Whiplash-associated disorders, or WAD, describe injuries sustained from sudden acceleration/deceleration movements. It is a common outcome after a motor vehicle collision but can also be caused by sports injuries, falls, or assaults. Whiplash refers to the mechanism of the injury, while WAD refers to the presence of symptoms like pain, stiffness, muscle spasm, and headaches. A WAD prognosis is unpredictable, with some cases remaining acute with a full recovery, while others progress to chronic conditions with long-term symptoms and disability. Early intervention recommendations include rest, chiropractic care and physical rehabilitation, massaging and stretching exercises, and an anti-inflammatory diet.
Whiplash Associated Disorders
Cervical hyperextension injuries happen to drivers and passengers of moving, slow-moving (less than 14 miles per hour), and stationary vehicles when struck from behind.
The individual’s body is thrown forward, but the head does not follow the body and instead whips forward, resulting in hyperflexion or extreme forward movement of the neck.
The chin limits forward flexion, but the momentum can be sufficient to cause cervical distraction and neurological injuries.
When the head and neck have reached maximum flexion, the neck snaps back, resulting in hyperextension or extreme backward movement of the neck.
Pathology
Most WADs are considered soft tissue-based injuries with no fractures.
Stages
The injury goes through stages:
Stage 1
The upper and lower spine experiences flexion in stage one.
Stage 2
The spine takes on an S-shape while extending and eventually straightens, causing lordosis.
Stage 3
The entire spine is hyperextending with an intense force that causes the facet joint capsules to compress.
Symptoms
Whiplash-associated disorders can be classified through grades by the severity of symptoms, including neck pain, stiffness, occipital headache, cervical, thoracic, and lumbar back pain, upper-limb pain, and paraesthesia.
Grade 0
No complaints or physical symptoms.
Grade 1
Neck complaints but no physical symptoms.
Grade 2
Neck complaints and musculoskeletal symptoms.
Grade 3
Neck complaints and neurological symptoms.
Grade 4
Neck complaints and fracture and/or dislocation.
Most cervical fractures occur predominantly at C2 or C6, or C7.
A chiropractor will identify areas of restricted joint motion, muscle tension, muscle spasm, intervertebral disc injury, and ligament injury.
They will analyze posture, and spinal alignment, check for tenderness, tightness, and how well the spinal joints move.
This will allow the chiropractic physical therapy team to understand the injured body mechanics and how the spine is operating to make a thorough diagnosis.
The doctor will order imaging tests like an x-ray or an MRI to evaluate any degenerative changes that may have existed before the whiplash injury.
Once the injury has been accurately diagnosed, the chiropractor will design a personalized treatment plan.
Spinal Adjustments
Spinal manipulation is applied to areas of the spine that are out of alignment to realign the spine and activate the healing process.
Flexion-distraction technique is a gentle technique that uses slower, less intense pushing motions on the discs used to treat disc herniations that often occur after a whiplash injury.
Instrument-assisted manipulation utilizes special instruments to apply various forces or massage settings to the area.
Targeted spinal manipulation targets specific areas to rework, release, and rebuild the structures.
Massage Therapy stimulates the affected muscles to relax them from their tense state.
A treatment plan may utilize:
Instrument-assisted therapy
Trigger point therapy
Resistance-based stretches to rehabilitate soft tissue damage.
Our chiropractic team is ready to help you feel your best so you can return to normal activities and get on with your life.
Ritchie, C., Ehrlich, C. & Sterling, M. Living with ongoing whiplash-associated disorders: a qualitative study of individual perceptions and experiences. BMC Musculoskelet Disord 18, 531 (2017). doi.org/10.1186/s12891-017-1882-9
Sterling, Michele. “Whiplash-associated disorder: musculoskeletal pain and related clinical findings.” The Journal of manual & manipulative therapy vol. 19,4 (2011): 194-200. doi:10.1179/106698111X13129729551949
Wong, Jessica J et al. “Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration.” The spine journal: official Journal of the North American Spine Society vol. 16,12 (2016): 1598-1630. doi:10.1016/j.spinee.2015.08.024
Woodward, M N et al. “Chiropractic treatment of chronic ‘whiplash’ injuries.” Injury vol. 27,9 (1996): 643-5. doi:10.1016/s0020-1383(96)00096-4
Ankylosing spondylitis is an inflammatory condition that causes pain and stiffness in the spine’s joints. Over time, it can progress to fusing the bones of the spine/vertebrae, limiting the spine’s mobility and leading to discomfort symptoms. The condition is more common in men but also affects women. There is not a known, singular cause, but individuals with a particular gene, HLA-B27, have an increased risk of developing the condition. However, the gene itself does not mean an individual has ankylosing spondylitis; genetics and other outside and environmental factors also play a role. DMARDs, or Disease-Modifying Antirheumatic Drugs, suppress inflammation. An emerging DMARD treatment uses biologics that further target and suppresses specific inflammatory compounds.
Biologics
Unlike regular medications, which are synthesized, biologics are made from and inside living sources.
They are grown in cultures or harvested from blood.
Biologics are complex and expensive.
Biologics provide some of the most powerful treatments for many conditions.
Two biologics commonly used to treat ankylosing spondylitis are:
TNF – tumor necrosis factor, TNF inhibitors are a biological medication that targets and suppresses TNF, which is involved in inflammatory processes throughout the body.
Blocking or suppressing TNF decreases inflammation and can delay the progression of ankylosing spondylitis.
It could be administered through an injection or infusion to provide the medication.
Side Effects
Side effects associated with this medication, along with other conditions, include:
IL – interleukin – IL-17 is a protein involved in inflammatory processes and conditions.
IL-17 inhibitors suppress inflammation which are newer medications that have been shown to benefit those with ankylosing spondylitis.
Doctors often administer IL-17 inhibitors through an injection.
Side Effects
Minor side effects include:
Headaches
Runny nose
Irritation at the injection site.
More serious side effects include:
Certain cancers
Severe infections
High blood pressure
Other Treatments
Treatment goals for ankylosing spondylitis include:
Slowing the disorder’s progression.
Decreasing inflammation.
Reducing pain.
Improving or maintaining joint and spinal range of motion.
Biologics are not the first-line treatment for ankylosing spondylitis.
Providers usually first treat an initial diagnosis with anti-inflammatory medications, like NSAIDs, to decrease inflammation and slow the condition’s progression.
Chiropractic care and physical therapy are recommended to maintain and/or improve posture, muscle strength, and endurance.
Recommended lifestyle and nutritional modifications.
Posture training stretches and exercises.
Optimal movement strategies to safely and confidently complete everyday tasks.
Biologic Medications
Biologics for ankylosing spondylitis may or may not be suitable. These medications are meant to help relieve the inflammation associated with the condition and slow the disorder’s progression. Your healthcare team will work with you to determine the right treatment option/s and explain the benefits, risks, and types of treatment. They will monitor the condition, track progress, and adjust the plan accordingly.
Chen C, Zhang X, Xiao L, Zhang X, Ma X. Comparative Effectiveness of Biologic Therapy Regimens for Ankylosing Spondylitis: A Systematic Review and a Network Meta-Analysis. Medicine (Baltimore). 2016 Mar;95(11):e3060. doi: 10.1097/MD.0000000000003060. PMID: 26986130; PMCID: PMC4839911.
Gerriets V, Goyal A, Khaddour K. Tumor Necrosis Factor Inhibitors. [Updated 2022 July 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK482425/
Lindström, U., Olofsson, T., Wedrén, S. et al. Biological treatment of ankylosing spondylitis: a nationwide study of treatment trajectories on a patient level in clinical practice. Arthritis Res Ther 21, 128 (2019). doi.org/10.1186/s13075-019-1908-9
Yin, Y., Wang, M., Liu, M. et al. Efficacy and safety of IL-17 inhibitors for the treatment of ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Res Ther 22, 111 (2020). doi.org/10.1186/s13075-020-02208-w
Subluxation is when a joint shifts out of alignment, which can happen to any joint in the body. Spinal subluxation indicates a misalignment of one or more portions of the spinal vertebrae. It is common in the spine from all the reaching, bending, twisting, and flexing the body goes through. Spinal subluxations, if left untreated, can cause disc degeneration, permanent nerve damage, neurological conditions, and chronic pain symptoms. A subluxation chiropractor will realign and decompress the spine combined with massage therapy to relax the muscles and restore mobility and function.
Subluxation Chiropractor
Some subluxations don’t cause any problems or pain, but that doesn’t mean they aren’t affecting the back and body. A spinal subluxation can cause long-term problems by:
Research shows that spinal subluxations can affect many facets of the body. Long-term effects may include:
Sleep problems
Low energy
Brain fog
Mood swings
Anxiety and depression
Digestive issues
Respiratory problems
Bone spurs
Spinal arthritis
Chiropractic Care
When the spine is out of alignment, it can cause issues throughout the body. Changes in one area affect the rest of the body. A subluxation chiropractor looks at the spine’s neurological and mechanical components and aims to reset everything back into its proper position. Similar to the way a massage helps the mind and body relax and de-stress, a spinal adjustment helps by:
Increasing circulation
Relieving discomfort and pain
Releasing tension
Improving mood
Reducing stress levels
Improving sleep function
Increasing energy levels
When the spine is properly aligned, the body can operate at its full potential.
Green, J D et al. “Anterior subluxation of the cervical spine: hyperflexion sprain.” AJNR. American journal of neuroradiology vol. 2,3 (1981): 243-50.
Meyer, S. “Thoracic spine trauma.” Seminars in roentgenology vol. 27,4 (1992): 254-61. doi:10.1016/0037-198x(92)90004-l
Neva MH, Häkkinen A, Mäkinen H, et al. High prevalence of asymptomatic cervical spine subluxation in patients with rheumatoid arthritis waiting for orthopedic surgeryAnnals of the Rheumatic Diseases 2006;65:884-888.
Nourollahi, Maryam, et al. “Awkward trunk postures and their relationship with low back pain in hospital nurses.” Work (Reading, Mass.) vol. 59,3 (2018): 317-323. doi:10.3233/WOR-182683
Vernon, Howard. “Historical overview and update on subluxation theories().” Journal of chiropractic humanities vol. 17,1 (2010): 22-32. doi:10.1016/j.echu.2010.07.001
The lumbar region of the spine has various muscles and nerve roots that work together with the lower body extremities, like the hips, buttocks, legs, knees, and feet, for mobility and walking function. The various muscles in the buttock region include the gluteal muscles. They have a casual relationship with the hip muscles as they work together for hip mobility and erect good posture in the body. These various muscles and nerves also supply sensory-motor function for the legs to be mobile and provide hip mobility. The piriformis is one of the muscles assisting in the hips and buttock region. When this muscle becomes overused, it can cause mobility issues in the legs and affect a person’s ability to walk. Today’s article looks at the piriformis muscle, how trigger points are associated with piriformis syndrome, and how to manage piriformis syndrome associated with trigger points. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like sciatic pain and piriformis syndrome treatments related to trigger points, to aid individuals dealing with pain symptoms along the piriformis muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer
What Is The Piriformis Muscle?
Have you been having issues walking from one place to another? Do you feel muscle tightness in your hips or buttock region? Or are you experiencing radiating pain traveling to your knees and feet? These pain symptoms are correlated with trigger points affecting the piriformis muscle. The piriformis is a flat, pear-shaped muscle, one of the six short rotator muscle groups in the gluteal region of the hips and thighs. The rotator muscle groups consist of the following:
Gemelli
Quadratus Femoris
Obturator Internus
Obturator Externus
This muscle is parallel to the posterior margins of the gluteus medius and deep into the gluteus maximus. This muscle is very important to the body as it provides lower-body movement by stabilizing the hip joint and can lift and rotate the thighs away from the body. The piriformis muscle also surrounds the sciatic nerve, as this long nerve runs deep beneath the piriformis and enters the gluteal region of the rear. When the piriformis muscle becomes overused or suffers from associated traumatic factors, it can aggravate the sciatic nerve and even develop tiny nodules known as trigger points, causing mobility issues.
Trigger Points Associated With Piriformis Syndrome
When abnormal factors affect the piriformis muscles, they can develop into trigger points associated with piriformis syndrome and cause issues in the pelvic and hip regions of the body. According to Dr. Janet G. Travell, M.D., “Myofascial Pain and Dysfunction,” trigger points can be activated when repetitive strain affects the piriformis muscle and causes symptoms of muscle weakness and pain in the hips. This causes overlapping issues in the surrounding muscles and the sciatic nerve, making diagnosing tricky for trigger points. Studies reveal that trigger points associated with piriformis syndrome may potentially cause muscle spasms or an inflammatory process to irritate the sciatic nerve that may be presented as identical to lumbar disk syndrome without neurological findings. Trigger points associated with piriformis syndrome may mimic chronic issues like fibromyalgia. Even though trigger points are tricky to pinpoint in a thorough examination, there are various ways to reduce the pain and prevent trigger points from affecting the piriformis muscle causing sciatic nerve pain.
Trigger Point Of The Week: Piriformis Muscle- Video
Have you been dealing with sciatic nerve pain? Have you found it difficult to walk for a short period? Or are you dealing with muscle tenderness or soreness in your buttock or hips? People experiencing these symptoms could be dealing with piriformis syndrome associated with trigger points. The piriformis is a small, fan-shaped muscle, one of the six short rotator muscle groups that help with hip and thigh mobility through stabilization. The piriformis muscles also surround the sciatic nerve and can succumb to injuries. When traumatic forces affect the hips and thighs, the piriformis muscle develops nodules known as trigger points, causing the muscle to irritate the sciatic nerve and cause pain in the legs. The video above shows where the piriformis muscle is located and how trigger points can mimic sciatic nerve pain in the leg without neurological findings. Studies reveal that trigger points could be a rare anatomical variation that can correlate with piriformis syndrome associated with sciatica. However, there is some good news, as there are ways to manage piriformis syndrome associated with trigger points.
Managing Piriformis Syndrome Associated With Trigger Points
Various techniques can help manage piriformis syndrome associated with trigger points to relieve the piriformis muscle. Studies reveal that Kinesio tape on the piriformis muscle can help reduce pain and improve many individuals’ hip joint range of motion. Other techniques like stretching or deep tissue massage can help loosen up the stiff muscles and relieve trigger points from forming on the piriformis. For sciatica pain associated with trigger points along the piriformis muscle, decompression therapy can help the piriformis muscle lay off pressure on the sciatic nerve and reduce aggravated pain. These techniques can help improve hip joint mobility and increase the range of motion to the hips and lower extremities.
Conclusion
The piriformis is a small muscle that provides hip and thigh mobility. This small muscle surrounds the sciatic nerve, which helps give motor function to the legs. When traumatic factors affect the piriformis muscle, it can develop trigger points and cause sciatic pain in the hips. This causes mobility issues and pain around the hips. Various treatments are provided to help reduce the trigger points along the piriformis muscle and reduce sciatic nerve pain from causing more problems to the hips and legs mobility.
References
Chang, Carol, et al. “Anatomy, Bony Pelvis and Lower Limb, Piriformis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 3 Oct. 2022, www.ncbi.nlm.nih.gov/books/NBK519497/.
Pfeifer, T, and W F Fitz. “[The Piriformis Syndrome].” Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete, U.S. National Library of Medicine, 1989, pubmed.ncbi.nlm.nih.gov/2618150/.
R;, Hashemirad F;Karimi N;Keshavarz. “The Effect of Kinesio Taping Technique on Trigger Points of the Piriformis Muscle.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 8 Feb. 2016, pubmed.ncbi.nlm.nih.gov/27814861/.
Ro, Tae Hoon, and Lance Edmonds. “Diagnosis and Management of Piriformis Syndrome: A Rare Anatomic Variant Analyzed by Magnetic Resonance Imaging.” Journal of Clinical Imaging Science, Medknow Publications & Media Pvt Ltd, 21 Feb. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5843966/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Back discomfort symptoms include stiffness, spasms, tenderness, and headaches often caused by unhealthy posture and overuse muscle strain. Breathing back discomfort can be caused by injuries to the spinal musculoskeletal system, conditions and/or disease in the back, lungs, or heart, and other conditions unrelated to the back. When taking a breath, the intercostal muscles surrounding the rib cage contract, expanding the chest and allowing the lungs to fill with air. These muscles directly affect the spine, which is why back issues can present when breathing. Chiropractic care, decompression, and massage therapy, combined with a functional medicine approach, can realign the spine, release tight muscles, and restore function.
Breathing Back Discomfort
A problem in the back could be a root cause for discomfort and back problems while breathing.
Spinal Conditions
Scoliosis
Scoliosis causes the spine to curve sideways, either in one direction, creating a C shape, or generating an S shape in two directions.
The curvature can be so minimal that it cannot be seen or so severe that it can be life-threatening. Most scoliosis cases fall in between.
Taking deep breaths can cause discomfort and pain because the spine curvature puts extra strain on certain muscles meant to support the body’s weight in tandem with other muscles that have limited function or are no longer functioning.
The condition normally begins in adolescence but can start later in life.
Scoliosis treatment varies depending on the severity.
Monitor
A spinal physician will monitor the individual for mild curvature, as sometimes the process stops before it becomes serious. This is known as the wait-and-see, what-happens approach.
Kyphosis is another curve in the back that is supposed to be there.
Instead of curving like scoliosis, kyphosis causes a curve forward in the thoracic spine/upper back.
Problems arise when the curve is too pronounced.
This curve can come from unhealthy posture, Scheuermann’s disease, or being born with it.
Kyphosis causes breathing back discomfort by straining the muscles in the upper back, which are used for each breath.
Treatment often involves chiropractic and/or physical therapy to restore proper curvature and reduce inflammation.
A back brace could be prescribed if discomfort and pain continue.
Spinal fusion could be recommended for severe cases.
Lungs
The lungs and the spine are close to each other, which is why back discomfort and problems with breathing are connected.
Pneumonia
Pneumonia is an infection in the lungs that causes the tiny sacks known as alveoli to fill with fluid.
This is where the body takes oxygen from the inhaled air to the bloodstream.
The infection causes inflammation and discomfort symptoms in and around the chest and back while taking deep breaths.
Lung Cancer
Lung cancer can cause back issues and pain.
Frequently coughing causes the muscles around the ribs and back to become overused and strained from the jerking and heaving.
The strained muscles cause discomfort and pain when taking a breath.
Tumors can push on sensitive nerves in the back, causing inflammation and pain.
Pleurisy
There is a thin layer of protective tissue surrounding the lungs called pleura.
Pleurisy describes the layer becoming infected and/or inflamed, which causes discomfort symptoms in the back when breathing.
Pleurisy can be caused by injury, infection, or cancer.
Individuals with autoimmune disorders are more at risk of developing the condition.
Pneumothorax
Pneumothorax describes a full or partial lung collapse, usually on one side.
The lung can collapse as a result of severe illness or injury.
The lung collapses because air gets between the pleura and the lung and not allowing the lung to expand.
Pain with breathing is a common indicator of pneumothorax.
Individuals with this condition also experience severe shortness of breath and chest pain on one side.
Pulmonary Embolism
A pulmonary embolism occurs when a blood clot gets stuck in an artery, blocking blood flow to part of the lung.
The lungs will display signs of distress through back pain when trying to take a deep breath.
This is a life-threatening condition that causes chest pain, coughing up blood, a heart rate over 100 beats per minute, dizziness or leg swelling, and painful breathing; get to an emergency room immediately.
Heart
Heart Attack
The nerves associated with pain in the muscles and bones differ from those surrounding the organs, including the heart.
However, a heart attack can cause back pain as the nerves of the heart travel along the same path as spinal nerves, specifically in the upper back.
The brain can misinterpret pain signals from the same roots that supply peripheral nerves in the chest, arm, jaw, and back.
Because they share nerve pathways, the upper back can present with pain during a heart attack.
Aortic Dissection
The largest artery in the body is called the aorta.
It comes off the top of the heart and then drops to supply blood to the rest of the body.
Sometimes, the vessel can get a small tear in the chest area, which grows from the blood circulation pressure.
Aortic dissection can cause intense back pain while breathing.
Chiropractic care, decompression, and massage therapy combined with functional medicine can help realign the spine, stretch and loosen the overused and strained muscles, and provide postural training and nutritional planning to help alleviate symptoms and restore function.
Deep Breathing Back Pain
References
Costumbrado J, Ghassemzadeh S. Spontaneous Pneumothorax. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK459302/
Floman, Y., Burnei, G., Gavriliu, S. et al. Surgical management of moderate adolescent idiopathic scoliosis with ApiFix®: a short peri- apical fixation followed by post-operative curve reduction with exercises. Scoliosis 10, 4 (2015). doi.org/10.1186/s13013-015-0028-9
Hunter MP, Regunath H. Pleurisy. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK558958/
Mansfield JT, Bennett M. Scheuermann Disease. [Updated 2022 Aug 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK499966/
Raitio A, Syvänen J, Helenius I. Vertebral Body Tethering: Indications, Surgical Technique, and a Systematic Review of Published Results. Journal of Clinical Medicine. 2022; 11(9):2576. doi.org/10.3390/jcm11092576
Many individuals utilize the lower half of their bodies to go to different places and use the various surrounding muscles that provide stability on the hips and low back while supporting the upper body’s weight. Along the lower back is the buttock region, where the gluteal muscles help stabilize the pelvis, extend the hips, and rotate the thighs. The gluteal muscles also help shape and support the spine and have an erect posture in the body. One of the gluteal muscles that support the lower body is the gluteus medius, which can succumb to injuries and strain when overused or strained. This leads to developing trigger points that can cause various issues in the lower extremities and lead to corresponding chronic conditions. Today’s article focuses on the gluteus medius muscles, how the lumbago is associated with gluteus medius trigger pain, and various techniques to manage trigger points along the gluteus medius muscle. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like butt and low back pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the gluteus medius muscles near and surrounding the body’s lower extremities. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer
What Is The Gluteus Medius?
Have you been experiencing pain near your buttock and lower back? Have you been feeling unstable when you are walking? What about feeling pain in your tailbone that makes it unbearable to sit down? Many of these issues are associated with referred pain caused by trigger points affecting the gluteus medius. As part of the gluteal muscle region, the gluteus medius lies between the gluteus maximus and minimus is a flat, triangular muscle and is the primary hip abductor. The gluteus medius and minimus work together for internal rotation for the thighs and lateral rotation for the knees when they are extended. The gluteus medius muscles also help stabilize the pelvis, while the trunk maintains an upright position when the legs are in motion. Studies reveal that the gluteus medius is a key lateral hip muscle that correlates with muscle function with other muscle groups like the quadriceps and abdominal muscles. When injuries or not activating the gluteal muscles often, various muscle issues can cause problems to the gluteus medius muscles.
Lumbago Associated With Gluteus Medius Trigger Pain
Dysfunction in the hips can lead to various issues that can either be acute or chronic, depending on how severely the muscles have been overused or injured. Studies reveal that low back pain has been identified as the leading contributor to disability and when there is dysfunction in the lumbopelvic-hip complex, causing a reduction in gluteus medius strength. When the gluteus medius muscles have become overused or injured through trauma, it can develop trigger points on the muscle causing low back pain issues. When trigger points affect the gluteus medius, additional studies reveal that latent trigger points along the gluteus medius muscles may cause joint movement limitation while causing overload by affecting muscle activation from the hips.
According to Dr. Janet G. Travell, M.D.’s book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” patients with active trigger points along their gluteus medius complain of pain when they are doing normal actions like walking or sitting. The pressure from the trigger points along the gluteus medius causes the individual to be in a slumped position, causing them to be uncomfortable. This causes instability in the hips and lower body extremities, making many people miserable. The book also explains that the referred pain patterns caused by gluteus medius trigger points can overlap other chronic conditions like sacroiliac joint dysfunction, low back pain, and inflammation of the subgluteus medius bursa.
Trigger Point Of The Week: Gluteus Medius- Video
Have you been dealing with hip pain? Do you feel uncomfortable pain when walking or sitting down? Or Do you feel muscle stiffness or tenderness near your tailbone constantly? If you have been experiencing these painful symptoms constantly in your lower back or your hips, it could be due to your gluteus medius muscles being affected by trigger points. The video above overviews the gluteus medius location and how trigger points or myofascial pain syndrome causes referred pain to the lower back and hips. When trigger points affect the gluteus medius, the referred pain can overlap and correlate to low back and hip pain, thus causing various issues to the muscles surrounding the low back and buttock region. Regarding trigger points affecting the gluteus medius, they can be treatable through multiple techniques specific to the low back, buttocks, and hips.
Various Techniques For Managing Trigger Pain Along The Gluteus Medius
When issues of low back or hip pain begin to cause a problem in the lower extremities, the gluteus muscles can invoke pain-like symptoms in the affected muscle regions, thus developing trigger points. Even though trigger points are tricky to diagnose, they can be treated with various techniques that many people can incorporate into their daily lives. Exercises like resistance training on the gluteus medius can help improve hip abductor functionality and increase the strength of the gluteus medius. To manage trigger points along the gluteus medius, many people must do these corrective actions to reduce the pain that they may be causing to their glutes. When people are putting on pants, it is best to sit down and then put on their pants to prevent muscle strain on their hips and gluteus medius. Another corrective action is to move around after sitting down for a prolonged period to avoid trigger pain from developing. These corrective actions and techniques can help strengthen the lower body extremities and improve hip mobility.
Conclusion
As part of the gluteal muscle region, the gluteus medius lies between the gluteus maximus and minimus by being a primary hip abductor. The gluteus medius helps with pelvic stabilization and helps the trunk maintain an upright position when the legs are in motion. When normal or traumatic factors affect the gluteus medius, it can develop trigger points on the muscle fibers, causing referred pain to the hips and lower back. Trigger points along the gluteus medius are manageable through various techniques that people can use to prevent hip and low back issues. These techniques can minimize the trigger points and strengthen the gluteus medius muscles in the glutes.
References
Bagcier, Fatih, et al. “The Relationship between Gluteus Medius Latent Trigger Point and Muscle Strength in Healthy Subjects.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, Jan. 2022, pubmed.ncbi.nlm.nih.gov/35248262/.
Sadler, Sean, et al. “Gluteus Medius Muscle Function in People with and without Low Back Pain: A Systematic Review.” BMC Musculoskeletal Disorders, BioMed Central, 22 Oct. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6805550/.
Shah, Aashin, and Bruno Bordoni. “Anatomy, Bony Pelvis and Lower Limb, Gluteus Medius Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK557509/.
Stastny, Petr, et al. “Strengthening the Gluteus Medius Using Various Bodyweight and Resistance Exercises.” Strength and Conditioning Journal, Strength and Conditioning Journal, June 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4890828/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Whiler, Lisa, et al. “Gluteus Medius and Minimus Muscle Structure, Strength, and Function in Healthy Adults: Brief Report.” Physiotherapy Canada. Physiotherapie Canada, University of Toronto Press, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5963550/.
Back pain is one of the most common reasons individuals go to a doctor, massage therapist, physiotherapist, osteopath, and chiropractor. Various health conditions, some spine-related, others not, list back pain as a symptom. Many of these conditions begin in the stomach or abdominal cavity, which leads to stomach and back pain. Stomach and back pain happening simultaneously, independently, or in combination could be caused by gut problems, back issues, or something completely different. Understanding what causes these two types of pain simultaneously can help figure out a treatment plan.
Stomach Back Pain Causes
Problems in the abdominal cavity and stomach issues can cause back pain and vice versa. Symptoms can also include referred pain when the pain is felt in one part of the body but is caused by pain or injury in another area. Stomach back pain causes depend on the type of condition/s that can include:
Appendicitis
Inflammation in the appendix can cause sudden sharp pain in the abdomen.
It presents mostly in the lower right area of the abdomen but can appear in or spread to other sites, especially the back.
A chiropractic functional medicine team can work with an individual’s primary physician or specialist to develop a personalized treatment plan to alleviate back pain symptoms, re-balance the body, strengthen the musculoskeletal system and restore function.
Inadomi JM, Bhattacharya R, Hwang JH, Ko C. Chapter 7, The Patient with Gas and Bloating. Yamada’s Handbook of Gastroenterology. 4th ed. John Wiley & Sons; 2019. doi.org/10.1002/9781119515777.ch7
Krames E, Mousad DG. Spinal Cord Stimulation Reverses Pain and Diarrheal Episodes of Irritable Bowel Syndrome: A Case Report. Neuromodulation. 2004 Mar 22;7(2):82-88. doi.org/10.1111/j.1094-7159.2004.04011.x
Stephen Norman Sullivan, “Functional Abdominal Bloating with Distention,” International Scholarly Research Notices, vol. 2012, Article ID 721820, 5 pages, 2012. doi.org/10.5402/2012/721820
Weisman, Michael H et al. “Axial Pain and Arthritis in Diagnosed Inflammatory Bowel Disease: US National Health and Nutrition Examination Survey Data.” Mayo Clinic proceedings. Innovations, quality & outcomes vol. 6,5 443-449. 16 Sep. 2022, doi:10.1016/j.mayocpiqo.2022.04.007
Whorwell PJ. Chapter 13, Abdominal Bloating. Irritable Bowel Syndrome: Diagnosis and Clinical Management. Emmanuel A, Quigley EMM (eds.). John Wiley & Sons; 2013. doi.org/10.1002/9781118444689.ch13
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Stomach Back Pain Causes
