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 upper body works because it provides stability for the body and motor-sensory functions to the arms, neck, shoulders, and chest. The muscles surrounding each body section have different roles and outputs that have specific jobs for body functionality. For the chest body area, the various muscles are there to support the shoulders and arms while protecting the chest cavity and the internal organs inside. Some of the different chest muscles even support the internal organs and the rest of the muscles. One of those muscles is known as the serratus anterior muscle. Today’s article looks at this muscle, how trigger points affect the serratus anterior muscle, and various actions to manage trigger points along the serratus anterior. We refer patients to certified providers who provide different techniques in pain therapies associated with trigger points to aid many suffering from pain-like symptoms along the serratus anterior muscle along the ribcage. We encourage patients by referring them to our associated medical providers based on their examination when it is appropriate. We designate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
What Is The Serratus Anterior?
Have you been experiencing pain in your sides? Do you notice that your shoulders feel stiff when rotating backward? Or are you experiencing any cardiovascular disorders that are causing you pain? Pain can come in many forms and affect a person differently, as most of these symptoms are associated with trigger points affecting the serratus anterior muscle along the side of the ribs. The serratus anterior muscles work in the body because this muscle is located deep within the scapula (shoulder blades) and the pectoral muscles. Some of the functions that the serratus anterior provides are that it helps pull the shoulder blades forward around the thorax by allowing anteversion and protraction of the arms.
A great example is when a boxer is throwing a punch. This motor action is done with the long thoracic nerve. The long thoracic nerve originated from the C-5 and C-6 regions of the cervical spine and is the motor nerve for the serratus anterior muscle to allow an anterolateral motion for the shoulder blades that allows arm elevation. Another function of the serratus anterior is that it helps lift the ribs and provide assistance with respiration. The serratus anterior muscle also helps protect the side of the ribcage.
Trigger Points Affecting The Anterior Serratus Muscle
The serratus anterior muscle and the long thoracic nerve work hand-in-hand to provide motor function to the arms but can succumb to various injuries that can cause the development of trigger points or myofascial pain syndrome in the anterior serratus muscle. According to Dr. Travell, M.D.’s book, “Myofascial Pain & Dysfunction,” trigger points may be activated when the serratus anterior muscle has been overused and strained from excessive exercises like prolonged running, pushups, or heavy weight lifting or even extreme coughing from respiratory diseases. Other studies reveal that trigger points affecting the serratus anterior muscle can cause radiating pain along the anterior chest wall that can mimic radiculopathy and often be confused with chronic mechanical neck pain, instability in the glenohumeral, and even shoulder impingement syndrome. Trigger points are often difficult to diagnose due to the referred pain in the affected muscle. The various factors that contribute to the development of trigger points can be simple, like an overused muscle or even a slightly poor posture stance that can cause an imbalance in the body.
Trigger Point Release On The Serratus Anterior- Video
Have you been dealing with pain in the side of your ribs? What about experiencing stiffness or pain when throwing a punch? Do you feel any aches or soreness when adjusting your posture? These symptoms you are experiencing could contribute to the development of trigger points affecting the serratus anterior muscle. The serratus anterior covers the side of the ribcage and lies deep within the scapula and pectoral muscle. This muscle allows the motor function to the arms as it pulls the scapula forward around the thorax when someone throws a punch. However, when the muscle is overused, it can develop trigger points along the serratus anterior muscle and mimic chronic issues in the chest cavity. This causes referred pain to travel from the side of the ribs down to the hand, causing pain-like symptoms to the ring and pinky fingers. Fortunately, various treatments help manage trigger points in the serratus anterior muscle. The video above shows where the trigger points are located in the serratus anterior and how to release the trigger points from the affected muscle to relieve the pain and manage trigger points from returning to the muscle.
Various Actions To Manage Trigger Points Along The Serratus Anterior
When the serratus anterior is affected by trigger points, many people will often feel pain along their sides and complain about their chest hurting for an unknown reason. When this happens, they would be referred to a pain specialist like a chiropractor or a massage therapist to manage trigger points associated with the serratus anterior through various techniques. Studies reveal that techniques like intramuscular neural distribution of the serratus anterior muscle can help reduce the effects of trigger points in the affected muscle to reduce pain-like symptoms. Other methods like thoracic spinal manipulation, dry-needling, acupuncture, or stretching the muscle group can help loosen the stiff muscles and lower trigger points from forming. However, other actions that many people should consider are modifying or avoiding strenuous activities that can reactivate the serratus anterior muscle trigger points. Even when the person is sleeping, putting a pillow under to support the arm can prevent the scapula from falling forward.
Conclusion
The serratus anterior muscle is located at the side of the ribs and is deep within the scapula (the shoulder blades) and the poster muscles. The serratus anterior muscle works with the long thoracic nerve by providing motor function to the arms by allowing anterolateral motion. This allows the individual to throw a punch in a boxing match while lifting the ribs and assisting with respiration. When the serratus anterior muscle succumbs to injuries or has been overused, it can develop into trigger points and cause various issues affecting the body’s chest cavity. Trigger points are treatable through multiple therapies that can manage trigger points while reducing the pain effects rendered in the serratus anterior muscles. These therapies return mobility and motor function to the arms and the serratus anterior muscles.
References
Bautista, Alexander, et al. “Serratus Anterior Muscle Pain Syndrome: A Diagnostic Conundrum.” OUP Academic, Oxford University Press, 11 Feb. 2017, https://academic.oup.com/painmedicine/article/18/8/1600/2990174?login=false.
Long, Kirsten, and Forshing Lui. “Anatomy, Thorax, Long Thoracic Nerve.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 31 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK535396/.
Neuropathy therapeutic massage is a system of structured palpations or movements of the body’s soft tissues. When the nerves don’t get enough oxygen and nutrients from blood circulation, symptoms like tenderness, tingling, numbness, and pain can present. The best way to move the blood is by massaging the circulation in and around the numb and sore areas and throughout the body. Many types of massage therapy are available for various health-related issues. This includes:
Pain alleviation and management
Injury rehabilitation and prevention
Stress alleviation
Anxiety and depression therapy
Immune system restoration
Increasing relaxation
Facilitating overall wellness
Neuropathy Therapeutic Massage
Neuropathy therapeutic massage: The objective is to stimulate blood flow throughout the body. This is because the more muscles move, the better they can maintain blood circulation to nourish the nerves and the body, which is why physical activity/exercise/movement is encouraged. Benefits include:
De-stressing the nerves that are causing tingling, numbness, and burning.
The discomfort eases as the muscles are lengthened and loosened, releasing the tightness and pressure.
Endorphins (natural painkillers) are released, minimizing the pain.
Increase in circulation
Reduced spasms and cramping
Increased joint flexibility
Mobility restoration
Symptom relief
Decreased anxiety
Improved sleep quality
Increased energy levels
Improved concentration
Reduced fatigue
Massage Techniques
Massaging techniques include:
Kneading
Stroking
Gliding
Percussion
Vibration
Friction
Compression
Passive stretching
Active stretching
Effleurage
This can be firm or light soothing, stroking movements without dragging the skin, using the fingertips or the palms.
Petrissage
Lifting or picking up muscles and rolling the skin.
Tapotement
Striking with the side of the hand, usually with slightly flexed fingers, rhythmic finger movements, or short rapid movements with the sides of the hand.
There are different types of massage, those that are for comfort and those for specific conditions or diseases. A few include:
Swedish Massage
Generally regarded as the most common form of massage, this technique involves a combination of five basic strokes and concentrates on the muscles and connective tissues.
Used to improve circulation, relaxation, pain relief, and overall maintenance and well-being.
Sports Massage
Sports massage therapies are used in preventative and therapeutic settings.
Athletes use the technique during warm-ups, training, and competition to treat and/or help in:
Injury prevention
Improved flexibility
Full range of motion
Improved performance
Helps to focus and mental clarity.
Reflexology
This technique uses a system of points on the hands, feet, and ears that correspond to or reflex other body areas.
Reflexologists apply appropriate pressure to these points to stimulate energy flow, to relieve pain or blockages throughout the body.
Reflexology is also used to ease stress and promote relaxation.
Aromatherapy
Various essential oils derived from plants, herbs, flowers, and roots have therapeutic qualities.
Aromatherapy involves essential oils to produce a certain effect; for example, lavender is used to induce calmness and relaxation.
When combined with body massage, aromatherapy can enrich the experience immensely.
A few drops can be added to massage cream or oil and applied to the skin.
Connective tissue massage is similar to myofascial release in that it involves working with the fascia, or soft tissue, to relieve pain, tightness, and discomfort.
The theory of connective tissue massage is that tight, restricted body areas negatively affect other body areas.
Practitioners/therapists hook their fingers into the connective tissue and use pulling strokes to lengthen the tissues.
This releases tension, improves mobility and reduces stress.
Deep-Tissue Massage
Deep-tissue massage utilizes slow strokes, direct pressure, and/or friction across the grain of the muscles with the fingers, thumbs, and/or elbows.
Its purpose is to reach the fascia beneath the muscles going deep into the muscles and connective tissue to release aches and pains.
Therapists thoroughly understand the human body and have been trained to administer deep-tissue massage.
The technique is used in treating chronic pain, inflammation, and injury.
Geriatric Massage
Geriatric massage involves treating the elderly and addressing specific needs related to age, conditions, and illness.
The sessions are usually shorter and involve gentle techniques to facilitate pain relief, relaxation, and overall wellness.
Lymph Drainage Therapy
This technique involves the application of light, rhythmic strokes to alleviate various conditions related to the body’s lymph system.
The lymph system supports the immune system and is responsible for flushing toxins and draining fluid.
When lymph circulation slows down or stops, fluid can build up and cause physical problems like inflammation, edema, and neuropathies.
Therapists restore lymph flow by using a mapping system to assess problem areas, then apply gentle pressure using the fingers and hands to reactivate circulation.
Neuromuscular Therapy
Neuromuscular therapy is massage applied to specific muscles, often used to increase blood circulation, release muscle tension knots/trigger points, and/or release pain/pressure on nerves.
This therapy is also known as trigger-point therapy in that concentrated finger pressure is applied to specific points to alleviate muscular pain.
HealthCare
Neuropathy therapeutic massage is used in combination to enhance regular medical care. Let a doctor know when trying massage therapies, and follow any standard treatment plans. Some forms of massage can cause soreness the next day but should be combined with a sense of improvement and being healthier. If any part of the massage doesn’t feel right or is painful, let the therapist know immediately. Most serious issues come from too much pressure during the massage or sensitivity or allergy to massage oils. Massage therapy caution includes the following:
Vigorous massage should be avoided by individuals with bleeding disorders or low blood platelet counts and taking blood-thinning medications.
Massage therapy should not be done in areas with blood clots, fractures, healing wounds, skin infections, weakened bones from osteoporosis or cancer, or after recent surgery.
Cancer patients should discuss any concerns about massage therapy with their oncologist.
Pregnant women should consult their healthcare provider before using massage therapy.
Peripheral Neuropathy Recovery
References
American Massage Therapy Association defines massage therapy and basic massage therapy terms. www.amtamassage.org
Complementary and alternative methods: types of bodywork. Available at www.cancer.org
Gok Metin, Zehra, et al. “Aromatherapy Massage for Neuropathic Pain and Quality of Life in Diabetic Patients.” Journal of nursing scholarship: an official publication of Sigma Theta Tau International Honor Society of Nursing vol. 49,4 (2017): 379-388. doi:10.1111/jnu.12300
MassageTherapy.com. www.massagetherapy.com
National Institutes of Health, National Center for Complementary and Alternative Medicine
Samuels, Noah, and Eran Ben-Arye. “Integrative Approaches to Chemotherapy-Induced Peripheral Neuropathy.” Current oncology reports vol. 22,3 23. 11 Feb. 2020, doi:10.1007/s11912-020-0891-2
Sarısoy, Pınar, and Ozlem Ovayolu. “The Effect of Foot Massage on Peripheral Neuropathy-Related Pain and Sleep Quality in Patients With Non-Hodgkin’s Lymphoma.” Holistic nursing practice vol. 34,6 (2020): 345-355. doi:10.1097/HNP.0000000000000412
Thomas, Ewan, et al. “Peripheral Nerve Responses to Muscle Stretching: A Systematic Review.” Journal of sports science & medicine vol. 20,2 258-267. 8 Mar. 2021, doi:10.52082/jssm.2021.258
Zhang, Yong-Hui, et al. “Exercise for Neuropathic Pain: A Systematic Review and Expert Consensus.” Frontiers in medicine vol. 8 756940. 24 Nov. 2021, doi:10.3389/fmed.2021.756940
The upper back is part of the thoracic region of the spine, surrounded by various muscles that protect the thoracic joints and help assist with respiratory functionality for the lungs. The upper back muscles consist of the rhomboids and the trapezoid muscles that provide functionality to the scapula or shoulder blades. Other superficial muscles offer assistance to the thoracic spine. The serratus posterior muscle is one of the superficial muscles that helps the thoracic spine and, like all superficial muscles, can succumb to injuries that can lead to the development of overlapping referred pain symptoms known as trigger points. Today’s article focuses on the serratus posterior muscle function in the back, how trigger points are causing upper back pain, and various techniques to manage trigger points in the upper back. We refer patients to certified providers who are diverse in upper back pain therapies to aid many people suffering from myofascial pain syndrome or trigger points associated with the serratus posterior muscle along the upper back. We advised patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Serratus Posterior Muscle Function In The Back
Have you been dealing with constant upper back pain? Do you feel soreness at the base of your neck? Or are you having difficulty breathing? Most of the symptoms cause pain in the serratus posterior muscles that can lead to the development of myofascial pain syndrome or trigger points along the upper back. The serratus posterior has various roles in the upper back as it is not only part of the extrinsic muscles but also part of the accessory breathing muscle. The serratus posterior muscle helps with inspiration, which causes the chest cavity to expand as it is a superficial muscle attached to the ribs and is less commonly known. Studies show that the serratus posterior muscle is deep within the rhomboid muscles and is superficial. Even though this muscle is superficial when it has been overused through various activities, that can cause hypertrophy in the accessory respiratory muscles. Additional studies reveal that the serratus posterior superior muscle is considered clinically insignificant but has been impaired by myofascial pain syndrome or trigger points that can lead to upper back pain.
Trigger Points Causing Upper Back Pain
As stated earlier, the upper back is part of the thoracic region of the spine, and when various factors begin to affect the body, the back muscles tend to be involved. Studies reveal numerous sources of spinal pain in the thoracic spine. One is a myofascial pain syndrome affecting the serratus posterior muscles causing referred upper back pain. Myofascial pain syndrome or trigger points can be activated when the serratus posterior muscle is overloaded from thoracic respiratory issues like coughing due to pneumonia, asthma, or chronic emphysema. When respiratory problems affect the muscles in the thoracic region of the back, it leads to the development of trigger points, leading to overlapping issues like referred pain, motor dysfunction, and autonomic phenomena. According to Dr. Travell, M.D., in the upper back, trigger points can make the serratus posterior muscle cause overlapping risk profiles along the shoulder blades and have referred pain travel to the hands. This can make many individuals suffer from serious pain-like symptoms, causing them to be miserable.
Releasing Trigger Points Related Tension In The Upper Back-Video
Have you been dealing with respiratory issues causing you to be hunched over constantly? Do you feel soreness or tenderness at the base of your neck? Or are you suffering from upper back pain? These symptoms are associated with trigger points that are affecting the serratus posterior muscles causing upper back pain. Trigger points, or myofascial pain syndrome, is a musculoskeletal disorder that causes tenderness along the affected muscle that causes referred pain to the surrounding muscles in the body. Trigger points associated with the serratus posterior muscles can cause referred pain in the upper back and mimic various chronic conditions. Trigger point pain is difficult to diagnose but can be manageable with treatment. The video above gives examples of how to treat trigger points to relieve tension in the upper back.
Various Techniques To Manage Trigger Points In The Upper Back
When it comes to upper back pain, many individuals will go to pain specialists like massage therapists or chiropractors to relieve any issues affecting the upper back. These pain specialists utilize various techniques like stretching, spinal manipulation, massages, and ischemic compression to alleviate pain and manage trigger points from forming further in the affected muscle. Pain specialists like massage therapists or chiropractors are excellent for locating pain-like symptoms associated with trigger points. Even though treatment can help manage symptoms associated with trigger points, many people can still incorporate these techniques, like deep breathing or correcting their posture, to prevent the upper back muscles from becoming strained and causing more issues than before.
Conclusion
The serratus posterior muscles have various roles in the upper back region of the body. These superficial muscles are extrinsic and accessory breathing muscles that help expand the chest cavity. When multiple issues affect the upper back muscles, like strenuous activities or respiratory problems, it can develop trigger points along the serratus posterior muscles and invoke pain-like symptoms to travel down to the hand, causing mobility issues. Thankfully, various techniques that pain specialists like chiropractors and massage therapists use can help manage trigger points from escalating and can bring upper back mobility to the body once again.
References
Altafulla, Juan J, et al. “An Unusual Back Muscle Identified Bilaterally: Case Report.” Cureus, Cureus, 15 June 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093753/.
Briggs, Andrew M, et al. “Thoracic Spine Pain in the General Population: Prevalence, Incidence and Associated Factors in Children, Adolescents and Adults. A Systematic Review.” BMC Musculoskeletal Disorders, BioMed Central, 29 June 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720379/.
Mitchell, Brittney, et al. “Anatomy, Back, Extrinsic Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 Aug. 2021, https://www.ncbi.nlm.nih.gov/books/NBK537216/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Vilensky, J A, et al. “Serratus Posterior Muscles: Anatomy, Clinical Relevance, and Function.” Clinical Anatomy (New York, N.Y.), U.S. National Library of Medicine, July 2001, https://pubmed.ncbi.nlm.nih.gov/11424195/.
The chest in the body has many functions: it helps provide stability on the shoulders, helps protect the heart and lungs, and bears most of the weight of the rest of the upper body. The chest is home to the pectoralis (major and minor) and the serratus anterior muscles, providing mobility and compression to the chest. As the chest muscles protect the heart and lungs, the other muscles, known as the accessory muscles, aid the heart and lungs regarding respiratory and ventilation. In contrast, the primary chest muscles can not provide that function. The sternalis muscle is one accessory muscle that assists the heart and the lungs. Today’s article examines the sternalis muscle in the chest, how myofascial pain syndrome is associated with the sternalis muscle, and various techniques for managing myofascial pain syndrome on the sternalis muscle. We refer patients to certified providers specializing in chest pain therapies to aid many people suffering from myofascial pain syndrome associated with the sternalis muscle along the chest. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Sternalis Muscle In The Chest
Have you been experiencing respiratory issues that are affecting your chest? What about feeling muscle tightness in the middle of your chest? Or are you experiencing radiating pain traveling down your elbow? These symptoms are often associated with pain caused by trigger points along the chest affecting the sternalis muscle. Studies reveal that the sternalis muscle is an anatomical variant along the anterior thoracic region of the body. The sternalis muscle is located right in the middle of the chest and is toward the end of the pectoralis muscles. “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., explained that the sternalis muscle often occurs bilaterally or unilaterally in the body and may attach itself either in the pectoralis muscle or the sternocleidomastoid. The sternalis muscle could even become a continuation of these muscles as well.
One of the unique functions of the sternalis muscle for the body is that it is an accessory muscle. An accessory muscle refers to various muscles that assist the breathing muscles. Since the sternalis muscle assists the other muscles as an accessory muscle, this muscle help opens the airways to allow more oxygen to the lungs. This muscle is extremely useful when it comes to exercising the body. However, this muscle is superficial and can succumb to various issues that affect the chest and internal organs.
Myofascial Pain Syndrome Associated With The Sternalis Muscle
Since the sternalis muscle is superficial, many issues can affect the middle of the chest and invoke pain-like symptoms that overlap and develop myofascial pain syndrome or trigger points in the sternalis. The symptoms associated with myofascial pain syndrome affecting the sternalis muscle are intense, deep pain that can occasionally cause soreness in the sternum. Studies reveal that since the sternalis is an accessory muscle, it can be overlooked, and symptomatic incidences can affect the chest and surrounding organs. To that point, symptoms like muscular imbalances, overuse tendinopathies, or neural compression syndromes can cause the sternalis muscle to ache and activate trigger points. When active trigger points affect the sternalis muscle, it correlates with myocardial infarction or angina pectoris mimicking cardiovascular disorders. Myofascial pain syndrome is tricky to diagnose, but it is treatable with various techniques that can manage the pain.
Massage Techniques For The Sternalis Muscle-Video
Have you been experiencing pain in the middle of your chest? Are you experiencing symptoms of cardiovascular disorders? Or does your chest hurts when you’re coughing? Myofascial pain syndrome or trigger points affecting the sternalis muscle are associated with many symptoms. Myofascial pain syndrome is a condition that affects the musculoskeletal system by causing the affected muscles to be overused and causing referred pain. Studies reveal that issues like myofascial pain syndrome begin to affect the chest wall cavity of the body; many patients think they have a cardiac disease causing greater impairment in their daily activities, causing emotional stress and a higher level of anxiety. All is not lost, though, as there are various techniques to reduce the pain and other chronic symptoms while managing myofascial pain syndrome on the sternalis muscle. The video above explains the sternalis muscle and shows different approaches to stretching and massaging the sternalis muscle on the chest.
Various Techniques For Managing Myofascial Pain Syndrome On The Sternalis Muscle
When a doctor examines the sternalis muscle, many individuals will often complain about experiencing chest and heart pain since the muscle is located in the front-middle of the chest. However, all is not lost, as various techniques can help relieve the pain along the sternalis muscle while managing myofascial pain syndrome. As stated earlier, trigger points can mimic other chronic conditions that can affect not only the muscle itself but the surrounding organs. Gently stretching the chest can help reduce the aches in the surrounding muscles and trigger point formation. Another technique that many people can incorporate is ischemic compression on the sternalis muscle combined with moist heat. The ischemic compression allows a sense of discomfort, but no pain should be inflicted to reduce pain symptoms and manage myofascial pain syndrome.
Conclusion
The sternalis muscle is located in the middle of the chest and helps the surrounding muscles to breathe and expand. This muscle works together with the pectoralis and the sternocleidomastoid muscle by attaching itself to these muscles in a unilateral or bilateral muscle. When traumatic forces or events affect the chest, this superficial muscle can be affected and develop myofascial pain syndrome that mimics cardiovascular disorders. Fortunately, various techniques like gentle chest stretch and ischemic compression can help manage trigger points and reduce pain in the chest.
References
Bell, Daniel J. “Accessory Muscles of Respiration: Radiology Reference Article.” Radiopaedia Blog RSS, Radiopaedia.org, 23 July 2022, https://radiopaedia.org/articles/accessory-muscles-of-respiration?lang=us.
Raikos, Athanasios, et al. “Sternalis Muscle: An Underestimated Anterior Chest Wall Anatomical Variant.” Journal of Cardiothoracic Surgery, BioMed Central, 16 May 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3117696/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
Verdon, François, et al. “Chest Wall Syndrome among Primary Care Patients: A Cohort Study.” BMC Family Practice, BioMed Central, 12 Sept. 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2072948/.
Diagnosing ankylosing spondylitis usually involves multiple tests. When doctors order blood tests to diagnose ankylosing spondylitis, an individual is experiencing worsening symptoms in their back and joints. Often, a blood test diagnosis means the doctor is looking for evidence of anything else that could be causing the symptoms. However, blood tests by themselves cannot definitively diagnose ankylosing spondylitis, but when combined with imaging and assessment, they can provide important clues that point to the answers.
Ankylosing Spondylitis Blood Test Diagnosis
Ankylosing spondylitis is arthritis that primarily affects the spine and hips. It can be difficult to diagnose as no single test can provide thorough information for a definitive diagnosis. A combination of diagnostic tests are utilized, including a physical exam, imaging, and blood tests. Doctors are not only looking for results that will point to ankylosing spondylitis, but they are looking for any results that might point away from the spondylitis results that might provide a different explanation for symptoms.
Physical Exam
The diagnostic process will begin with the individual’s medical history, family history, and physical exam. During the exam, the doctor will ask questions to help rule out other conditions:
How long have symptoms been presenting?
Do symptoms get better with rest or exercise?
Are the symptoms getting worse or staying the same?
Are the symptoms worse at a particular time of day?
The doctor will check for limitations in mobility and palpate tender areas. Many conditions can cause similar symptoms, so the doctor will check to see if the pain or lack of mobility is consistent with ankylosing spondylitis. The feature sign of ankylosing spondylitis is pain and stiffness in the sacroiliac joints. The sacroiliac joints are located in the lower back, where the base of the spine and pelvis meet. The doctor will look at other spinal conditions and symptoms:
Back pain symptoms caused by – injuries, posture patterns, and/or sleeping positions.
The HLA-B27 gene corresponds with ankylosing spondylitis; if an individual has it, one of their parents has it.
Imaging
X-rays often serve as the first step to a diagnosis.
As the disease progresses, new small bones form between the vertebrae, eventually fusing them.
X-rays work best at mapping the disease progression than the initial diagnosis.
An MRI provides clearer images in the early stages as smaller details are visible.
Blood Tests
Blood tests can help rule out other conditions and check for signs of inflammation, providing supportive evidence along with the results of imaging tests. It typically only takes about a day or two to get the results. The doctor may order one of the following blood tests:
Antinuclear antibodies, or ANA, go after the proteins in the cell’s nucleus, telling the body its cells are the enemy.
This activates an immune response that the body fights to eliminate.
A study determined that ANA is found in 19% of individuals suffering from ankylosing spondylitis and is higher in women than men.
Combined with other tests, the presence of ANA provides another clue to a diagnosis.
Gut Health
The gut microbiome plays an important role in triggering the development of ankylosing spondylitis and its treatment.
Tests to determine the gut’s health can give a doctor a complete picture of what is happening inside the body.
Blood test diagnoses for ankylosing spondylitis and other inflammatory conditions rely heavily on piecing together different tests alongside clinical exams and imaging.
Causes, Symptoms, Diagnosis, and Treatment
References
Cardoneanu, Anca, et al. “Characteristics of the intestinal microbiome in ankylosing spondylitis.” Experimental and therapeutic medicine vol. 22,1 (2021): 676. doi:10.3892/etm.2021.10108
Prohaska, E et al. “Antinukleäre Antikörper bei Spondylitis ankylosans (Morbus Bechterew)” [Antinuclear antibodies in ankylosing spondylitis (author’s transl)]. Wiener klinische Wochenschrift vol. 92,24 (1980): 876-9.
Sheehan, Nicholas J. “The ramifications of HLA-B27.” Journal of the Royal Society of Medicine vol. 97,1 (2004): 10-4. doi:10.1177/014107680409700102
Wenker KJ, Quint JM. Ankylosing Spondylitis. [Updated 2022 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470173/
Xu, Yong-Yue, et al. “Role of the gut microbiome in ankylosing spondylitis: an analysis of studies in the literature.” Discovery medicine vol. 22,123 (2016): 361-370.
The chest has the pectoralis major muscle that works with the upper half of the body that provides mobility and power. The pectoralis major also surrounds the clavicle skeletal structure and works with the thoracic spine. The chest allows mobility to the arms and stability to the shoulders while working together with the shoulder and arm muscles. Many individuals utilize the upper body more when working out, lifting, or carrying objects from one place to another. This causes the muscle to become overused and succumb to injuries that can affect the functionality of the chest and invoke pain-like symptoms in the body. One of the chest muscles affected by pain is the pectoralis muscles, especially the pectoralis minor muscle. Today’s article looks at the pectoralis minor muscle, how myofascial pain affects the pectoralis minor, and how to manage myofascial pain associated with the pectoralis minor. We refer patients to certified providers specializing in chest pain therapies to aid many people suffering from trigger point pain affecting the minor muscles of the pectoralis. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer
The Pectoralis Minor Muscle
Have you been experiencing pain in your upper-mid back? Do you feel like your chest is feeling compressed constantly? Do you feel the tension in your shoulders that makes it difficult to reach behind your back? Most of these symptoms are signs that many individuals are developing myofascial pain along the pectoralis muscles, especially the pectoralis minor. The pectoralis minor muscle is a thin triangular-shaped muscle below the pectoralis major. It has a crucial part of the chest as it helps stabilize the scapula (the shoulder blades) and is in front of the thoracic wall of the spine. The pectoralis minor is also part of the respiratory muscle group that works with the lungs. The pectoralis minor muscle has many functions for the shoulder blades, which include:
Stabilization
Depression
Abduction or Protraction
Internal Rotation
Downwards Rotation
When environmental factors begin to affect the lungs and cause respiratory issues in the body, the surrounding respiratory muscle group also gets involved, causing the body to be hunched over.
Myofascial Pain Affecting The Pectoralis Minor
When environmental factors begin to affect the lungs, it causes the respiratory muscles to contract and become compressed. This is just one of the many factors that can affect the pectoralis minor muscle. The other factor is that the pectoralis minor muscle may be short in the chest and when individuals try to reach behind their backs. This causes the pectoralis minor muscle to to be overstretched and develop myofascial pain or trigger points along the muscle fibers. The book, “Myofascial Pain and Dysfunction,” written by Dr. Travell, M.D., described the pain from myofascial pain associated with the pectoralis minor to be similar to cardiac pain. This is known as referred pain caused by myofascial pain syndrome and it can be a bit difficult to diagnose since it can mimic other chronic issues. Studies reveal that shortening or any sort of tightness of the pectoralis minor is one of the potential biomechanical mechanisms that is associated with an altered scapular alignment which causes pain and shoulder movement impairments. Overusing the pectoralis minor muscles creates tiny nodules that can affect the stability of the shoulders and causes upper-mid back problems in the thoracic region of the spine.
An Overview Of Trigger Points On The Pectoralis Minor- Video
Have you been experiencing difficulty inreaching behind your back? Do you feeling your body becoming more hunched over than usual? Or have you been experiencing chest pain constantly? These pain-like symptoms are caused by myofascial pain associated with the pectoralis minor muscle. The pectoralis minor muscle helps with the stability of the shoulders and studies reveal that when the presense of myofascial trigger points are linked to shoulder and upper body disorders, it can increase the risk of overlapping conditions that trigger points can mimic. Myofascial trigger points are a common complaint as it can significantly impact a person’s daily activites by causing the taut muscle band to be tender or hypersenitive. When this happens, it can lead to issues of muscle imbalance, weakness and impaired motor function. Thankfully, there are various techniques that can help reduce the pain symptoms and issues in the pectoralis minor muscle, while mananging the trigger points. The video above explainshow to tell when your chest muscles are tight and various tests to know when the pectoralis muscles (both the minor and major) are being affected by trigger points.
Managing Myofacial Pain Associated With Pectoralis Minor
When dealing with chest pains associated with myofascial pain along the pectoralis minor, there are many techniques they can incorporate to prevent myofascial pain from causing further damage to the muscle itself and the surrounding muscles. Various chest stretches can help gently loosen the stiff muscles, warm the pectoralis minor, and improve mobility to the chest and shoulders. Correct posture can help prevent the body from being hunched over constantly and let the surrounding muscles and the pectoralis minor relax. If the pain is unbearable, studies reveal that treatments like dry needling and palpations on the pectoralis minor muscles can help manage the pain caused by trigger points. This kind of treatment allows the muscle to release the trigger point and, combined with a hot or cold pack, can reduce the chances of myofascial pain from forming again in the muscle.
Conclusion
Underneath the pectoralis major muscle, the pectoralis minor is a thin triangular-shaped muscle that helps stabilize the shoulder blades and is located in the front of the thoracic wall of the spine. This tiny muscle is part of the respiratory muscles that have a causal relationship with the lungs and can succumb to environmental factors that can lead to the development of myofascial pain or trigger points on the pectoralis minor. Myofascial pain associated with the pectoralis minor muscle can mimic cardiovascular issues and invoke pain in the muscle. Fortunately, various treatments can help relieve and manage myofascial pain from re-occurring in the pectoralis minor.
References
Bagcier, Fatih, et al. “Three Simple Rules in Pectoral Muscle’s Trigger Point Treatment, Which May Be a Cause of Chest Pain: Position, Palpation, and Perpendicular Needling.” American Board of Family Medicine, American Board of Family Medicine, 1 Nov. 2020, https://www.jabfm.org/content/33/6/1031.long.
Baig, Mirza A, and Bruno Bordoni. “Anatomy, Shoulder and Upper Limb, Pectoral Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, https://www.ncbi.nlm.nih.gov/books/NBK545241/.
Morais, Nuno, and Joana Cruz. “The Pectoralis Minor Muscle and Shoulder Movement-Related Impairments and Pain: Rationale, Assessment and Management.” Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, U.S. National Library of Medicine, Jan. 2016, https://pubmed.ncbi.nlm.nih.gov/26530726/.
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, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060458/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
The chest in the upper half of the body comprises various structures that each have a job to keep the body functioning. The chest has different large muscles surrounding the ribcage and helps protect the vital organs that allow the host to breathe. The essential organs protected by the ribcage and the chest muscles include the heart and the lungs. These two organs aid the chest with blood circulation, breathing, and digestion to keep the body moving and functional. When injuries or chronic conditions begin to affect the chest, it can cause the muscles surrounding the ribcage to contract and tighten, causing the heart and lungs to work harder and causing various issues to affect the body. This can lead to chronic symptoms in the chest and affect a person’s life. Today’s article looks at the pectoralis major muscle in the chest, how trigger point pain is associated with chest pain, and how to manage trigger points in the chest. We refer patients to certified providers who specialize in chest pain therapies to aid many people suffering from trigger point pain affecting the pectoralis major muscles. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., takes note of this information as an educational service only. Disclaimer
The Pectoralis Major Muscles In The Chest
Have you been experiencing unexplainable chest pains that mimic heart issues? Do you feel muscle stiffness near your clavicle? Or do your chest muscles feel tenser and sorer than usual? Many of these issues affecting the chest could result from trigger points associating with the chest along the pectoralis major muscles. The pectoralis major is the superior and largest muscle in the chest wall’s front area. This muscle looks like a thick fan that surrounds the clavicle and works with the chest and arms to provide mobility and power to the upper body. Studies reveal that the pectoralis major muscle plays an important role in upper limb movements. To that point, it can help with the adduction and medial rotation of the arm, according to the book by Dr. Travell, M.D. “Myofascial Pain and Dysfunction,” the pectoralis muscle works with the rest of the chest muscles while being assisted by the teres major and minor muscles, the anterior and posterior deltoid muscles, the subscapularis muscles, and the tricep muscles. The pectoralis major muscles can also be affected by multiple issues affecting the chest and the rest of the upper half of the body.
Trigger Point Pain Associated With The Chest
When the pectoralis major muscles are affected by various issues, they can mimic other chronic conditions that are causing referred pain in different body areas. This is known as trigger point pain, and it can cause overlapping risk profiles on the pectoralis major muscles that can affect the chest. Trigger points are slightly difficult to diagnose as many factors, like repetitive motions or lifting heavy objects, can cause the affected muscles to develop tiny knots along the muscle fibers and cause pain-like symptoms. Many people with chest pains often complain that something is affecting their heart as they place their hands on their chest and gently rub the affected area. However, when their doctors examine them, the issue is not their hearts but their chest muscles. Studies reveal that trigger points affecting the affected muscle can mimic issues like cardiovascular dysfunction in the heart. To that point, active trigger points in the pectoralis major muscle can cause somato-visceral pain to the heart, mimicking cardiovascular issues like paroxysmal arrhythmia. It can also cause visceral-somatic pain where the heart suffers from cardiovascular problems affecting the pectoralis major muscles.
Trigger Point Therapy On The Pectoralis Major-Video
Have you been dealing with chest pains that cause you to hunch over? Does your chest seem to feel tight when you stretch? Or have your chest muscles feel tender to the touch? These pain symptoms are caused by trigger points affecting the pectoralis muscles. Trigger points are generated when a person overuses their muscles from daily activities or succumbs to muscle injuries that cause referred pain in different body areas. So trigger points affecting the pectoralis major muscle may cause chest pains. The video above explains the pectoralis muscles and where the trigger points are located that cause referred pain to the shoulders and the rest of the upper half of the body. Trigger points associated with the chest along the pectoralis major muscles can be treatable through various treatments and techniques that can reduce the symptoms and prevent trigger points from forming along the affected muscle in the future.
Ways To Manage Trigger Points On The Chest
When trigger points affect the pectoralis major muscles, they can invoke chest pain-like symptoms that resemble a cardiovascular disorder. Fortunately, pain specialists like chiropractors, massage therapists, and physiotherapists can utilize various techniques to help reduce the pain caused by trigger points. Studies reveal that when local and referred pain affects the pectoralis major muscle, multiple massage treatments targeting the trigger points can help alleviate the symptoms causing chest pains. Another way people can manage trigger points is by stretching the pectoralis major muscle to relieve tension and soreness in the chest. Incorporating various stretching techniques to alleviate chest pain can help loosen up the stiff muscles and warm them up before a vigorous workout. This allows the pectoralis muscles to provide optimal output on a person’s health and wellness.
Conclusion
The pectoralis major is a thick fan-shaped muscle located on the chest. This muscle works with the shoulders and upper half of the body while protecting the heart and the lungs from various injuries and chronic conditions. When these muscles become affected by injuries or chronic conditions, they can develop trigger points along the chest, causing referred pain to the pectoralis major muscles. This can lead to somato-visceral and visceral-somatic pain symptoms in the chest and make many individuals miserable. Luckily pain specialists who can help manage trigger points along the affected muscle utilize various techniques to reduce the symptoms and prevent trigger points from forming in the affected muscle again. This allows the individual to continue with their daily activities without worrying about chest pains.
References
Haładaj, Robert, et al. “Anatomical Variations of the Pectoralis Major Muscle: Notes on Their Impact on Pectoral Nerve Innervation Patterns and Discussion on Their Clinical Relevance.” BioMed Research International, Hindawi, 2 Apr. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466946/.
Moraska, Albert F, et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.” American Journal of Physical Medicine & Rehabilitation, U.S. National Library of Medicine, Sept. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561477/.
Simons, David G. “Cardiology and Myofascial Trigger Points: Janet G. Travell’s Contribution.” Texas Heart Institute Journal, U.S. National Library of Medicine, 2003, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC152827/.
Solari, Francesca, and Bracken Burns. “Anatomy, Thorax, Pectoralis Major Major.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 26 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK525991/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
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