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Back Clinic Health Team. The level of functional and metabolic efficiency of a living organism. In humans, it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological, and social changes in an environment. Dr.Alex Jimenez D.C., C.C.S.T, a clinical pain doctor who uses cutting-edge therapies and rehabilitation procedures focused on total health, strength training, and complete conditioning. We take a global functional fitness treatment approach to regain complete functional health.

Dr. Jimenez presents articles both from his own experience and from a variety of sources that pertain to a healthy lifestyle or general health issues. I have spent over 30+ years researching and testing methods with thousands of patients and understand what truly works. We strive to create fitness and better the body through researched methods and total health programs.

These programs and methods are natural and use the body’s own ability to achieve improvement goals, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. As a result, individuals live a fulfilled life with more energy, a positive attitude, better sleep, less pain, proper body weight, and education on maintaining this way of life.


An Overview Of Lumbago

An Overview Of Lumbago

Introduction

Many individuals don’t realize that the various muscles in their back help provide functionality to the body. The back muscles help move, bend, rotate, and help the individual stand up straight when they are out and about. The back muscles also help protect the cervical, thoracic, and lumbar sections of the spine and work together with the head, neck, shoulders, arms, and legs to provide mobility. When the body begins to wear down with age naturally, it can lead to back issues that can limit a person’s mobility, or normal activities can cause the back muscles to be overused and develop trigger points to invoke back pain or lumbago. Today’s article looks at the thoracolumbar paraspinal muscles in the back, how the lumbago is associated with trigger points, and treatments to relieve the lumbago in the thoracolumbar muscles. We refer patients to certified providers who provide different techniques in thoracic lumbar back pain therapies associated with trigger points to aid many suffering from pain-like symptoms along the thoracolumbar paraspinal muscles along the back, causing lumbago. We encourage patients by referring them to our associated medical providers based on their examination when it is appropriate. We designate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer

The Thoracolumbar Paraspinal Muscles In The Back

 

Have you been finding it difficult to walk even for a short period? Do you feel aches and soreness when getting out of bed? Are you constantly in pain when bending over to pick up items from the ground? These various actions that you are doing incorporate the thoracolumbar paraspinal muscle in the back, and when issues affect these muscles, it can lead to lumbago associated with trigger points. The thoracolumbar paraspinal in the back is a group of muscles closely surrounded by the thoracolumbar spine, where the thoracic region ends, and the lumbar region begins. The thoracolumbar paraspinal muscles in the back have a casual relationship with the body as it requires contribution from the systems requiring movement. Studies reveal that the thoracolumbar paraspinal muscles are modulated through communication with the three sub-systems, which include:

  • The passive system: vertebrae, discs, and ligaments
  • The active system: muscles and tendons
  • The control system: central nervous system and nerves

Each system provides muscular activities when a person is bending down to pick up an object or doing simple movements. However, when the muscles become overused, it can lead to various issues affecting the back and surrounding muscles.

 

Lumbago Associated With Trigger Points

 

Studies reveal that paraspinal muscle integrity plays a very critical role when it comes to the maintenance of spinal alignment in the back. When the thoracolumbar paraspinal muscles become overused from normal activities, it can affect the back by causing back pain symptoms or lumbago associated with trigger points. In Dr. Travell, M.D.’s book “Myofascial Pain and Dysfunction,” trigger points may be activated due to sudden movements or sustained muscular contraction over time that leads to the development of lumbago. Atrophy issues in the paraspinal muscles can contribute to lumbago associated with trigger points that cause deep referred pain in the thoracolumbar regions of the back. Active trigger points in the deep muscle group of the thoracolumbar paraspinal can impair movement between the vertebrae during flexion or side bending. 

 


An Overview Of Lumbago- Video

Lumbago or back pain is one of the most common issues that many individuals, from acute to chronic, depending on how severe the pain is inflicted on the back. Have you been feeling pain in your mid-lower back? Do you feel an electric shock when you run down your leg in a weird position? Or have you felt tenderness in the middle of your back? Experiencing these symptoms could indicate that the thoracolumbar paraspinal muscles are affected by trigger points associated with lumbago. The video explains what lumbago is, the symptoms, and various treatment options to relieve the pain and manage trigger points that are causing the thoracolumbar muscles issues in the back. Many individuals who suffer from lumbago don’t often realize that various factors can affect the surrounding muscles in the thoracolumbar region and mask other previous conditions from which they could suffer. Regarding managing lumbago associated with trigger points, various treatment options can help reduce the pain affecting the thoracolumbar paraspinal muscles while managing trigger points for progressing further in the back.


Treatments To Relieve Lumbago In The Thoracolumbar Muscles

 

Since lumbago or back pain is a common issue for many people, various treatments can reduce the pain-like symptoms in the thoracolumbar muscles and manage the associated trigger points. Some of the simplest treatments that many individuals can use are to correct how they are standing. Many individuals often lean on one side of their bodies which causes the thoracolumbar paraspinal muscles on the opposite sides to be overloaded. This causes spinal subluxation or misalignment to the thoracolumbar region. Another treatment that many people can incorporate into their daily lives is by going to a chiropractor for a spinal adjustment for the thoracolumbar spine. Studies reveal that chiropractic care combined with physical therapy can relieve the thoracolumbar back while reducing the pain symptoms associated with trigger points by loosening the stiff muscles and causing relief to the back. 

 

Conclusion

The back has various muscles known as the thoracolumbar paraspinal muscles that allow movement and mobility to the body. The back muscles help protect the cervical, thoracic, and lumbar sections of the spine while working with the rest of the body’s components to keep the body stable. When natural aging or actions affect the back muscles, it can lead to various pain issues that can activate trigger points causing lumbago or back pain. Fortunately, some treatments can help alleviate back pain in the thoracolumbar paraspinal muscles while managing trigger points to bring back mobility to the back.

 

References

Bell, Daniel J. “Paraspinal Muscles: Radiology Reference Article.” Radiopaedia Blog RSS, Radiopaedia.org, 10 July 2021, radiopaedia.org/articles/paraspinal-muscles?lang=us.

du Rose, Alister, and Alan Breen. “Relationships between Paraspinal Muscle Activity and Lumbar Inter-Vertebral Range of Motion.” Healthcare (Basel, Switzerland), MDPI, 5 Jan. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4934538/.

He, Kevin, et al. “The Implications of Paraspinal Muscle Atrophy in Low Back Pain, Thoracolumbar Pathology, and Clinical Outcomes after Spine Surgery: A Review of the Literature.” Global Spine Journal, SAGE Publications, Aug. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7359686/.

Khodakarami, Nima. “Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation.” Healthcare (Basel, Switzerland), MDPI, 24 Feb. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7151187/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.

Disclaimer

Residual Backache On The Serratus Posterior Inferior

Residual Backache On The Serratus Posterior Inferior

Introduction

As the “backbone” of the body, the thoracic region of the back has various muscles that help support the ribcage and protect the heart and lungs from injuries. The thoracic spine’s main function is providing respiration and maintaining good posture. However, various habits can cause issues to the muscles in the thoracic spine, which leads to upper back pain and the development of trigger points. One of the thoracic muscles affected by trigger points is the serratus posterior inferior muscle. Today’s article looks at the serratus posterior inferior muscle, how trigger points affect the thoracic region of the back, and how to manage thoracic back pain associated with trigger points. We refer patients to certified providers who provide different techniques in thoracic back pain therapies associated with trigger points to aid many suffering from pain-like symptoms along the serratus posterior inferior muscle along the back. We encourage patients by referring them to our associated medical providers based on their examination when it is appropriate. We designate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer

What Is The Serratus Posterior Inferior Muscle?

Have you felt aches and pain when bending down to pick something up? What about feeling tenderness near your lower back? Or have you experienced muscle stiffness when stretching? Many of these symptoms are associated with back pain that correlates to overusing the thoracic muscles, which includes the serratus inferior posterior muscles. The serratus posterior muscles (superior and inferior) are accessory breathing muscles as part of the extrinsic muscles. The serratus posterior inferior helps with the chest cavity’s expiration, while the superior help with inspiration. Some of the functionalities that the serratus posterior inferior provides are that in a bilateral action, the inferior works with the superior muscles to reduce the extension of the thoracic vertebrae.

 

 

In contrast, the unilateral action for the serratus posterior inferior muscle helps rotate the spine to the opposite sides. Studies reveal that based on the attachment of the serratus, the posterior inferior and superior are generally considered insignificant muscles. Since the serratus posterior muscles help aid respiration to the thoracic region, it can be succumbed to trigger points or myofascial pain syndrome that can affect the thoracic part of the back.

 

How Trigger Points Affect The Thoracic Region?

 

When the serratus posterior muscles in the thoracic region are affected by myofascial pain syndrome or trigger points, it correlates to the various activities the person has been doing that cause muscle strain along the serratus inferior posterior muscle. The book, “Myofascial Pain & Dysfunction” explains that when individuals feel a nagging ache in the lower thoracic region of the back, it correlates to residual backache associated with trigger points. Studies reveal that trigger points or myofascial pain syndrome are musculoskeletal pain disorder that affects one or multiple muscles in the body. Since back pain is common, trigger points can cause hyperirritability in the muscle’s taut band due to various factors that can cause strain on the affected muscle. When it comes to the serratus posterior inferior muscle developing active trigger points, it’s due to overload strain from combined movements like lifting, turning, and reaching for items that can also affect the surrounding muscles in the thoracic region of the back.

 


Trigger Point Of The Week: Serratus Posterior Inferior- Video

Have you been dealing with pain in your upper back in the thoracic region? Do you experience tenderness or soreness near your ribcage? Or have you felt a twinge of pain when turning your torso? Most of these symptoms are common signs that the thoracic region is affected by trigger points along the serratus posterior inferior muscle. The video explains where the serratus posterior inferior is located while pinpointing where the trigger points are located in the thoracic region of the back. Trigger points associated with thoracic back pain mimic other chronic conditions that can cause muscle tension and strain on the upper back. Studies reveal that latent and active trigger points affecting the upper thoracic area muscles can make many individuals feel more pain than they can tolerate. This can affect how a person functions and can make them feel inadequate. However, it is possible to incorporate a variety of treatments to reduce the pain and manage trigger points from progressing further in the thoracic region of the back.


Managing Thoracic Back Pain Associated With Trigger Points

 

Various treatments are available to reduce the pain affecting the thoracic region of the back and even manage trigger points associated with the serratus posterior inferior muscle. Many individuals often go to a chiropractor to relieve their back pain. Chiropractors utilize their hands and various techniques to manipulate the spine and can even pinpoint where the trigger points affect the multiple muscles in the thoracic region. Chiropractors even work with other pain specialists to devise a treatment procedure to reduce the symptoms while managing thoracic back pain associated with trigger points. Studies reveal that by when pain specialists like chiropractors begin identifying proper treatment strategies for managing thoracic back pain associated with trigger points, it might be able to reduce pain and improve function for many people dealing with thoracic back pain.

 

Conclusion

The thoracic region of the back has various muscles that help support the ribcage and protect vital organs, which include the heart and the lungs. One of the muscles in the thoracic region is the serratus posterior inferior muscle, an accessory breathing muscle that helps with the chest cavity expiration and helps reduce the extension of the thoracic vertebrae. When the inferior muscle becomes overused by various movements, it can develop trigger points along the inferior muscle, causing thoracic back pain. Trigger points along the serratus inferior posterior muscles can mimic other chronic conditions that can cause symptoms of muscle tension and strain on the upper back. Luckily, various treatments have been available to reduce pain symptoms and manage thoracic back pain associated with trigger points. These treatments can bring back mobility to the thoracic region of the back without the individual being in pain.

 

References

Chen, Chee Kean, and Abd Jalil Nizar. “Myofascial Pain Syndrome in Chronic Back Pain Patients.” The Korean Journal of Pain, The Korean Pain Society, June 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3111556/.

Dor, Adi, et al. “Proximal Myofascial Pain in Patients with Distal Complex Regional Pain Syndrome of the Upper Limb.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, July 2019, pubmed.ncbi.nlm.nih.gov/31563368/.

Mitchell, Brittney, et al. “Anatomy, Back, Extrinsic Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK537216/.

Ortega-Santiago, Ricardo, et al. “Widespread Pressure Pain Sensitivity and Referred Pain from Trigger Points in Patients with Upper Thoracic Spine Pain.” Pain Medicine (Malden, Mass.), U.S. National Library of Medicine, 1 July 2019, pubmed.ncbi.nlm.nih.gov/30821833/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.

Vilensky , J A, et al. “Serratus Posterior Muscles: Anatomy, Clinical Relevance, and Function.” Clinical Anatomy (New York, N.Y.), U.S. National Library of Medicine, July 2001, pubmed.ncbi.nlm.nih.gov/11424195/.

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Trigger Points Affecting The Serratus Anterior

Trigger Points Affecting The Serratus Anterior

Introduction

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, 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, www.ncbi.nlm.nih.gov/books/NBK535396/.

Lung, Kirsten, et al. “Anatomy, Thorax, Serratus Anterior Muscles – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 7 Oct. 2021, www.ncbi.nlm.nih.gov/books/NBK531457/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.

Yi, Kyu-Ho, et al. “Intramuscular Neural Distribution of the Serratus Anterior Muscle: Regarding Botulinum Neurotoxin Injection for Treating Myofascial Pain Syndrome.” Toxins, MDPI, 11 Apr. 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9033065/.

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The Body’s Ability To Heal: Back Clinic Chiropractic

The Body’s Ability To Heal: Back Clinic Chiropractic

The body’s ability to heal itself is quite remarkable. When injury or illness presents, the body’s systems activate to deal with the problem and restore itself to health. The spine’s bones protect the communication pathways of the spinal cord and nerve roots. If the nervous system suffers injury or is damaged in some way, causing impairment, it can cause malfunctioning of the tissues and organs throughout the body. Chiropractic care combined with functional medicine can restore and enhance the body’s self-healing abilities to optimal levels.The Body's Ability To Heal Enhanced With Chiropractic

The Body’s Ability To Heal Itself

A healthy body regenerates, fights infection, heals wounds, and repairs damage. The body is in a constant state of removing damage and producing new, healthy tissues.

  • Cells can heal themselves when they become unhealthy and replicate to replace injured or damaged cells.
  • The body produces new cells to heal the damage if a bone gets fractured or broken.
  • When the skin gets cut, the blood clots, stopping the bleeding, white blood cells remove the injured and dead cells, and new healthy cells repair the damaged tissue.
  • The immune system deals with viruses, bacteria, and toxins.
  • Natural destroyer cells recognize when the body’s cells have been invaded by a virus and destroy the infected cell.

Inflammation

Inflammation is the body’s reaction to an injury or infection, activating the immune system to restore the injured or infected area to health.

  • A fever is the body’s raising its temperature to levels that will kill viruses and bacteria.
  • The elevation in temperature also triggers certain cellular mechanisms which help the body fight the infection.

Stem Cells

The body heals and regenerates itself through stem cells.

  • Once the body is formed, embryonic stem cells disappear, and adult stem cells take over.
  • The adult stem cells divide, producing an identical stem cell and a healthy, mature cell of a specific type.
  • Each type of adult stem cell only can become certain types of tissue.
  • For example, Mesenchymal Stem Cells can regenerate bone, fat, muscle, and cartilage cells.
  • Neural Stem Cells help regenerate nerve tissue in the brain and spinal cord.
  • Epithelial Stem Cells regenerate skin.
  • Adult stem cells can reproduce for a long time but eventually stop reproducing as efficiently.

Nervous System

The nervous system assists the whole body in maintaining communication, using electrical and chemical impulses to send and receive messages. The system reacts to changes inside and outside the body. Infections, injuries, disorders, and conditions can cause imbalances causing communication problems that can lead to health issues. Common problems of the nervous system include:

  • Sciatica – Pressure on a nerve/s caused by a slipped, bulging, or herniated disc in the spine or arthritis of the spine and, sometimes, other factors.
  • Headaches
  • Dizziness
  • Neuralgia
  • Shingles – Infection of sensory nerves caused by the varicella-zoster virus.
  • Stroke – Lack of blood to part of the brain.
  • Parkinson’s disease – The death of neurons in a part of the brain called the midbrain. Symptoms include shaking and mobility problems.
  • Epilepsy – Abnormal electrical activity in the brain causing seizures.
  • Meningitis – Inflammation of the membrane covering the brain.
  • Multiple sclerosis – The myelin sheaths protecting the nerves of the central nervous system become damaged and deteriorates.

Chiropractic Care

Subluxations are misaligned or damaged joints that are not functioning correctly. These joints can place pressure on a nerve, which interferes with the normal nervous system function. Chiropractic care can realign, restore and maintain neuromusculoskeletal system health to reactivate the body’s natural healing abilities.


Cerebral Palsy Chiropractic Treatment


References

Haavik, Heidi, et al. “Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in Chronic Pain Patients: A Preliminary Study.” Journal of manipulative and physiological therapeutics vol. 40,3 (2017): 127-138. doi:10.1016/j.jmpt.2016.10.002

Lee, Courtney, et al. “Mind-body therapies for the self-management of chronic pain symptoms.” Pain medicine (Malden, Mass.) vol. 15 Suppl 1 (2014): S21-39. doi:10.1111/pme.12383

Maltese PE, Michelini S, Baronio M, Bertelli M. Molecular foundations of chiropractic therapy. Acta Biomed. 2019 Sep 30;90(10-S):93-102. doi: 10.23750/abm.v90i10-S.8768. PMID: 31577263; PMCID: PMC7233649.

McSwan, Joyce, et al. “Self-Healing: A Concept for Musculoskeletal Body Pain Management – Scientific Evidence and Mode of Action.” Journal of pain research vol. 14 2943-2958. 21 Sep. 2021, doi:10.2147/JPR.S321037

Navid, Muhammad Samran et al. “The effects of chiropractic spinal manipulation on central processing of tonic pain – a pilot study using standardized low-resolution brain electromagnetic tomography (sLORETA).” Scientific reports vol. 9,1 6925. 6 May. 2019, doi:10.1038/s41598-019-42984-3

It Could Be More Than Upper Back Pain

It Could Be More Than Upper Back Pain

Introduction

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, 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, www.ncbi.nlm.nih.gov/pmc/articles/PMC2720379/.

Mitchell, Brittney, et al. “Anatomy, Back, Extrinsic Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK537216/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.

Vilensky, J A, et al. “Serratus Posterior Muscles: Anatomy, Clinical Relevance, and Function.” Clinical Anatomy (New York, N.Y.), U.S. National Library of Medicine, July 2001, pubmed.ncbi.nlm.nih.gov/11424195/.

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Myofascial Pain Syndrome Causing Issues On The Sternalis Muscle

Myofascial Pain Syndrome Causing Issues On The Sternalis Muscle

Introduction

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, radiopaedia.org/articles/accessory-muscles-of-respiration?lang=us.

Gruber, L, et al. “A Rare Case of a Symptomatic Sternalis Muscle: Ultrasonograpy and MRI Correlation.” Ultrasound International Open, © Georg Thieme Verlag KG, Nov. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5120977/.

Raikos, Athanasios, et al. “Sternalis Muscle: An Underestimated Anterior Chest Wall Anatomical Variant.” Journal of Cardiothoracic Surgery, BioMed Central, 16 May 2011, 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, www.ncbi.nlm.nih.gov/pmc/articles/PMC2072948/.

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The Pectoralis Minor Being Affected By Myofascial Pain

The Pectoralis Minor Being Affected By Myofascial Pain

Introduction

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, 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, 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, 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, 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.

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