Many people use their hands when going to work or doing normal things in their daily lives. The hands correlate with the five finger digits that provide grip strength when holding onto items in various sizes and weights that the hand muscles can handle. The hands have multiple muscles, tendons, and ligaments that travel past the wrist and forearms. These three components in the upper body have a casual relationship with the shoulders to provide stability and mobilization to the upper extremities. When the various muscles, tendons, and ligaments succumb to traumatic forces or injuries that cause pain to the forearms, wrists, and hands, it can develop myofascial pain syndrome or trigger points to generate overlapping risk profiles that mask other symptoms. Today’s article looks at the thumb muscles, how myofascial trigger pain affects the thumb, and how to prevent and manage the trigger thumb from occurring further in the hands. We refer patients to certified providers specializing in hand and wrist pain therapies to aid many people suffering from trigger thumb and fingers affecting their hands. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer
A Look At The Thumb Muscles
Have you been experiencing a strong decrease in your grip when holding something? What about hearing popping or snapping sounds when moving your fingers or thumb? Or have you experienced pain near your wrist or at the palm of your hands? When people are experiencing pain along their fingers, especially thumbs, it can develop into myofascial trigger pain along the thumb. As part of the hand, the thumb has muscles that provide movement and motor skills to make the thumb mobile. The two muscles: the adductor pollicis and the opponens pollicis, allow the thumb to move and touch each of the other finger digits. The adductor pollicis in the hand has deep, intricate, superimposed layers of muscles, tendons, and fascial compartments that work together to be versatile to the thumb. This muscle is triangular-shaped with a two-headed structure, and its main function is to adduct the thumb. This means that the adductor pollicis allows the thumb to move, touch the palm, and be close to the index finger. To that point, this muscle provides the thumb pinching and gripping movements.
The other muscle is known as the opponens pollicis, and this muscle helps provides small hand movements for the thumb by allowing it to touch the tips of each of the digits. The opponens pollicis muscle works together with the adductor pollicis muscle as it allows the hand to cup objects while also making the pinching grip possible for the hand. The oppponens pollicis muscle also works with the various muscles, nerves, and bones to be in sync in providing movement to the hands and provide mobility strength.
How Myofascial Trigger Pain Affects The Thumb
The adductor and oppenens pollicis muscles can provide gripping and pinching motions to the hands without causing pain; however, when the thumb muscle ligaments have been overused or been through trauma, they can develop into myofascial trigger pain along the thumb muscles, causing trigger thumb. Studies reveal that causes for the trigger thumb to form are repetitive gripping motions and overusing of the thumb muscle. This causes the flexor tendon sheath to narrow along the thumb joint and causes clicking or popping sensations when the thumb is trying to extend, thus leading to the development of myofascial trigger pain. According to the book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., when myofascial trigger pain begins to affect the hand’s functionality, it can make many individuals lose the pinching motion in their hands as they aren’t able to hold the object they are using. Even simple actions like pulling weeds in the garden can cause stress on the thumb and cause tenderness to the affected muscle.
An Overview Of Trigger Finger & Trigger Thumb-Video
Are you having difficulty holding items in your hands? Do you feel like your fingers are locking up constantly? Or does it hurt when you extend your thumb or fingers? If you have been experiencing these pain symptoms in your hands and fingers, it could be due to myofascial trigger pain associated with the thumb and fingers along the hands. Trigger fingers or trigger thumbs is a common ailment that affects the mobility function of the hands and can invoke pain in the affected joints causing them to lock up. The video above explains what trigger fingers and trigger thumbs, the symptoms and causes, and how to treat and manage the pain. When pain is associated with the hands and fingers, causing trigger points to form along the affected muscle, many individuals begin to feel hopeless when they aren’t able to hold items. Thankfully, there are various ways to manage trigger thumb and prevent pain from causing further damage.
How To Manage & Prevent Trigger Thumb
When trigger thumb begins to affect a person’s ability to grasp objects, it can cause them to feel miserable and can greatly affect their quality of life. All is not lost, as there are various ways to manage trigger thumbs and prevent future pain symptoms from continuously affecting a person’s mobility in their hands. Studies show that multiple treatments like splinting can help gain mobility back to the thumb and prevent the joint from locking up, causing pain. Other therapies like hand and wrist stretches can help loosen up the stiff tendons and muscles and even bring back mobility strength to the hands. Many doctors advise their patients to start using different hand and wrist exercises to relax the aching muscles and get circulation back to the hands. Another way to prevent the trigger thumb from affecting the hands is to do stretch exercises for the adductor and opponens pollicis muscles with heat to relax and loosen the stiff muscles while also restoring flexion and extension to the thumb.
Conclusion
The thumbs provide the functionality to the hands by allowing gripping and pinching motions when people pick up objects. The two muscles that provide this motion are the adductor and oppnens pollicis muscles. When traumatic forces begin to affect these two muscles in the thumb, it can develop a trigger thumb associated with pain. This causes the thumb to lock up and invoke pain when someone tries to extend their thumbs. Trigger thumbs occur when individuals overuse the thumb muscles and causes the grip strength to weaken. Luckily, available treatments can help restore mobility to the thumb and prevent it from locking up.
Reference
Acosta, Jonathan R, et al. “Anatomy, Shoulder and Upper Limb, Hand Adductor Pollicis.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, https://www.ncbi.nlm.nih.gov/books/NBK526059/.
Akhtar, Sohail, et al. “Management and Referral for Trigger Finger/Thumb.” BMJ (Clinical Research Ed.), BMJ Publishing Group Ltd., 2 July 2005, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC558536/.
Nguyen, John D, and Hieu Duong. “Anatomy, Shoulder and Upper Limb, Hand Opponens Pollicis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, https://www.ncbi.nlm.nih.gov/books/NBK546603/.
Pencle, Fabio J, et al. “Trigger Thumb.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 July 2022, https://www.ncbi.nlm.nih.gov/books/NBK441854/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
The elbows and the forearms have a casual relationship with each other as they provide flexion and retraction of the arms in the body. Each different muscle group in the body has the job of making the body functional. The arms help the body to carry items while the shoulders provide stability to the head and neck. The head and neck work together to allow rotation and movement. Finally, the legs and hips stabilize the body’s upper half and move from place to place. Traumatic events or injuries that affect the arms can lead to pain along the muscles in the forearms. This can lead to the muscles becoming inflamed and developing myofascial pain syndrome or trigger points along the affected muscles. One of the muscles in the forearms that can be affected by myofascial pain syndrome is the supinator muscles. Today’s article looks at the supinator muscles, how myofascial pain affects the supinator muscles, and how to manage myofascial pain syndrome along the supinator muscles. We refer patients to certified providers who specialize in elbow pain treatments to aid individuals suffering from myofascial pain syndrome associated with the supinator muscles near the elbow and forearm. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer
What Is The Supinator Muscle?
Are you experiencing any pain along your forearm or elbow? What about feeling stiffness along your thumb? Do you feel any tenderness or soreness in your forearm muscle? People who have been experiencing these symptoms might be dealing with myofascial pain syndrome that is affecting their supinator muscles. According to Dr. Travell, M.D.’s book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” the supinator muscle is a flat spiral muscle under the elbow joint and is located in the posterior compartment of the forearm. The supinator muscle function is to supinate or turn the forearm when the elbow is in a position of flexion or extension. The supinator muscle also works together with the bicep brachii muscles. Studies reveal that the biceps function provides stability and assists with internal rotation with the elbow joint by interacting with the supinator muscle. Both of these muscles provide supination and flexion strength to the elbow. However, the supinator muscle can also be affected by injuries in the elbows and forearms, causing referred pain along the forearms and parts of the hand, primarily the thumb.
Myofascial Pain Affecting The Supinator Muscle
When the supinator muscle is suffering from pain, various issues can cause the pain to occur near the elbow and forearm. Multiple factors can include:
Carrying a large, heavy bag.
Playing tennis.
Extreme movements cause the elbow to be hyperextended and lead to myofascial pain syndrome or trigger points along the supinator muscles.
Now tennis elbow is often associated with trigger points as it affects the lateral head of the triceps and the extensor muscles next to the supinator muscles. Studies reveal that tennis elbow usually occurs on the dominant arm and is regarded as an overuse injury that involves repetitive extension against resistance. To that point, the repetitive motions can lead to the development of trigger points along the supinator muscles.
Many people with active trigger points in the supinator muscles often complain about twinges of pain located in the front or back of the elbow, along with muscle tenderness in the supinator muscle. Myofascial pain syndrome can also mimic other chronic pain conditions in the arm that causes referred pain symptoms associated with the muscle. Myofascial pain syndrome causes the affected muscle to be hyperirritable and causes the surrounding nerves that are intertwined with the muscles to be compressed. This causes various symptoms in the forearms, like tingling sensations, numbness, and a decrease in grip strength. All is not lost as multiple ways to manage myofascial pain syndrome along the supinator muscles.
How To Release Supinator Trigger Points- Video
Are you experiencing twinges of pain near your elbow? What about radiating pain along your thumb? Do you feel tenderness or muscle weakness on your forearms or your elbow? Many of these symptoms are due to the development of myofascial pain syndrome or trigger points that are affecting the supinator muscles. Trigger points can mimic other chronic pain conditions that can cause referred pain to the rest of the body. The video above explains where trigger points are located in the supinator muscle and how to release the trigger points from that muscle. Various techniques can help manage myofascial pain syndrome that is affecting the supinator muscles and can help alleviate the pain-like symptoms that are along the muscle fibers.
Managing Myofascial Pain Syndrome Along The Supinator Muscles
When managing myofascial pain syndrome along the supinator muscles, many individuals can incorporate these techniques as part of their daily activities. Many individuals can go to a pain specialist that targets myofascial pain syndrome through palpations and massages. Studies reveal that incorporating a diagnosis of where the palpations have occurred and massaging the affected muscle can release the trigger points from the muscle and reduce pain. Another technique many people can utilize to manage myofascial pain syndrome is not overextending the elbow to cause trigger points to form. This is extremely important for tennis players to prevent tennis elbows from forming and reduce the chances of trigger points forming along the supinator muscles. And lastly, doing isotonic exercises can help strengthen and condition the supinator muscles to prevent injuries. These techniques allow the individual to be pain-free and continue with their daily lives.
Conclusion
The supinator muscles are located underneath the elbow, allowing forearm rotation when the elbow is flexed or extended. When the supinator muscle is affected by injuries or repetitive motions, it can develop trigger points or myofascial pain syndrome. This causes referred pain along the elbow to parts of the hand, primarily the thumb. Trigger points can even overlap and cause symptoms of “tennis elbow” to cause pain along the muscle and joints. Luckily, various techniques can prevent trigger points from developing further and reduce the pain in the elbows and forearms. To that point, the individual can continue doing their daily activities.
References
Bron, Carel, et al. “Interrater Reliability of Palpation of Myofascial Trigger Points in Three Shoulder Muscles.” The Journal of Manual & Manipulative Therapy, Journal of Manual & Manipulative Therapy, Inc., 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565638/.
Cutts, S, et al. “Tennis Elbow: A Clinical Review Article.” Journal of Orthopaedics, Elsevier, 10 Aug. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926298/.
Güleçyüz, Mehmet F, et al. “Reference Values of Flexion and Supination in the Elbow Joint of a Cohort without Shoulder Pathologies.” BioMed Research International, Hindawi, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674724/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Vol. 1, Williams & Wilkins, 1999.
The low back is a common source of discomfort and soreness among volleyball players because of repetitive jumping, bending, and rotating of the trunk. Adolescents have an increased risk of this injury because their vertebral bones are still developing, which increases the risk for stress fractures. Chiropractic care, massage therapy, decompression, rest, and athletic training can help expedite pain relief and heal the injury.
Volley Back Pain
Muscle or ligament strains are the most common injury from repetitive jumping, bending, rotating movements, and hyperextension during serving, hitting and setting. This can lead to excessive compression forces on the discs and joints, causing reduced blood circulation, increasing the risk of overload injuries. One study reported that low back pain is experienced in 63% of players. However, if low-back pain is accompanied by pain that runs down the leg along with numbness or weakness in the foot or ankle, the issue could be a herniated disc.
Causes
One common reason is endurance imbalances in the muscles that stabilize the low back. The core muscles provide stability to the low back and spine for all movements. If imbalances are present, a player may spike or serve the ball with intense turning and arching. The added actions cause increased pressure in the joints and hip, gluteal, and leg muscles, affecting the spine’s stability.
The gluteals run from the back of the pelvis/hip bones down to the outside of the thigh.
The gluteal muscles prevent the trunk and hips from overbending forward when landing.
If the gluteal muscles do not have the strength and endurance to perform this motion, the upper body will bend too far forward, causing poor landing posture and decreased spine stability.
Anterior Pelvic Tilt
Studies have shown that players with low back pain tend to stand and land with an anterior pelvic tilt. This is an unhealthy posture when the front of the pelvis tilts forward, and the back of the pelvis raises. Landing hard with an anterior pelvic tilt causes increased arching and increases the pressure in the joints.
Chronic back pain
Warning signs of a more serious back problem include:
Pain that has lasted for more than 1 week and is not improving or getting worse.
Pain that prevents sleep or causes the individual to constantly wake up.
Difficulty sitting.
Back soreness when performing basic tasks and chores.
Significant pain on the court when jumping, landing, or rotating.
Chronic pain ranges from aches to shooting or throbbing pain that can run down the buttocks and legs.
Chiropractic Care
A chiropractor can alleviate volleyball back pain, rule out a more severe injury, such as a stress fracture or herniated disc, and provide a healthier and faster recovery. According to a study, athletes who received chiropractic care showed better speed and mobility. Quick reflexes and hand-eye coordination depend on an optimal functioning nervous system. 90% of the central nervous system travels through the spine. When one or more spinal segments are misaligned, the effect on the nervous system can seriously impact and disrupt nerve circulation, affecting speed, mobility, reflexes, and hand-eye coordination. Chiropractic adjustments will:
Relax and reset the back muscles.
Realign and decompress the spine.
Remove the pressure around the nerve roots.
Strengthen the core.
Improve and increase range of motion, strength, and overall endurance.
Anterior Pelvic Tilt
References
Haddas R, Sawyer SF, Sizer PS, Brooks T, Chyu MC, James CR. “Effects of Volitional Spine Stabilization and Lower-Extremity Fatigue on the Knee and Ankle During Landing Performance in a Population With Recurrent Low Back Pain.” J Sport Rehabil. 2017 Sep;26(5):329-338. doi: 10.1123/jsr.2015-0171.
Hangai M. et al., Relationship Between Low Back Pain and Competitive Sports Activities During Youth, Am J Sports Med 2010; 38: 791-796; published online before print January 5, 2010, doi:10.1177/0363546509350297.
Jadhav, K.G., Deshmukh, P.N., Tuppekar, R.P., Sinku, S.K.. A Survey of Injuries Prevalence in Varsity Volleyball Players. Journal of Exercise Science and Physiotherapy, Vol. 6, No. 2: 102-105, 2010 102
Mizoguchi, Yasuaki, et al. “Factors associated with low back pain in elite high school volleyball players.” Journal of physical therapy science vol. 31,8 (2019): 675-681. doi:10.1589/jpts.31.675
Movahed,Marziehet al. (2019). “Single leg landing kinematics in volleyball athletes: A comparison between athletes with and without active extension low back pain.”
Sheikhhoseiniet al. (2018). “Altered Lower Limb Kinematics during Jumping among Athletes with Persistent Low Back Pain”
Chiropractic treatment focuses on the musculoskeletal and nervous systems. As with all body systems, specific nutrients protect and increase their functional strength. Various chiropractic-recommended supplements can help in the treatment of musculoskeletal issues and help transform an individual’s health.
Chiropractic Education
Chiropractors study food-based supplements that are bio-available to cells and are easily absorbed by the body. These food-based supplements and vitamins are seen as food by the body. Supplements are used in detoxification to overcome nutritional deficiencies and enhance an individual’s diet by taking nutrients to optimum levels. Immune system health can also be strengthened by keeping the body resistant to diseases.
Functional Nutrition
Chiropractic medicine study’s all the building blocks of the body that, include:
Holistic nutrition teaches that the body heals from within, which is why healing the gut first, is essential to healing the rest of the body and maintaining health.
Recommended Chiropractic Supplements
Dietary supplements that directly impact the health of the musculoskeletal and the nervous system.
Potassium
Potassium is an important regulator of nerve impulses.
Electrochemical signals or action potentials use potassium and sodium to generate responses from cells in the nervous system.
Potassium is necessary for turning off nerve impulses and preventing the uncontrolled signaling of nerves.
Uncontrolled signaling can lead to movement disorders.
Calcium
Calcium is necessary for the regulation of the action potentials throughout the body.
Calcium helps initiate action potentials and helps the cells return to a normal state afterward.
Calcium contributes to the development of the nervous system helping guide the nerve cells.
Calcium is a major element of bone health to repair bones’ and facilitate regrowth.
The body will take the calcium from the bones if there is a calcium deficiency.
Vitamin D
One of the most important nutrients for bone health.
Vitamin D helps promote bone development and growth.
Facilitates calcium absorption helping the body process and absorb the calcium.
B12 is essential to the function of the nervous system and the body’s metabolism.
B12 breaks complex carbohydrates into more simplistic glucose for basic functions.
B12 helps maintain the nerve insulator myelin, which is necessary for nerve transmission.
B12 deficiency has been linked to the loss of myelin and can lead to serious conditions like Alzheimer’s.
B12 shots deliver the nutrient directly to the bloodstream bypassing the absorption process necessary for oral supplements.
Vitamin K
Vitamin K helps balance and facilitate calcium absorption.
Vitamin K helps strengthen bones and increase bone density.
Often recommended for individuals with osteopenia and osteoporosis to help prevent fractures.
How To Choose Supplements
References
Lee, Mi Kyung, et al. “The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network.” Chiropractic & manual therapies vol. 26 7. 20 Feb. 2018, doi:10.1186/s12998-018-0175-1
Nguyen, Douglas L. “Guidance for supplemental enteral nutrition across patient populations.” The American journal of managed care vol. 23,12 Suppl (2017): S210-S219.
Pludowski, Pawel, et al. “Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence.” Autoimmunity reviews vol. 12,10 (2013): 976-89. doi:10.1016/j.autrev.2013.02.004
Song, Yong-Ak, et al. “Electrochemical activation and inhibition of neuromuscular systems through modulation of ion concentrations with ion-selective membranes.” Nature materials vol. 10,12 980-6. 23 Oct. 2011, doi:10.1038/nmat3146
The body is a functional machine that requires many muscles, organs, ligaments, joints, and tissues that provide everyday movements. In the upper extremities, the head, neck, and shoulders have many muscles, ligaments, and tissues that work together with the nerve roots from the nervous system that provides sensory-motor function to make the fingers move, the shoulders rotate, and the head turns from side to side. When injuries or common issues affect the muscles in the head, neck, or shoulders, it can cause small nodules to form along the muscle fibers of the affected muscle area and cause referred pain in different locations of the body. Today’s article looks at the scalene muscles, how trigger points affect the scalene muscles while mimicking shoulder pain, and how to manage chronic pain associated with trigger points. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulders affecting the scalene muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Are The Scalene Muscles?
Have you been experiencing tingling sensations running down your fingertips? Do you feel stiffness when rotating your neck or shoulders? Or do you feel muscle soreness in your shoulders? Many individuals who are feeling any of these symptoms affecting their neck or shoulders could be dealing with trigger point pain along the scalene muscles. The scalene muscles play a crucial part in the head and neck as they are deep muscles positioned laterally on the cervical tract of the spine. These muscles have three different branches: the anterior, medius, and posterior, which play the role of being accessory breathing muscles while being an important contributor to head and neck movement. To that point, it allows stability to the cervical spine. The scalene muscles even help support and elevate the upper rib cage when a person is lifting, pulling, or carrying heavy objects. However, like most muscles in the body, the scalene muscles can be prone to injury and can develop issues that can affect the upper extremities of the body.
Trigger Points Affects The Scalene Muscles Mimicking Shoulder Pain
When common injuries like pulling a muscle when carrying a heavy object or even a traumatic injury like being involved in an auto accident can cause pain in the affected area, over time, if not treated, can cause various symptoms to overlap and affect the muscles. When the scalene muscles are affected by injuries, they can develop tiny nodules along the taut muscle fibers and become hyperirritable to the surrounding areas of the upper half of the body. This is known as trigger point pain and can mimic other chronic issues that affect different body areas. To that point, trigger points affecting the scalene muscles may mimic shoulder pain in the upper half of the body. Studies reveal that scalene myofascial pain is a regional pain syndrome that originates pain in the neck area and radiates pain down to the arm. Since trigger points mimic other chronic issues, it is often misdiagnosed as another neck pain associated with radiculopathy when the scalene muscles are affected. When this happens, the muscles become stiff and weak, causing a reduction in the range of movement.
Studies reveal that when individuals suffer from acute whiplash-associated disorders, the local and referred pain can be elicited from active trigger points to reproduce neck and shoulder pain. This causes a higher disability that exhibits widespread pressure causing the muscles to be hypersensitive and reducing the cervical range of motion. Many individuals often complain about shoulder pain while rubbing the upper parts of their arms. The scalene muscle is affected by active trigger points, thus mimicking shoulder pain.
Scalenes Trigger Points-Video
Have you been feeling muscle stiffness in your neck or shoulders? Have you been experiencing a numbing sensation along your arms? Have you felt tenderness along your shoulders when you touch them? Many of these pain symptoms are associated with trigger points along the scalene muscles. The video above explains where the trigger points are located along the scalene muscles and how they are causing referred pain in the neck and shoulder areas. Many factors can lead to the causation of trigger point pain and overlap with other chronic issues that can affect the upper extremities of the body, using sleep as an example. Studies reveal that poor sleeping posture can affect the neck and shoulders, leading to muscle stiffness along the scalene muscles and developing trigger points over time. Fortunately, various ways to manage referred shoulder pain are associated with trigger points.
Management Of Chronic Shoulder Pain Associated With Trigger Points
Many individuals are referred to pain specialists that can alleviate trigger points along the scalene muscle to reduce the effects of shoulder and neck pain. When referred pain along the scalene muscles causes chronic shoulder pain associated with trigger points, many people often do various movements to alleviate the pain. However, it can cause more pain in the affected area and prevent relief from the neck and shoulders. Studies reveal that various treatments like physiotherapy, trigger point injections, manipulation of the cervical spine, or acupuncture can help relax and lengthen the muscle fibers associated with the scalene muscle. To that point, this allows the neck to extend further without pain and reduces the overlapping symptoms that affect the upper extremities of the body.
Conclusion
The scalene muscles play a crucial part in the head and neck area as deep muscles are positioned laterally on the cervical tract of the spine. These muscles help elevate the upper chest and laterally bend the neck from side to side. When injuries affect the scalene muscles and form tiny nodules known as trigger points, it can cause referred pain to the shoulders and the neck. To that point, symptoms like numbing or tingling sensations can travel down the arms and fingers. Fortunately, available treatments can reduce the symptoms and manage myofascial trigger pain along the shoulders and neck associated with the scalene muscles. This allows a better range of motion to the neck and shoulder and prevents future trigger points from forming in the scalene muscles.
References
Abd Jalil, Nizar, et al. “Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases.” The Malaysian Journal of Medical Sciences : MJMS, Penerbit Universiti Sains Malaysia, Jan. 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216145/.
Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Head and Neck, Scalenus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 16 Apr. 2022, https://www.ncbi.nlm.nih.gov/books/NBK519058/.
Fernández-Pérez, Antonio Manuel, et al. “Muscle Trigger Points, Pressure Pain Threshold, and Cervical Range of Motion in Patients with High Level of Disability Related to Acute Whiplash Injury.” The Journal of Orthopaedic and Sports Physical Therapy, U.S. National Library of Medicine, July 2012, https://pubmed.ncbi.nlm.nih.gov/22677576/.
Lee, Won-Hwee, and Min-Seok Ko. “Effect of Sleep Posture on Neck Muscle Activity.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, June 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468189/.
Thapa, Deepak, et al. “Management of Chronic Shoulder Pain with Restricted Mobility – a Case Series.” Indian Journal of Anaesthesia, Medknow Publications & Media Pvt Ltd, Nov. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125193/.
The muscles in the body help provide motion and protect the skeletal joints from harm. Each muscle group has ligaments, tissues, and muscle fibers that retract, stretch, and contract the body while helping the host to do everyday movements, breath, digest food, stabilize, and even rest. When a person is dealing with pain from a traumatic event or making repetitive motions, it can affect the muscles over time. Factors like not drinking enough water, constantly looking down on the phones, and being hunched over can cause strain on the muscles, causing overlapping pain on top of other chronic issues that may develop. When the muscles begin to cause pain along the shoulders and neck, it can become a risk of developing trigger points in the levator scapulae muscles. Today’s article examines the levator scapulae muscles, how trigger points affect these muscles, and how treatments can help manage the trigger points on the levator scapulae muscles. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points associated with the neck and shoulders affecting the levator scapulae muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Levator Scapulae?
Have you been dealing with pain along the neck or shoulders? Do you feel stiffness when turning your head from side to side? Or do you feel tenderness in the base of your neck and shoulders? Many individuals with shoulder and neck pain risk developing trigger points along the levator scapulae. The levator scapulae muscles originate from the posterior tubercles of the C1 through C4 vertebrae in the neck that is between the superior angle and the root of the scapulae spine. This superficial muscle’s primary function is to elevate the scapulae or the shoulder blades while working together with the trapezius and rhomboid muscles to assist the movement. The levator scapulae muscles also assist in providing neck extension, ipsilateral rotation, and lateral flexion. When pathologies like fibromyalgia, levator scapulae syndrome, or cervical myofascial pain begin to affect the levator scapulae muscles, the symptoms can potentially involve the shoulders and neck to cause referred pain to the upper extremities.
How Trigger Points Affect The Levator Scapulae?
Many individuals with shoulder and neck pain have described radiating pain from their neck to their shoulders. Known as referred pain, the pain is located in one area of the body but in a different location. Studies reveal that when pain radiates from the neck and shoulders, any movements that are overstretching the levator scapulae can aggravate overlapping symptoms on the affected side. This allows small nodules to form along the levator scapulae muscle fibers, causing trigger points to affect the shoulder and neck muscles.
Trigger point associated with the levator scapulae muscles causes the individual to have pain-like symptoms in the neck that causes muscle stiffness. This causes an emphasis on referred pain symptoms from the levator scapulae, like neck tension and restriction of range of motion on the neck. Studies reveal that pain over the superior angle of the levator scapulae is a common musculoskeletal disorder that is often accompanied by radiating pain on the neck, head, and shoulders. Some of the ways that trigger points form along the levator scapulae muscle can be due to ordinary factors like:
Stress
Posture
Over-exercising
Upper respiratory infections
Some of these factors above can shorten the levator scapulae muscle and restrict muscle movement to provide a full range of motion for the head and neck to turn. To that point, treatments are available to help loosen up and stretch the levator scapulae muscles to allow rotation and flexion on the neck and shoulders.
Trigger Points Anatomy On The Levator Scapulae- Video
Have you been dealing with stress that is affecting your neck and shoulders? Have you been dealing with neck stiffness when turning your head? Or have you been feeling muscle tenderness between the neck and shoulders? Some of these symptoms are associated with trigger points affecting the levator scapulae muscles between the neck and shoulder. The video above overviews common trigger points and how they affect the levator scapulae, causing shoulder and neck pain. Since the levator scapulae muscles lay behind the trapezius muscle, studies reveal that trigger points or myofascial pain syndrome can cause hyperirritability in the muscle tissues and affect mobility functions in the nerve ends. Even though referred pain affects the neck and shoulder of the body, treatments are available to manage trigger points on the levator scapulae and relieve neck and shoulder pain.
Treatments To Manage Trigger Points On The Levator Scapulae
When there is trigger point pain affecting the levator scapulae, some common complaints that many individuals often complain about are neck and shoulder pain. However, various ways can alleviate the pain symptoms from the neck and shoulders while managing trigger points associated with the levator scapulae. Studies reveal that stretching the levator scapulae muscle in a seated position can improve muscle length along the levator scapulae and the cervical range of motion. Stretching the levator scapulae muscle can help reduce the pain along the levator muscle. To that point, it even helps reduce muscle imbalances and movement dysfunction along the cervical joints. Many individuals are referred to pain specialists like chiropractors by their doctors to reduce pain and functionality disability in the neck and realign the spine to loosen up the stiff muscles caused by subluxation. Realigning the cervical spine and stretching can reduce future trigger points and reduce pain symptoms from affecting the muscle.
Conclusion
The levator scapulae muscles in the body provide movement functionality to the neck and shoulders. The levator scapulae work together with the trapezius and rhomboid muscles to elevate the shoulder blades and assist with neck extension, ipsilateral rotation, and lateral flexion. When pathologies affect the levator scapulae muscles, they can develop trigger point pain along the muscle and cause neck and shoulder pain. The factors that cause trigger point pain can either be ordinary or traumatic and cause referred pain to the neck and shoulders. Fortunately, treatments like stretching and adjustments can help reduce the pain and loosen up stiff muscles along the levator scapulae. This will allow a cervical range of motion back to the neck and shoulder and elongate the levator scapulae.
References
Akamatsu, Flávia Emi, et al. “Trigger Points: An Anatomical Substratum.” BioMed Research International, Hindawi Publishing Corporation, 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355109/.
Henry, James P, and Sunil Munakomi. “Anatomy, Head and Neck, Levator Scapulae Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 13 Aug. 2021, https://www.ncbi.nlm.nih.gov/books/NBK553120/.
Jeong , Hyo-Jung, et al. “Stretching Position Can Affect Levator Scapular Muscle Activity, Length, and Cervical Range of Motion in People with a Shortened Levator Scapulae.” Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, U.S. National Library of Medicine, 4 Apr. 2017, https://pubmed.ncbi.nlm.nih.gov/28578252/.
Kulow, Charlotte, et al. “Levator Scapulae and Rhomboid Minor Are United.” Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft, U.S. National Library of Medicine, Aug. 2022, https://pubmed.ncbi.nlm.nih.gov/35367623/.
Menachen, A, et al. “Levator Scapulae Syndrome: An Anatomic-Clinical Study.” Bulletin (Hospital for Joint Diseases (New York, N.Y.)), U.S. National Library of Medicine, 1993, https://pubmed.ncbi.nlm.nih.gov/8374486/.
The cervical spine has a casual relationship with the central nervous system as the brain and spinal cord works together to send neuron signals through the nerve pathways spread throughout the entire body. The cervical spine is part of the neck, where ligaments and muscles encompass the cervical joints to stabilize the head, neck, and shoulders. The neck has various muscles that support the head and can succumb to various injuries that can cause muscle strain and other associated symptoms that can affect the upper extremities of the body. Today’s article looks at the posterior cervical muscles, how trigger points affect the posterior cervical muscles, and how non-invasive treatments can help manage myofascial cervical pain. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with the neck affecting the posterior cervical muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Are The Posterior Cervical Muscles?
Have you been experiencing random headaches that affect your day? Do you feel any tension in your neck? Or do you experience stiffness and limited mobility when turning your neck? Most of these symptoms are associated with trigger pain affecting the posterior cervical muscle on the neck. The posterior cervical muscles function in the neck’s anatomic region while protecting the cervical spine. The muscles in the cervical spine form a triangle on the neck while providing functionality and movement to the neck, the head, shoulder, and upper back. Some of the muscles that work together with the cervical spine include:
Levator scapulae
SCM (Sternocleidomastiod)
Trapezius
Erector spinae
Deep cervical flexors
Suboccipitals
Semispinalis
Splenius
These muscles and soft tissues provide stability to the neck and work together with the tendons and ligaments to rotate, extend, and retract the head, neck, shoulders, and upper back. To that point, if the neck muscles become strained, it can lead to various issues that can cause pain to the neck and cervical spine.
How Trigger Points Affect The Posterior Cervical Muscles
Studies reveal that a musculoskeletal disorder known as cervical myofascial pain causes the surrounding muscles in the neck and shoulder regions to become tender to the touch and evoke pain in different areas of the body. When the posterior cervical muscle has become strained from various issues like poor posture, over-exercising, getting involved in an auto accident, or have suffered from a degenerative condition, it can cause the muscles to be overused, hypersensitive, and stiff while potentially being at risk of developing trigger points along the neck and shoulder muscles. Trigger points are a bit problematic as they are associated with referred pain and can be either latent or active as they create tiny nodules along the taut muscle fibers in the area. Research studies reveal that referred pain from cervical myofascial pain can be elicited by active trigger points on the affected muscle. To that point, the active trigger points can mimic other pain symptoms along the upper extremities, making diagnosing myofascial pain challenging. Thankfully there are ways to manage trigger point pain associated with the posterior cervical muscles along the neck and cervical spine.
Exercises For Neck & Shoulder Pain-Video
Have you been experiencing stiffness along the sides of your neck or on your shoulders? Do headaches make it impossible to get through an entire day? Or have you been feeling tightness along your jawline? Many people with neck pain and its associated symptoms could risk developing myofascial trigger pain along the posterior cervical muscles. Having myofascial trigger pain associated with the posterior cervical muscle and affecting the neck and upper extremities can cause many people to be miserable; however, there are many ways that people can utilize to relieve the pain along the posterior cervical muscles and manage myofascial cervical pain associated with the neck. The video above provides various neck and shoulder pain exercises correlating with myofascial trigger points. To that point, finding non-invasive available treatments to manage myofascial cervical pain can help reduce the effects of pain along the neck and posterior cervical muscles.
Non-Invasive Treatments To Manage Myofascial Cervical Pain
Many people suffer from neck pain associated with myofascial cervical pain; many factors can contribute to developing tiny nodules along the posterior muscles. Studies reveal that activities, whether work-related or for entertainment, can yield repetitive stress on the muscle groups that cause chronic tension in the muscle fibers to form trigger points. To that point, myofascial trigger pain causes the taut muscle bands to be hyper-sensitive and affect the muscle area. Many people suffering from myofascial trigger pain can utilize non-invasive treatments to manage myofascial pain associated with the posterior cervical muscle. Some of the treatments that help manage myofascial cervical pain include:
Acupuncture
Trigger point release therapy
Chiropractic care
Heat therapy
Exercise/stretching
Many of these treatments help release the trigger points from the affected muscles and help prevent them from re-occurring on the affected muscles along the upper extremities.
Conclusion
The neck has many muscles, ligaments, and tissues that help support the upper extremities of the body. When issues begin to affect the functionality of the neck muscles, it can lead to the development of myofascial trigger pain in the posterior cervical muscles along the neck to cause painful symptoms. This can lead to overlapping chronic issues like stiffness and tenderness in the upper extremities. Non-invasive treatments can help alleviate the pain and manage the symptoms caused by myofascial cervical pain in the upper extremities of the body. This allows the affected muscle to return to its functionality and prevents future issues from affecting the body.
References
Alghadir, Ahmad H, et al. “Efficacy of Combination Therapies on Neck Pain and Muscle Tenderness in Male Patients with Upper Trapezius Active Myofascial Trigger Points.” BioMed Research International, Hindawi, 10 Mar. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085833/.
Fernández-de-Las-Peñas, César, et al. “The Role of Myofascial Trigger Points in Musculoskeletal Pain Syndromes of the Head and Neck.” Current Pain and Headache Reports, U.S. National Library of Medicine, Oct. 2007, https://pubmed.ncbi.nlm.nih.gov/17894927/.
Stathakios, James, and Michael A Carron. “Anatomy, Head and Neck, Posterior Cervical Region.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 27 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK551521/.
Touma, Jeffrey, et al. “Cervical Myofascial Pain.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, https://www.ncbi.nlm.nih.gov/books/NBK507825/.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine