body/limb positions can cause or decrease numbness, tingling, or pins and needles.
Muscle weakness.
Dropping objects regularly.
Sharp pains in the hands, arms, low back, legs, or feet.
Restoring Function
Chiropractic treatments can help restore function and include:
Therapeutic Massage
Therapeutic massage will promote circulation to relieve numbness and tightness and help restore function and feeling.
Chiropractic
Chiropractic adjustments will realign the body and keep affected muscles and joints active.
Electrical Stimulation
Stimulators can activate injured nerves and muscles while the nerve regenerates and recovers.
Braces or Splints
These devices could be used to maintain the position of the affected limb, fingers, hand, or foot to improve muscle function and promote healing.
Exercise
Specifically, prescribed exercises will improve muscle strength, help to maintain range of motion, and reduce muscle cramps.
Diet
A nutritionist will develop a personalized anti-inflammatory diet to expedite healing.
Peripheral Therapy
References
Chen, Zhengrong. “Progress of peripheral nerve repair.” Chinese Journal of traumatology = Zhonghua Chuang Shang za Zhi vol. 5,6 (2002): 323-5.
Gordon, Tessa. “Electrical Stimulation to Enhance Axon Regeneration After Peripheral Nerve Injuries in Animal Models and Humans.” Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics vol. 13,2 (2016): 295-310. doi:10.1007/s13311-015-0415-1
WEBB, E M. “Peripheral nerve injuries; early surgical treatment.” California medicine vol. 80,3 (1954): 151-3.
Welch, J A. “Peripheral nerve injury.” Seminars in veterinary medicine and surgery (small animal) vol. 11,4 (1996): 273-84. doi:10.1016/s1096-2867(96)80020-x
The upper extremities of the body, which include the head, neck, shoulders, chest, and arms, all have a specific job of keeping the body functioning and helping move from place to place. The head and neck work together to allow the host to have the mobility to turn, rotate from side to side, and lean from one side. The shoulders work with the arms to let the muscles have a full range of motion and even help stabilize the upper body. The shoulders have various muscles, tendons, and ligaments to protect the skeletal joints and even work to do everyday activities like carrying or lifting items. When injuries begin to affect the muscle groups of the upper body, it can lead to pain-like symptoms that can lead to chronic conditions developing over time if not treated right away. One of the muscles in the upper body is called the coracobrachialis muscle, which can be affected by injuries. Today’s article observes the coracobrachialis muscle, how trigger points affect the upper arm muscles, and how to manage trigger points associated with the coracobrachialis muscle. We refer patients to certified providers who specialize in shoulder pain treatments to aid individuals suffering from trigger points associated with the coracobrachialis muscles along the upper arms. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer
What Is The Coracobrachialis Muscle?
Have you been dealing with pain from the upper arms to the hands? Do simple arm and shoulder stretches seem to be difficult to do? Or have you been dealing with symptoms of pain, stiffness, or tenderness in your upper arms? Experiencing these pain-like symptoms could overlap other conditions affecting the upper arms and develop trigger points along the muscles, including the coracobrachialis. The coracobrachialis is the smallest muscle located in the front of the upper arm’s anterior that originated in the shoulder coracoid process. This small muscle is connected to the tendon located at the short head of the bicep brachii, and according to Dr. Janet Travell, M.D., the coracobrachialis muscle function helps flex and adduct the arms at the shoulders while working together with the surrounding muscles of the upper arm and shoulders. This allows the arms to move forward slightly and inward. This means that the coracobrachialis muscle will enable individuals to place their arms behind their back without pain. However, like any muscle in the body, injuries can occur in the upper arms and lead to the development of trigger points along the upper arm muscles affecting the coracobrachialis muscle.
How Trigger Points Affect The Upper Arm Muscles?
When the upper arm and the coracobrachialis muscle suffer from pain, tiny nodules along the muscle fiber bands known as trigger points can cause referred pain to the upper arms. Now trigger points are tricky to diagnose due to mimicking overlapping conditions affecting the upper arms. Studies reveal that non-specific arm pain could potentially be one of the causes that trigger points mimic due to strenuous physical activities or work-related activities that can overuse the upper arm muscles.
Studies reveal that individuals with idiopathic arm pain deal with high variable upper-extremity dysfunction, which could play a factor in pain-like symptoms along the surrounding muscles of the arms and shoulders. Many people often experience pain when reaching behind their back for the coracobrachialis affected by trigger points. Since the coracobrachialis works with the surrounding muscles in the shoulders and upper arms, trigger points associated with the coracobrachialis correspond to those muscles causing overlapping risk profiles. Trigger points affecting the coracobrachialis muscle can also mimic nerve entrapment since the coracobrachialis helps the bicep muscles when flexing. Pain associated with trigger points could potentially irritate the surrounding nerves in the muscle fibers, which causes radiating pain along the arms.
Treating The Coracobrachialis Muscle-Video
Does your arm feel stiff when trying to reach behind your back? Do your shoulders ache for no apparent reason? Or have you experienced sharp, shooting pain down your arm? Many people experience pain along their shoulders and arms, affecting their mobility to hold and carry items. They deal with overlapping symptoms associated with trigger points along the coracobrachialis muscle. Trigger points along the coracobrachialis muscle are developed when the upper arm muscles have been overused and irritate the surrounding nerves. This causes radiating referred pain down the arms and can affect a person’s ability to hold items. Thankfully there are ways to manage trigger points along the coracobrachialis and its surrounding muscles. The video above demonstrates a massage technique that works along the coracobrachialis muscle to release nerve entrapment and manage trigger points along the surrounding muscles.
Ways To Manage Trigger Points Affecting The Coracobrachialis
There are various techniques that many specialists, like chiropractors, massage therapists, and physiotherapists, can use to identify and manage trigger points in the body. Since trigger points are tricky to diagnose due to causing referred pain along the surrounding muscles, treatments like stretching, massages, acupuncture, and chiropractic adjustments can help alleviate the pain and reduce future trigger points from forming. Studies reveal that pain specialists could manage trigger points associated with shoulder pain along the coracobrachialis through treatments of manual compression and other various techniques. Once treatments have been incorporated to relieve trigger point pain along the affected muscle, many people can further prevent the symptoms from returning by not lifting or carrying heavy objects and not forcing their coracobrachialis to be a substitute for their bicep muscles.
Conclusion
The coracobrachialis is a short muscle that works with the bicep muscle and helps with mobility and motor functions for the arms and shoulders. This muscle allows the arms to move forward and can be placed in the back without pain. When muscle injuries affect the surrounding muscles that work with the coracobrachialis, it can develop trigger points associated with pain along the upper arms. When this happens, it can lead to symptoms of stiffness, pain, and tenderness in the upper arms, causing mobility issues. Pain specialists for trigger points can utilize various treatments to relieve the pain and reduce the effects that trigger points cause on the affected muscle. This allows the upper arms to gain mobility back and the host to do various activities without feeling pain.
References
Bron, Carel, et al. “Treatment of Myofascial Trigger Points in Patients with Chronic Shoulder Pain: A Randomized, Controlled Trial.” BMC Medicine, BioMed Central, 24 Jan. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3039607/.
Moradi, Ali, et al. “Nonspecific Arm Pain.” The Archives of Bone and Joint Surgery, Archives of Bone and Joint Surgery Co., Dec. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4151410/.
Ring, David, et al. “Idiopathic Arm Pain.” The Journal of Bone and Joint Surgery. American Volume, U.S. National Library of Medicine, July 2004, pubmed.ncbi.nlm.nih.gov/15252084/.
The shoulders help stabilize the upper extremities of the body and provide a wide range of movements for the arms. The shoulders have many muscles, ligaments, and tendons that help support the joints from injuries and utilize the motor function to do everyday actions like throwing a ball or stretching for long distances. Even though the shoulders help stabilize the upper extremities, they are still prone to injuries since the shoulder muscles are constantly used throughout the day. One of the shoulder muscles that are continuously utilized is the deltoid muscle, which can lead to the development of trigger points when it becomes injured. Today’s article examines the deltoid muscles, how trigger points affect the deltoids and shoulders, and managing trigger points associated with the deltoid muscles. We refer patients to certified providers specializing in shoulder pain treatments to aid individuals suffering from trigger points associated with the deltoid muscles along the shoulders. We also guide and inform 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 the patient requests. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Deltoid Muscle?
Have you been feeling pain on the top of your shoulders? Do your shoulders feel stiff when rotating them? Or do you feel radiating pain along your upper arms? Individuals with shoulder pain may be experiencing trigger points affecting their deltoid muscles. The deltoids are large triangular-shaped muscles that are associated with the shoulder girdle. The deltoids sit on top of the shoulder girdle and have anterior and posterior sections that work together with the rotator cuff muscles that provide a full range of motion to the arms. Studies reveal that the deltoid muscles have a more complex structure since the intramuscular tendons from the deltoids help provide different functions when it comes to the shoulders and arms’ motor function. According to Dr. Janet G. Travell, M.D., the anterior sections of the deltoid muscles are used in sports activities. In contrast, the posterior section works with the rotator cuff muscles for mobility. Injuring the deltoid muscles can lead to the development of trigger points associated with shoulder pain.
How Do Trigger Points Affect The Deltoids & Shoulders?
Regarding the shoulders, they can succumb to various injuries that can become an issue over time, lead to the development of trigger points in the shoulder muscles, and cause referred pain to the upper arms. Trigger points or myofascial pain syndrome along the deltoid muscles may invoke referred pain to the shoulders. Studies reveal that myofascial pain syndrome is often described as the sensory, motor, and autonomic symptoms caused by trigger points that cause tender spots on the hardened muscle to produce pain. Trigger points are a bit tricky to diagnose since they mimic other chronic conditions in the body. The deltoid muscles are superficial, and trigger points can cause referred pain to the muscles that mimic arthritis in the shoulder joints. Some of the other symptoms associated with trigger points along the shoulders and deltoids include:
Limited range of mobility
Tenderness in the shoulder muscles
Muscle spasms
Muscle pain
Stiffness in the deltoid muscles
Pain in the shoulders can cause the body to become unstable and cause many individuals to develop a hunched position over time to reduce the pain they are feeling; fortunately, there are various ways to manage the pain associated with trigger points along the shoulders and deltoid muscles.
Trigger Point Release On The Deltoid Muscle- Video
Have you been feeling stiffness along the shoulders or the deltoid muscles? Have you experienced muscle tenderness in your upper arms? Or do you feel like being hunched over reduces the pain in your shoulders? If you have been experiencing any of these symptoms, it could be the development of trigger points associated with shoulder pain along the deltoid muscles. Trigger points cause referred pain to the affected muscle area and are developed when the muscles are overused. For the deltoid muscles, when active trigger points affect the deltoids’ anterior or posterior sections, it can cause the muscles to twitch and later cause moderate tension. The video above explains where the trigger points are located on the deltoid muscles and how to release them through palpations and massages. This is one of the techniques that can help manage trigger points from affecting the shoulders and deltoid muscles.
Managing Trigger Points Associated With The Deltoid Muscles
When dealing with trigger points associated with the deltoid muscles can be managed through various techniques that many people can utilize to reduce the pain symptoms along the upper arms and shoulders. Studies reveal that dry needling is one of the techniques that can relieve trigger points to ease the pain intensity and irritability to the shoulders. Other techniques that many people can utilize are to correct how they carry heavy objects to reduce the load on their shoulders, stretch the arms and shoulders to minimize soreness and alleviate tight muscles, and even take a hot shower to relax the shoulder muscles, can reduce the chances of trigger points from forming in the future.
Conclusion
The deltoid is located on top of the shoulder girdle and is a large triangular-shaped muscle that works together with the rest of the shoulder and the rotator cuff muscles. The shoulders have many muscles, ligaments, and tendons that provide stability and perform everyday functionality to the body. When the shoulders become injured, the affected muscles could potentially develop trigger points to cause referred pain to the shoulders and upper arms. When trigger points affect the deltoid muscles, it can cause them to have symptoms of stiffness, tenderness, and pain that mimic other chronic conditions affecting the shoulders and arms. Thankfully, various techniques relieve referred pain from the arms and help manage trigger points along the deltoid muscle. This allows the deltoid muscle to relax and reduce trigger points from developing further on the shoulders.
References
Bron, Carel, and Jan D Dommerholt. “Etiology of Myofascial Trigger Points.” Current Pain and Headache Reports, Current Science Inc., Oct. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3440564/.
Calvo-Lobo, César, et al. “Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults with Nonspecific Shoulder Pain: A Randomized Clinical Trial.” Journal of Geriatric Physical Therapy (2001), Wolters Kluwer Health, Inc., 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5728593/.
Elzanie, Adel, and Matthew Varacallo. “Anatomy, Shoulder and Upper Limb, Deltoid Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 15 May 2022, www.ncbi.nlm.nih.gov/books/NBK537056/.
Uneven hips can throw the back out of natural alignment and cause back stiffness, tightness, discomfort, and pain. Hips that are off-balance unhealthily affect standing, sitting, sleeping posture, walking gait, and overall movements. Biomechanics issues cause the core and spine stabilizing muscles to become weakened and fatigued from overcompensating to keep the body up and moving. Over time this can lead to chronic pain in the back, hips, knees, and feet. Chiropractic care can restore proper hip and spinal alignment and wellness.
Uneven Hips
Misaligned hips can be caused by work or sports injury, exercise, vehicle collision, and/or general wear and tear. When hips are out of alignment, they have shifted from their centered position. They could be rotated forward or backward, forcing the spine and the lower limbs to compensate, resulting in the spine tilting that can make the legs appear uneven. Discomfort may be one-sided low back pain near the sacroiliac joint, causing a stiff/tight back, limited motion, and/or pain symptoms. Because the spine and lower limbs have to compensate for the unevenness, the shoulders and upper back, connected to the pelvis through the spine, are also affected and result in:
Back pain.
Hip and gluteal muscle pain.
Uneven leg length.
Knee, ankle, and foot issues and pain.
Uneven shoulders.
The shoulder blades can stick out on the side of the lower hip.
Rib discomfort and pain.
The rib cage could protrude out on one side. However, this could be due to advanced scoliosis.
Therapy
Staying active is recommended and includes stretching and core strengthening. General stretches recommended to optimize hip equity include:
Hamstring stretch
For this stretch, lie on a flat surface with your legs extended straight out.
Bend the right leg at the knee, placing the right foot on the ground.
Use a towel, belt, or band to grab and wrap around the left foot.
Keep the hip/buttock on the left side planted on the floor.
Slowly raise the left leg upward as far as possible until you feel the stretch.
Once you feel a stretch or restriction in the hamstring, hold the position for 30 seconds.
Repeat on the other side.
Perform 2 to3 times.
Hip flexor stretch
Kneel on the affected leg and bend the healthy leg out in front with the foot flat on the floor.
Back straight.
Slowly push the hips forward until you feel the stretch in the upper thigh and hip.
Hold the stretch for around 15 to 30 seconds.
Chiropractic Care
Chiropractic treatment is a highly recommended non-surgical option for uneven hips and pelvic tilt. Depending on the severity of the misalignment, underlying issues, and body scanning images, hip alignment treatment could include:
Soft tissue therapeutic massage
Chiropractic muscle release for tight hip flexors, quadriceps, hamstrings, and glutes.
Kiapour, Ali et al. “Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain.” International journal of spine surgery vol. 14, Suppl 1 3-13. 10 Feb. 2020, doi:10.14444/6077
Lee, Jeong-Hoon, et al. “The effect of Graston technique on the pain and range of motion in patients with chronic low back pain.” Journal of physical therapy science vol. 28,6 (2016): 1852-5. doi:10.1589/jpts.28.1852
Patel, Rikin V et al. “Pelvic Tilt and Range of Motion in Hips With Femoroacetabular Impingement Syndrome.” The Journal of the American Academy of Orthopaedic Surgeons vol. 28,10 (2020): e427-e432. doi:10.5435/JAAOS-D-19-00155
Rivière, C et al. “Spine-hip relations add understandings to the pathophysiology of femoro-acetabular impingement: A systematic review.” Orthopaedics & traumatology, surgery & research : OTSR vol. 103,4 (2017): 549-557. doi:10.1016/j.otsr.2017.03.010
Suits, William H. “Clinical Measures of Pelvic Tilt in Physical Therapy.” International journal of sports physical therapy vol. 16,5 1366-1375. 1 Oct. 2021, doi:10.26603/001c.27978
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/.
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