The Digestive Process: Functional Medicine Sciatica Clinic

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

The body needs food for fuel, energy, growth, and repair. The digestive process breaks down food into a form the body can absorb and use for fuel. The broken-down food gets absorbed into the bloodstream from the small intestine, and the nutrients are carried to the cells throughout the body. Understanding how the organs work together to digest food can help with health goals and overall health.

Table of Contents

The Digestive Process

The organs of the digestive system are the following:

Mouth
Esophagus
Stomach
Pancreas
Liver
Gallbladder
Small intestine
Large intestine
Anus

The digestive process starts with the anticipation of eating, stimulating the glands in the mouth to produce saliva. The digestive system’s primary functions include:

Mixing food
Moving food through the digestive tract – peristalsis
The chemical breakdown of food into smaller absorbable components.

The digestive system converts food into its simplest forms, which include:

Glucose – sugars
Amino acids – protein
Fatty acids – fats

Proper digestion extracts nutrients from food and liquids to maintain health and function properly. Nutrients include:

Carbohydrates
Proteins
Fats
Vitamins
Minerals
Water

Mouth and Esophagus

The food is ground up by the teeth and moistened with saliva to swallow easily.
Saliva also has a special chemical enzyme that starts breaking down carbohydrates into sugars.
Muscular contractions of the esophagus massage the food into the stomach.

Stomach

The food passes through a small muscle ring into the stomach.
It gets mixed with gastric chemicals.
The stomach churns the food to break it down further.
The food is then squeezed into the first part of the small intestine, the duodenum.

Small Intestine

Once in the duodenum, the food mixes with more digestive enzymes from the pancreas and bile from the liver.
The food passes into the lower parts of the small intestine, called the jejunum and the ileum.
Nutrients are absorbed from the ileum, lined with millions of villi or thread-like fingers that facilitate the absorption.
Each villus is connected to a mesh of capillaries, which is how nutrients get absorbed into the bloodstream.

Pancreas

The pancreas is one of the largest glands.
It secretes digestive juices and a hormone called insulin.
Insulin helps regulate the amount of sugar in the blood.
Problems with insulin production can lead to conditions like diabetes.

Liver

The liver has several different roles that include:

Breaks down fats using bile stored in the gallbladder.
Processes proteins and carbohydrates.
Filters and processes impurities, medications, and toxins.
Generates glucose for short-term energy from compounds like lactate and amino acids.

Large Intestine

A large reservoir of microbes and healthy bacteria live in the large intestine and play an important role in healthy digestion.
Once the nutrients have been absorbed, the waste is passed into the large intestine or bowel.
Water is removed, and the waste gets stored in the rectum.
It is then passed out of the body through the anus.

Digestive System Health

Ways to keep the digestive system and the digestive process healthy include:

Drink More Water

Water helps the food flow more easily through the digestive system.
Low amounts of water/dehydration are common causes of constipation.

Add More Fiber

Fiber is beneficial to digestion and helps with regular bowel movements.
Incorporate both soluble and insoluble fiber.
Soluble fiber dissolves in water.
As soluble fiber dissolves, it creates a gel that can improve digestion.
Soluble fiber may reduce blood cholesterol and sugar.
It helps your body improve blood glucose control, which can aid in reducing your risk for diabetes.
Insoluble fiber does not dissolve in water.
Insoluble fiber attracts water into the stool, making it softer and easier to pass with less strain on the bowels.
Insoluble fiber can help promote bowel health and regularity and supports insulin sensitivity which can help reduce the risk of diabetes.

Balanced Nutrition

Eat fruit and vegetables daily.
Choose whole grains over processed grains.
Avoid processed foods in general.
Choose poultry and fish more than red meat and limit processed meats.
Cut down on sugar.

Eat Foods with Probiotics or Use Probiotic Supplements

Probiotics are healthy bacteria that help combat unhealthy bacteria in the gut.
They also generate healthy substances that nourish the gut.
Consume probiotics after taking antibiotics that often kill all the bacteria in the gut.

Eat Mindfully and Chew Food Slowly

Chewing food thoroughly helps to ensure the body has enough saliva for digestion.
Chewing food thoroughly also makes it easier for nutritional absorption.
Eating slowly gives the body time to digest thoroughly.
It also allows the body to send cues that it is full.

How The Digestive System Works

References

GREENGARD, H. “Digestive system.” Annual review of physiology vol. 9 (1947): 191-224. doi:10.1146/annurev.ph.09.030147.001203

Hoyle, T. “The digestive system: linking theory and practice.” British journal of nursing (Mark Allen Publishing) vol. 6,22 (1997): 1285-91. doi:10.12968/bjon.1997.6.22.1285

https://www.merckmanuals.com/home/digestive-disorders/biology-of-the-digestive-system/overview-of-the-digestive-system

https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

Martinsen, Tom C et al. “The Phylogeny and Biological Function of Gastric Juice-Microbiological Consequences of Removing Gastric Acid.” International journal of molecular sciences vol. 20,23 6031. 29 Nov. 2019, doi:10.3390/ijms20236031

Ramsay, Philip T, and Aaron Carr. “Gastric acid and digestive physiology.” The Surgical clinics of North America vol. 91,5 (2011): 977-82. doi:10.1016/j.suc.2011.06.010

Residual Backache On The Serratus Posterior Inferior

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Table of Contents

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

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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

Serratus Posterior Inferior - Trigger Point of the Week

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, https://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, https://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, https://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, https://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, https://pubmed.ncbi.nlm.nih.gov/11424195/.

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Herniated Disc Signs It Is Returning To Normal: Sciatica Clinic

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Male doctor consults patient and shows the model of several spines in modern clinic — Doctor consults patient and shows the model of several spines in modern clinic. Healthcare concept

Herniated disc injuries and the time it takes to heal depend on the injury’s cause, the severity, and where it occurred along the spine. Symptoms can last a few days to months. Chiropractic treatment, massage therapy, and decompression realign the spine and return the disc to its correct position. Still, the herniated disc signs it is returning to normal can take time as the rest of the spine and body adjust to the realignment.

Table of Contents

Herniated Disc Signs It Is Returning To Normal

Most cases take a few weeks with healing time depending on health conditions, physical activity level, and age. However, in severe cases, a herniated disc can take up to several months to fully heal, but discomfort symptoms usually resolve sooner.

Expectations From a Healing Disc

Resting the spine and taking it easy after the injury is recommended.
Too much rest is not recommended as it can cause muscle stiffness.
While the herniated disc is healing, a primary doctor may prescribe anti-inflammatories or muscle relaxants to help ease discomfort.
A chiropractor and/or physical therapist can teach exercises and stretches to relieve pressure on nerves, loosen tight muscles, and improve circulation.

Signs The Herniated Disc Is Healing

Most herniated discs cause significant pain in the back and neck from the nervous system, causing some of the muscles of the low back or neck to spasm to protect the area from further damage.
Usually, the muscle spasms relax within the first days of the injury.
After spinal decompression, neurological symptoms like the sharp, shooting pain down a nerve in the arm or leg are the first symptoms to go away.
Then muscle weakness along the path of the nerve goes away.
Numbness in the extremities can linger around longer.

Length of Time

The wear and tear of adult spinal discs, combined with unhealthy posture habits, job occupation, previous injuries, etc., decrease blood circulation.
This is why it can take some time to heal completely, as the entire blood supply needs to reset to optimal circulation.
Nerve compression causing aches and pain sensations down the nerves can also take time.

Regular Activity

Returning to regular activities depends on the individual’s case and condition. It is essential not to overdo things that can cause excessive loading of the spine before the disc has fully healed, which increases the risk of re-herniation and other injuries.

Inactivity can slow the healing process and cause inflammation.
Patients are encouraged to return to activities that generate gentle motion to stimulate the stabilizing muscles to function properly and increase blood circulation to the injured area.
Individuals are recommended to:
Learn posture improvement when walking, sitting, standing, and sleeping.
Adjust sleep patterns.
Incorporate anti-inflammatory nutrition during the healing process.
Engage in light, gentle exercises.
Keep the body hydrated.
Avoid alcohol during the healing process.
This provides a mechanical and biological environment that eventually becomes a personalized exercise physical therapy program.

DOC Spinal Decompression

References

Díez Ulloa, Máximo Alberto. “Role of Microangiogenensis in Disc Herniation Healing.” Journal of investigative surgery: the official journal of the Academy of Surgical Research vol. 34,6 (2021): 685. doi:10.1080/08941939.2019.1682725

Factors that influence recovery: Mayo Clinic. February 8, 2022. “Herniated disk.” https://www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095

Factors that influence recovery: NHS. March 22, 2021. “Slipped Disc.” https://www.nhs.uk/conditions/slipped-disc/

How to speed up healing time: American Academy of Orthopaedic Surgeons. January 2022. “Herniated Disk in the Lower Back” https://orthoinfo.aaos.org/en/diseases–conditions/herniated-disk-in-the-lower-back/

Keramat, Keramat Ullah, and Aisling Gaughran. “Safe physiotherapy interventions in large cervical disc herniations.” BMJ case reports vol. 2012 bcr2012006864. 18 Aug. 2012, doi:10.1136/bcr-2012-006864

Stoll, T et al. “Physiotherapie bei lumbaler Diskushernie” [Physiotherapy in lumbar disc herniation ]. Therapeutische Umschau. Revue therapeutique vol. 58,8 (2001): 487-92. doi:10.1024/0040-5930.58.8.487

Swartz, Karin R, and Gregory R Trost. “Recurrent lumbar disc herniation.” Neurosurgical focus vol. 15,3 E10. 15 Sep. 2003, doi:10.3171/foc.2003.15.3.10

Trigger Points Affecting The Serratus Anterior

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Table of Contents

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

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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

Trigger Point Release - Serratus Anterior

Have you been dealing with pain in the side of your ribs? What about experiencing stiffness or pain when throwing a punch? Do you feel any aches or soreness when adjusting your posture? These symptoms you are experiencing could contribute to the development of trigger points affecting the serratus anterior muscle. The serratus anterior covers the side of the ribcage and lies deep within the scapula and pectoral muscle. This muscle allows the motor function to the arms as it pulls the scapula forward around the thorax when someone throws a punch. However, when the muscle is overused, it can develop trigger points along the serratus anterior muscle and mimic chronic issues in the chest cavity. This causes referred pain to travel from the side of the ribs down to the hand, causing pain-like symptoms to the ring and pinky fingers. Fortunately, various treatments help manage trigger points in the serratus anterior muscle. The video above shows where the trigger points are located in the serratus anterior and how to release the trigger points from the affected muscle to relieve the pain and manage trigger points from returning to the muscle.

Various Actions To Manage Trigger Points Along The Serratus Anterior

When the serratus anterior is affected by trigger points, many people will often feel pain along their sides and complain about their chest hurting for an unknown reason. When this happens, they would be referred to a pain specialist like a chiropractor or a massage therapist to manage trigger points associated with the serratus anterior through various techniques. Studies reveal that techniques like intramuscular neural distribution of the serratus anterior muscle can help reduce the effects of trigger points in the affected muscle to reduce pain-like symptoms. Other methods like thoracic spinal manipulation, dry-needling, acupuncture, or stretching the muscle group can help loosen the stiff muscles and lower trigger points from forming. However, other actions that many people should consider are modifying or avoiding strenuous activities that can reactivate the serratus anterior muscle trigger points. Even when the person is sleeping, putting a pillow under to support the arm can prevent the scapula from falling forward.

Conclusion

The serratus anterior muscle is located at the side of the ribs and is deep within the scapula (the shoulder blades) and the poster muscles. The serratus anterior muscle works with the long thoracic nerve by providing motor function to the arms by allowing anterolateral motion. This allows the individual to throw a punch in a boxing match while lifting the ribs and assisting with respiration. When the serratus anterior muscle succumbs to injuries or has been overused, it can develop into trigger points and cause various issues affecting the body’s chest cavity. Trigger points are treatable through multiple therapies that can manage trigger points while reducing the pain effects rendered in the serratus anterior muscles. These therapies return mobility and motor function to the arms and the serratus anterior muscles.

References

Bautista, Alexander, et al. “Serratus Anterior Muscle Pain Syndrome: A Diagnostic Conundrum.” OUP Academic, Oxford University Press, 11 Feb. 2017, https://academic.oup.com/painmedicine/article/18/8/1600/2990174?login=false.

Long, Kirsten, and Forshing Lui. “Anatomy, Thorax, Long Thoracic Nerve.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 31 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK535396/.

Lung, Kirsten, et al. “Anatomy, Thorax, Serratus Anterior Muscles – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 7 Oct. 2021, https://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, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9033065/.

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Neuropathy Therapeutic Massage Chiropractic Sciatica Clinic

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Hospital Madrid_Property.jpg, Hospital Madrid_Javier David Dumitru.jpg, Hospital Madrid_Mariana Ramirez.jpg — Male physiotherapist giving feet massage to unrecognized woman lying in stretcher.

Neuropathy therapeutic massage is a system of structured palpations or movements of the body’s soft tissues. When the nerves don’t get enough oxygen and nutrients from blood circulation, symptoms like tenderness, tingling, numbness, and pain can present. The best way to move the blood is by massaging the circulation in and around the numb and sore areas and throughout the body. Many types of massage therapy are available for various health-related issues. This includes:

Pain alleviation and management
Injury rehabilitation and prevention
Stress alleviation
Anxiety and depression therapy
Immune system restoration
Increasing relaxation
Facilitating overall wellness

Table of Contents

Neuropathy Therapeutic Massage

Neuropathy therapeutic massage: The objective is to stimulate blood flow throughout the body. This is because the more muscles move, the better they can maintain blood circulation to nourish the nerves and the body, which is why physical activity/exercise/movement is encouraged. Benefits include:

De-stressing the nerves that are causing tingling, numbness, and burning.
The discomfort eases as the muscles are lengthened and loosened, releasing the tightness and pressure.
Endorphins (natural painkillers) are released, minimizing the pain.
Increase in circulation
Reduced spasms and cramping
Increased joint flexibility
Mobility restoration
Symptom relief
Decreased anxiety
Improved sleep quality
Increased energy levels
Improved concentration
Reduced fatigue

Massage Techniques

Massaging techniques include:

Kneading
Stroking
Gliding
Percussion
Vibration
Friction
Compression
Passive stretching
Active stretching

Effleurage

This can be firm or light soothing, stroking movements without dragging the skin, using the fingertips or the palms.

Petrissage

Lifting or picking up muscles and rolling the skin.

Tapotement

Striking with the side of the hand, usually with slightly flexed fingers, rhythmic finger movements, or short rapid movements with the sides of the hand.

These techniques may be applied with or without massage oils, topical ointments, salt or herbal preparations, hydromassage, thermal massage, or massage instruments/tools.

Massage Types

There are different types of massage, those that are for comfort and those for specific conditions or diseases. A few include:

Swedish Massage

Generally regarded as the most common form of massage, this technique involves a combination of five basic strokes and concentrates on the muscles and connective tissues.
Used to improve circulation, relaxation, pain relief, and overall maintenance and well-being.

Sports Massage

Sports massage therapies are used in preventative and therapeutic settings.
Athletes use the technique during warm-ups, training, and competition to treat and/or help in:
Injury prevention
Improved flexibility
Full range of motion
Improved performance
Helps to focus and mental clarity.

Reflexology

This technique uses a system of points on the hands, feet, and ears that correspond to or reflex other body areas.
Reflexologists apply appropriate pressure to these points to stimulate energy flow, to relieve pain or blockages throughout the body.
Reflexology is also used to ease stress and promote relaxation.

Aromatherapy

Various essential oils derived from plants, herbs, flowers, and roots have therapeutic qualities.
Aromatherapy involves essential oils to produce a certain effect; for example, lavender is used to induce calmness and relaxation.
When combined with body massage, aromatherapy can enrich the experience immensely.
A few drops can be added to massage cream or oil and applied to the skin.
Professional aromatherapists also blend oils to treat specific conditions.

Connective Tissue Massage

Connective tissue massage is similar to myofascial release in that it involves working with the fascia, or soft tissue, to relieve pain, tightness, and discomfort.
The theory of connective tissue massage is that tight, restricted body areas negatively affect other body areas.
Practitioners/therapists hook their fingers into the connective tissue and use pulling strokes to lengthen the tissues.
This releases tension, improves mobility and reduces stress.

Deep-Tissue Massage

Deep-tissue massage utilizes slow strokes, direct pressure, and/or friction across the grain of the muscles with the fingers, thumbs, and/or elbows.
Its purpose is to reach the fascia beneath the muscles going deep into the muscles and connective tissue to release aches and pains.
Therapists thoroughly understand the human body and have been trained to administer deep-tissue massage.
The technique is used in treating chronic pain, inflammation, and injury.

Geriatric Massage

Geriatric massage involves treating the elderly and addressing specific needs related to age, conditions, and illness.
The sessions are usually shorter and involve gentle techniques to facilitate pain relief, relaxation, and overall wellness.

Lymph Drainage Therapy

This technique involves the application of light, rhythmic strokes to alleviate various conditions related to the body’s lymph system.
The lymph system supports the immune system and is responsible for flushing toxins and draining fluid.
When lymph circulation slows down or stops, fluid can build up and cause physical problems like inflammation, edema, and neuropathies.
Therapists restore lymph flow by using a mapping system to assess problem areas, then apply gentle pressure using the fingers and hands to reactivate circulation.

Neuromuscular Therapy

Neuromuscular therapy is massage applied to specific muscles, often used to increase blood circulation, release muscle tension knots/trigger points, and/or release pain/pressure on nerves.
This therapy is also known as trigger-point therapy in that concentrated finger pressure is applied to specific points to alleviate muscular pain.

HealthCare

Neuropathy therapeutic massage is used in combination to enhance regular medical care. Let a doctor know when trying massage therapies, and follow any standard treatment plans. Some forms of massage can cause soreness the next day but should be combined with a sense of improvement and being healthier. If any part of the massage doesn’t feel right or is painful, let the therapist know immediately. Most serious issues come from too much pressure during the massage or sensitivity or allergy to massage oils. Massage therapy caution includes the following:

Vigorous massage should be avoided by individuals with bleeding disorders or low blood platelet counts and taking blood-thinning medications.
Massage therapy should not be done in areas with blood clots, fractures, healing wounds, skin infections, weakened bones from osteoporosis or cancer, or after recent surgery.
Cancer patients should discuss any concerns about massage therapy with their oncologist.
Pregnant women should consult their healthcare provider before using massage therapy.

Peripheral Neuropathy Recovery

References

American Massage Therapy Association defines massage therapy and basic massage therapy terms. www.amtamassage.org

Complementary and alternative methods: types of bodywork. Available at www.cancer.org

Gok Metin, Zehra, et al. “Aromatherapy Massage for Neuropathic Pain and Quality of Life in Diabetic Patients.” Journal of nursing scholarship: an official publication of Sigma Theta Tau International Honor Society of Nursing vol. 49,4 (2017): 379-388. doi:10.1111/jnu.12300

MassageTherapy.com. www.massagetherapy.com

National Institutes of Health, National Center for Complementary and Alternative Medicine

Samuels, Noah, and Eran Ben-Arye. “Integrative Approaches to Chemotherapy-Induced Peripheral Neuropathy.” Current oncology reports vol. 22,3 23. 11 Feb. 2020, doi:10.1007/s11912-020-0891-2

Sarısoy, Pınar, and Ozlem Ovayolu. “The Effect of Foot Massage on Peripheral Neuropathy-Related Pain and Sleep Quality in Patients With Non-Hodgkin’s Lymphoma.” Holistic nursing practice vol. 34,6 (2020): 345-355. doi:10.1097/HNP.0000000000000412

Thomas, Ewan, et al. “Peripheral Nerve Responses to Muscle Stretching: A Systematic Review.” Journal of sports science & medicine vol. 20,2 258-267. 8 Mar. 2021, doi:10.52082/jssm.2021.258

Zhang, Yong-Hui, et al. “Exercise for Neuropathic Pain: A Systematic Review and Expert Consensus.” Frontiers in medicine vol. 8 756940. 24 Nov. 2021, doi:10.3389/fmed.2021.756940

The Body’s Ability To Heal: Chiropractic Sciatica Clinic

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Instructor helping recovery exercise for recovering patient — Experienced instructor helps a recovering patient perform recovery exercises on a special roller in a wellness center

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.

Table of Contents

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

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Table of Contents

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

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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

Treatment of trigger point related tensions of the upper back

Have you been dealing with respiratory issues causing you to be hunched over constantly? Do you feel soreness or tenderness at the base of your neck? Or are you suffering from upper back pain? These symptoms are associated with trigger points that are affecting the serratus posterior muscles causing upper back pain. Trigger points, or myofascial pain syndrome, is a musculoskeletal disorder that causes tenderness along the affected muscle that causes referred pain to the surrounding muscles in the body. Trigger points associated with the serratus posterior muscles can cause referred pain in the upper back and mimic various chronic conditions. Trigger point pain is difficult to diagnose but can be manageable with treatment. The video above gives examples of how to treat trigger points to relieve tension in the upper back.

Various Techniques To Manage Trigger Points In The Upper Back

When it comes to upper back pain, many individuals will go to pain specialists like massage therapists or chiropractors to relieve any issues affecting the upper back. These pain specialists utilize various techniques like stretching, spinal manipulation, massages, and ischemic compression to alleviate pain and manage trigger points from forming further in the affected muscle. Pain specialists like massage therapists or chiropractors are excellent for locating pain-like symptoms associated with trigger points. Even though treatment can help manage symptoms associated with trigger points, many people can still incorporate these techniques, like deep breathing or correcting their posture, to prevent the upper back muscles from becoming strained and causing more issues than before.

Conclusion

The serratus posterior muscles have various roles in the upper back region of the body. These superficial muscles are extrinsic and accessory breathing muscles that help expand the chest cavity. When multiple issues affect the upper back muscles, like strenuous activities or respiratory problems, it can develop trigger points along the serratus posterior muscles and invoke pain-like symptoms to travel down to the hand, causing mobility issues. Thankfully, various techniques that pain specialists like chiropractors and massage therapists use can help manage trigger points from escalating and can bring upper back mobility to the body once again.

References

Altafulla, Juan J, et al. “An Unusual Back Muscle Identified Bilaterally: Case Report.” Cureus, Cureus, 15 June 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093753/.

Briggs, Andrew M, et al. “Thoracic Spine Pain in the General Population: Prevalence, Incidence and Associated Factors in Children, Adolescents and Adults. A Systematic Review.” BMC Musculoskeletal Disorders, BioMed Central, 29 June 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720379/.

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

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

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

Disclaimer

Mindful Eating Healthy Food Connection: Sciatica Clinic

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Beautiful young couple eating in restaurant. — Portrait of beautiful young couple eating in restaurant.

Mindful eating involves paying attention to what and how individuals eat, helping to become more aware of the body’s natural hunger and satisfaction cues. The process can help individuals become aware of the reasons behind their hunger and help to reduce cravings, control portion sizes, and develop long-term healthy eating habits.

Table of Contents

Mindful Eating

It’s easy to rush through meals and snacks without pausing to enjoy the experience while refueling the body. Like meditation, individuals focus on what they are eating, how it smells, tastes, and the bodily sensations experienced. It is a way of checking in with the mind and body throughout a meal or snack. Mindful eating puts the individual in touch:

With the foods.
Hunger levels.
Determine if it is true:
Physiological hunger.
Hedonic hunger – emotional, stressful, conditioned, celebratory, etc.

Benefits

Individuals do not have to go all-in but can adopt some principles of slowing down and tuning into the body to improve health. Benefits include:

Better Digestion

Slowing down and chewing food properly makes it easier to digest.

Improved Nutrition

Fast foods can cause a feeling of sluggishness and bloating.
Eating nutrient-packed meals provides more energy.
Improved nutrition means improved immune system health.
The awareness reinforces making healthier choices.

Satisfaction After Meals

Rushing to finish a meal means not enjoying the flavors and texture factors that can generate a sense of fullness and satisfaction.
Training the mind and body to be truly satisfied with meals and snacks leads to less stress and less craving.

Healthier Food Relationship

The body needs food physiologically for fuel and nourishment.
Individuals also develop emotional attachments to food associated with experiences and memories.
Addressing all aspects and influences in food relationships allows individuals to become more aware of their learned behaviors, perceptions, emotions, and mindsets.
Identifies behaviors that are not beneficial so the individual can work to improve them.

Improved Cardiometabolic Health

Mindful or intuitive eating has been shown to improve:

Blood sugar levels in pregnant women.
Inflammatory markers in postmenopausal women.
Lipid and blood pressure in overweight adults.

Food Consumption Health

Put away electronics and set aside time and space for eating only.
Eat in a setting where you are relaxed.
Eating in the car, in front of a computer while working, or on the phone doesn’t give full attention to the eating process and, as a result, can cause the individual to eat more or eat foods that are not healthy.
Sit down and take a few deep breaths before starting the meal.
If emotions are running high and are geared towards eating, see if you can acknowledge and express those emotions rather than eat through them.
This will help the digestive process and get the most out of the meal.
Eat a palette of colors, sample various salty, sweet, spicy, and umami/savory flavors, and take in the food with all the senses.
Not eating a variety of flavors at a meal can cause a feeling of missing something that can lead to unhealthy cravings.
Eat with others, as sharing food can enrich everyone involved and help focus on the experience, not the amount of food consumed.
Chew thoroughly, as digestion begins in the mouth, where enzymes are secreted in saliva to break down food.
Not properly chewing and making the food smaller can cause indigestion and other digestive problems.
Listen to your body and recognize when you have had enough or want more.
Waiting five minutes before getting another serving can help the body become more attuned to hunger and fullness cues.

Eat Mindfully

References

Cherpak, Christine E. “Mindful Eating: A Review Of How The Stress-Digestion-Mindfulness Triad May Modulate And Improve Gastrointestinal And Digestive Function.” Integrative medicine (Encinitas, Calif.) vol. 18,4 (2019): 48-53.

Espel-Huynh, H M et al. “A narrative review of the construct of hedonic hunger and its measurement by the Power of Food Scale.” Obesity science & practice vol. 4,3 238-249. 28 Feb. 2018, doi:10.1002/osp4.161

Grider, Hannah S et al. “The Influence of Mindful Eating and/or Intuitive Eating Approaches on Dietary Intake: A Systematic Review.” Journal of the Academy of Nutrition and Dietetics vol. 121,4 (2021): 709-727.e1. doi:10.1016/j.jand.2020.10.019

Hendrickson, Kelsie L, and Erin B Rasmussen. “Mindful eating reduces impulsive food choice in adolescents and adults.” Health psychology: official journal of the Division of Health Psychology, American Psychological Association vol. 36,3 (2017): 226-235. doi:10.1037/hea0000440

Morillo Sarto, Hector, et al. “Efficacy of a mindful-eating program to reduce emotional eating in patients suffering from overweight or obesity in primary care settings: a cluster-randomized trial protocol.” BMJ open vol. 9,11 e031327. 21 Nov. 2019, doi:10.1136/bmjopen-2019-031327

Nelson, Joseph B. “Mindful Eating: The Art of Presence While You Eat.” Diabetes spectrum: a publication of the American Diabetes Association vol. 30,3 (2017): 171-174. doi:10.2337/ds17-0015

Warren, Janet M et al. “A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviors: effectiveness and associated potential mechanisms.” Nutrition research reviews vol. 30,2 (2017): 272-283. doi:10.1017/S0954422417000154

Myofascial Pain Syndrome Causing Issues On The Sternalis Muscle

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Table of Contents

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

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The Sternalis Muscle In The Chest

Have you been experiencing respiratory issues that are affecting your chest? What about feeling muscle tightness in the middle of your chest? Or are you experiencing radiating pain traveling down your elbow? These symptoms are often associated with pain caused by trigger points along the chest affecting the sternalis muscle. Studies reveal that the sternalis muscle is an anatomical variant along the anterior thoracic region of the body. The sternalis muscle is located right in the middle of the chest and is toward the end of the pectoralis muscles. “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., explained that the sternalis muscle often occurs bilaterally or unilaterally in the body and may attach itself either in the pectoralis muscle or the sternocleidomastoid. The sternalis muscle could even become a continuation of these muscles as well.

One of the unique functions of the sternalis muscle for the body is that it is an accessory muscle. An accessory muscle refers to various muscles that assist the breathing muscles. Since the sternalis muscle assists the other muscles as an accessory muscle, this muscle help opens the airways to allow more oxygen to the lungs. This muscle is extremely useful when it comes to exercising the body. However, this muscle is superficial and can succumb to various issues that affect the chest and internal organs.

Myofascial Pain Syndrome Associated With The Sternalis Muscle

Since the sternalis muscle is superficial, many issues can affect the middle of the chest and invoke pain-like symptoms that overlap and develop myofascial pain syndrome or trigger points in the sternalis. The symptoms associated with myofascial pain syndrome affecting the sternalis muscle are intense, deep pain that can occasionally cause soreness in the sternum. Studies reveal that since the sternalis is an accessory muscle, it can be overlooked, and symptomatic incidences can affect the chest and surrounding organs. To that point, symptoms like muscular imbalances, overuse tendinopathies, or neural compression syndromes can cause the sternalis muscle to ache and activate trigger points. When active trigger points affect the sternalis muscle, it correlates with myocardial infarction or angina pectoris mimicking cardiovascular disorders. Myofascial pain syndrome is tricky to diagnose, but it is treatable with various techniques that can manage the pain.

Massage Techniques For The Sternalis Muscle-Video

Have you been experiencing pain in the middle of your chest? Are you experiencing symptoms of cardiovascular disorders? Or does your chest hurts when you’re coughing? Myofascial pain syndrome or trigger points affecting the sternalis muscle are associated with many symptoms. Myofascial pain syndrome is a condition that affects the musculoskeletal system by causing the affected muscles to be overused and causing referred pain. Studies reveal that issues like myofascial pain syndrome begin to affect the chest wall cavity of the body; many patients think they have a cardiac disease causing greater impairment in their daily activities, causing emotional stress and a higher level of anxiety. All is not lost, though, as there are various techniques to reduce the pain and other chronic symptoms while managing myofascial pain syndrome on the sternalis muscle. The video above explains the sternalis muscle and shows different approaches to stretching and massaging the sternalis muscle on the chest.

Various Techniques For Managing Myofascial Pain Syndrome On The Sternalis Muscle

When a doctor examines the sternalis muscle, many individuals will often complain about experiencing chest and heart pain since the muscle is located in the front-middle of the chest. However, all is not lost, as various techniques can help relieve the pain along the sternalis muscle while managing myofascial pain syndrome. As stated earlier, trigger points can mimic other chronic conditions that can affect not only the muscle itself but the surrounding organs. Gently stretching the chest can help reduce the aches in the surrounding muscles and trigger point formation. Another technique that many people can incorporate is ischemic compression on the sternalis muscle combined with moist heat. The ischemic compression allows a sense of discomfort, but no pain should be inflicted to reduce pain symptoms and manage myofascial pain syndrome.

Conclusion

The sternalis muscle is located in the middle of the chest and helps the surrounding muscles to breathe and expand. This muscle works together with the pectoralis and the sternocleidomastoid muscle by attaching itself to these muscles in a unilateral or bilateral muscle. When traumatic forces or events affect the chest, this superficial muscle can be affected and develop myofascial pain syndrome that mimics cardiovascular disorders. Fortunately, various techniques like gentle chest stretch and ischemic compression can help manage trigger points and reduce pain in the chest.

References

Bell, Daniel J. “Accessory Muscles of Respiration: Radiology Reference Article.” Radiopaedia Blog RSS, Radiopaedia.org, 23 July 2022, https://radiopaedia.org/articles/accessory-muscles-of-respiration?lang=us.

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, https://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, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3117696/.

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

Verdon, François, et al. “Chest Wall Syndrome among Primary Care Patients: A Cohort Study.” BMC Family Practice, BioMed Central, 12 Sept. 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2072948/.

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Blood Test Diagnosis Ankylosing Spondylitis Sciatica Clinic

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

shot-of-a-young-doctor-using-a-digital-tablet-duri-2022-10-06-04-36-42-utc_02 — Shot of a young doctor using a digital tablet during a consultation with a senior woman.

Diagnosing ankylosing spondylitis usually involves multiple tests. When doctors order blood tests to diagnose ankylosing spondylitis, an individual is experiencing worsening symptoms in their back and joints. Often, a blood test diagnosis means the doctor is looking for evidence of anything else that could be causing the symptoms. However, blood tests by themselves cannot definitively diagnose ankylosing spondylitis, but when combined with imaging and assessment, they can provide important clues that point to the answers.

Table of Contents

Ankylosing Spondylitis Blood Test Diagnosis

Ankylosing spondylitis is arthritis that primarily affects the spine and hips. It can be difficult to diagnose as no single test can provide thorough information for a definitive diagnosis. A combination of diagnostic tests are utilized, including a physical exam, imaging, and blood tests. Doctors are not only looking for results that will point to ankylosing spondylitis, but they are looking for any results that might point away from the spondylitis results that might provide a different explanation for symptoms.

Physical Exam

The diagnostic process will begin with the individual’s medical history, family history, and physical exam. During the exam, the doctor will ask questions to help rule out other conditions:

How long have symptoms been presenting?
Do symptoms get better with rest or exercise?
Are the symptoms getting worse or staying the same?
Are the symptoms worse at a particular time of day?

The doctor will check for limitations in mobility and palpate tender areas. Many conditions can cause similar symptoms, so the doctor will check to see if the pain or lack of mobility is consistent with ankylosing spondylitis. The feature sign of ankylosing spondylitis is pain and stiffness in the sacroiliac joints. The sacroiliac joints are located in the lower back, where the base of the spine and pelvis meet. The doctor will look at other spinal conditions and symptoms:

Back pain symptoms caused by – injuries, posture patterns, and/or sleeping positions.
Lumbar spinal stenosis
Rheumatoid arthritis
Psoriatic arthritis
Diffuse idiopathic skeletal hyperostosis

Family History

Family history plays a part in diagnosis because of the genetic element of ankylosing spondylitis.
The HLA-B27 gene corresponds with ankylosing spondylitis; if an individual has it, one of their parents has it.

Imaging

X-rays often serve as the first step to a diagnosis.
As the disease progresses, new small bones form between the vertebrae, eventually fusing them.
X-rays work best at mapping the disease progression than the initial diagnosis.
An MRI provides clearer images in the early stages as smaller details are visible.

Blood Tests

Blood tests can help rule out other conditions and check for signs of inflammation, providing supportive evidence along with the results of imaging tests. It typically only takes about a day or two to get the results. The doctor may order one of the following blood tests:

HLA-B27

HLA-B27 test.

The HLA-B27 gene reveals a red flag that ankylosing spondylitis could be present.
Individuals with this gene have a much higher risk of developing the condition.
Combined with symptoms, other labs, and tests, it can help confirm a diagnosis.

ESR

Erythrocyte sedimentation rate or ESR test.

An ESR test measures inflammation in the body by calculating the rate or how fast red blood cells settle to the bottom of a blood sample.
If they settle faster than normal, the result is elevated ESR.
That means the body is experiencing inflammation.
ESR results may come back high, but these alone do not diagnose AS.

CRP

C-reactive protein – CRP test.

A CRP test checks CRP levels, a protein associated with inflammation in the body.
Elevated CRP levels signal inflammation or infection in the body.
It is a useful tool for measuring disease progression after diagnosis.
It often corresponds with changes in the spine shown on X-ray or MRI.
Only 40-50% of individuals with ankylosing spondylitis experience an increased CRP.

ANA

ANA test

Antinuclear antibodies, or ANA, go after the proteins in the cell’s nucleus, telling the body its cells are the enemy.
This activates an immune response that the body fights to eliminate.
A study determined that ANA is found in 19% of individuals suffering from ankylosing spondylitis and is higher in women than men.
Combined with other tests, the presence of ANA provides another clue to a diagnosis.

Gut Health

The gut microbiome plays an important role in triggering the development of ankylosing spondylitis and its treatment.
Tests to determine the gut’s health can give a doctor a complete picture of what is happening inside the body.
Blood test diagnoses for ankylosing spondylitis and other inflammatory conditions rely heavily on piecing together different tests alongside clinical exams and imaging.

Causes, Symptoms, Diagnosis, and Treatment

References

Cardoneanu, Anca, et al. “Characteristics of the intestinal microbiome in ankylosing spondylitis.” Experimental and therapeutic medicine vol. 22,1 (2021): 676. doi:10.3892/etm.2021.10108

Prohaska, E et al. “Antinukleäre Antikörper bei Spondylitis ankylosans (Morbus Bechterew)” [Antinuclear antibodies in ankylosing spondylitis (author’s transl)]. Wiener klinische Wochenschrift vol. 92,24 (1980): 876-9.

Sheehan, Nicholas J. “The ramifications of HLA-B27.” Journal of the Royal Society of Medicine vol. 97,1 (2004): 10-4. doi:10.1177/014107680409700102

Wenker KJ, Quint JM. Ankylosing Spondylitis. [Updated 2022 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470173/

Xu, Yong-Yue, et al. “Role of the gut microbiome in ankylosing spondylitis: an analysis of studies in the literature.” Discovery medicine vol. 22,123 (2016): 361-370.

The Pectoralis Minor Being Affected By Myofascial Pain

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Table of Contents

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

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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

Are Your Chest Muscles Tight (Pec Major or Minor) How To Tell

Have you been experiencing difficulty inreaching behind your back? Do you feeling your body becoming more hunched over than usual? Or have you been experiencing chest pain constantly? These pain-like symptoms are caused by myofascial pain associated with the pectoralis minor muscle. The pectoralis minor muscle helps with the stability of the shoulders and studies reveal that when the presense of myofascial trigger points are linked to shoulder and upper body disorders, it can increase the risk of overlapping conditions that trigger points can mimic. Myofascial trigger points are a common complaint as it can significantly impact a person’s daily activites by causing the taut muscle band to be tender or hypersenitive. When this happens, it can lead to issues of muscle imbalance, weakness and impaired motor function. Thankfully, there are various techniques that can help reduce the pain symptoms and issues in the pectoralis minor muscle, while mananging the trigger points. The video above explainshow to tell when your chest muscles are tight and various tests to know when the pectoralis muscles (both the minor and major) are being affected by trigger points.

Managing Myofacial Pain Associated With Pectoralis Minor

When dealing with chest pains associated with myofascial pain along the pectoralis minor, there are many techniques they can incorporate to prevent myofascial pain from causing further damage to the muscle itself and the surrounding muscles. Various chest stretches can help gently loosen the stiff muscles, warm the pectoralis minor, and improve mobility to the chest and shoulders. Correct posture can help prevent the body from being hunched over constantly and let the surrounding muscles and the pectoralis minor relax. If the pain is unbearable, studies reveal that treatments like dry needling and palpations on the pectoralis minor muscles can help manage the pain caused by trigger points. This kind of treatment allows the muscle to release the trigger point and, combined with a hot or cold pack, can reduce the chances of myofascial pain from forming again in the muscle.

Conclusion

Underneath the pectoralis major muscle, the pectoralis minor is a thin triangular-shaped muscle that helps stabilize the shoulder blades and is located in the front of the thoracic wall of the spine. This tiny muscle is part of the respiratory muscles that have a causal relationship with the lungs and can succumb to environmental factors that can lead to the development of myofascial pain or trigger points on the pectoralis minor. Myofascial pain associated with the pectoralis minor muscle can mimic cardiovascular issues and invoke pain in the muscle. Fortunately, various treatments can help relieve and manage myofascial pain from re-occurring in the pectoralis minor.

References

Bagcier, Fatih, et al. “Three Simple Rules in Pectoral Muscle’s Trigger Point Treatment, Which May Be a Cause of Chest Pain: Position, Palpation, and Perpendicular Needling.” American Board of Family Medicine, American Board of Family Medicine, 1 Nov. 2020, https://www.jabfm.org/content/33/6/1031.long.

Baig, Mirza A, and Bruno Bordoni. “Anatomy, Shoulder and Upper Limb, Pectoral Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, https://www.ncbi.nlm.nih.gov/books/NBK545241/.

Morais, Nuno, and Joana Cruz. “The Pectoralis Minor Muscle and Shoulder Movement-Related Impairments and Pain: Rationale, Assessment and Management.” Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, U.S. National Library of Medicine, Jan. 2016, https://pubmed.ncbi.nlm.nih.gov/26530726/.

Ribeiro, Daniel Cury, et al. “The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature.” BMC Musculoskeletal Disorders, BioMed Central, 25 July 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060458/.

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

Disclaimer

Back Injuries From Vehicle Collisions Sciatica Clinic

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Female Driver With Whiplash Injury Standing By Damaged Car After — Young woman rubbing neck in pain from whiplash injury standing by damaged car after traffic accident

Back injuries from vehicle collisions vary from person to person. Common injuries may include strains, sprains, herniated discs, and fractures, and individuals dealing with certain spinal conditions like spinal stenosis may cause the medical condition to accelerate. Still, the force and physical impact the body absorbs during a crash, no matter how minor the accident or how safe the car is, will cause bodily aches and pains with the potential for other spinal conditions. Chiropractic care, massage, decompression, and traction therapy can relieve symptoms and restore mobility and function.

Table of Contents

Back Injuries From Vehicle Collisions

Depending on how the impact affects the spine, problems can present in various areas of the back. The violent motion can sprain, strain, and fracture spinal components. Even minor incidents can impact mobility. Symptoms can stem from inflammation, compressed nerves, or fractures. Any damage can have long-lasting effects on the vertebrae, nerve roots, and back muscles. A vehicle collision can affect the following:

Lumbar vertebrae – lower back
Thoracic vertebrae – middle/upper back
Cervical vertebrae – neck

Each area consists of bones, tissues, muscles, nerves, tendons, and ligaments extending from the neck to the pelvis.

The most common back injuries are to the neck and lower back, where the most movement and shifting occurs, often causing nerve damage.
The central placement and rigid structure make middle back injuries less common.
Upper back injuries that connect the rib and chest region can affect breathing.
Soft tissue injuries might not show up immediately.

Symptoms

After a vehicle collision, it’s common to feel sore all over. The symptoms can range from manageable discomfort to complete immobility. Individuals may experience the following:

Muscle spasms

The muscle may repeatedly twitch, feel like hard knots, and feel tender to the touch.
Muscle spasms can vary in pain levels from mild to debilitating.

Stiffness

Individuals may not feel as flexible because of the muscle tension that activated during the crash to protect the body.
Stiffness can go away after light stretching or continue throughout the day.

Burning or Shooting Pain

A burning or shooting pain may travel down the back and buttocks through the back of one or both legs.
It can be mild, dull aches and pains that go away quickly or last for days.
Changing positions, such as sitting up after waking up or standing up after sitting, can cause sharp acute pain.
Facet disease may cause neck or shoulder pain.

Discomfort When Walking or Standing

Certain physical activities can cause a throbbing sensation or mild pain when attempting to perform various tasks.

Tingling and/or Numbness

Tense muscles can pinch nerves leading to sensations of tingling or numbness in the legs, feet, arms, or hands.

Head Issues

Headaches, dizziness, or disorientation can present.

Spinal Disorders

Back injuries from vehicle collisions can result in a degenerative disc disorder months or years later. It can also speed up health issues individuals didn’t know they had before the crash. As the body ages, previous damage combined with degeneration can result in:

Pinched nerves
Sciatica
Bulging discs
Herniated discs
Spinal stenosis
Degenerative disc disease
Foraminal stenosis
Spondylolisthesis
Spinal osteoarthritis
Bone spurs
Degenerative scoliosis

Discogenic pain

Damage to spinal discs causes discogenic pain, often sharp impulses or shooting sensations.
Individuals can experience symptoms in different ways:
Some individuals feel better when standing, sitting, or lying down, while the positions or motions worsen the symptoms for others.

Chiropractic Care and Therapies

Chiropractic treatment can rule out critical issues and expedite recovery time. Benefits include:

Pain Symptom Relief

Chiropractic relieves pain in the affected areas and throughout the body.
Massaging and decompression release endorphins.

Inflammation Alleviation

Micro-tears within the muscles and ligaments are common and cannot be found through a standard x-ray.
Spinal adjustments can bring the spine back into alignment, producing natural anti-inflammatory properties to assist with discomfort and heal the tears.

Scar Tissue Breakdown

Muscles can get scarred, causing stiffness and soreness.
Chiropractic massage targets these areas and breaks down the build-up quicker than if it was left to heal on its own.
Less scar tissue means faster recovery.

Range of Motion and Mobility Restored

Back injuries can result in restricted mobility.
It may be difficult to turn or move when the muscles are inflamed.
Mobilizing the spine through adjustments restores the proper range of motion.

Decreased Medication Use

Prescription pain medications can turn into dependency.
Chiropractic adjustments can ensure that the injury is healed and the pain is not just masked.

Long-Term Benefits

Receiving chiropractic care can help prevent minor injuries from worsening into serious and chronic conditions.

Post Whiplash Symptoms

References

Erbulut, Deniz U. “Biomechanics of neck injuries resulting from rear-end vehicle collisions.” Turkish neurosurgery vol. 24,4 (2014): 466-70. doi:10.5137/1019-5149.JTN.9218-13.1

National Spinal Cord Injury Statistical Center. (2020) “Spinal Cord Injury: Facts and Figures at a Glance.” https://www.nspine injurysc.uab.edu/Public/Facts%20and%20Figures%202020.pdf

Rao, Raj D et al. “Occupant and Crash Characteristics of Elderly Subjects With Thoracic and Lumbar Spine Injuries After Motor Vehicle Collisions.” Spine vol. 41,1 (2016): 32-8. doi:10.1097/BRS.0000000000001079

Rao, Raj D et al. “Occupant and crash characteristics in thoracic and lumbar spine injuries resulting from motor vehicle collisions.” The spine journal: official journal of the North American Spine Society vol. 14,10 (2014): 2355-65. doi:10.1016/j.spinee.2014.01.038

The Effects Of Trigger Points Affecting The Chest

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Table of Contents

Introduction

The chest in the upper half of the body comprises various structures that each have a job to keep the body functioning. The chest has different large muscles surrounding the ribcage and helps protect the vital organs that allow the host to breathe. The essential organs protected by the ribcage and the chest muscles include the heart and the lungs. These two organs aid the chest with blood circulation, breathing, and digestion to keep the body moving and functional. When injuries or chronic conditions begin to affect the chest, it can cause the muscles surrounding the ribcage to contract and tighten, causing the heart and lungs to work harder and causing various issues to affect the body. This can lead to chronic symptoms in the chest and affect a person’s life. Today’s article looks at the pectoralis major muscle in the chest, how trigger point pain is associated with chest pain, and how to manage trigger points in the chest. We refer patients to certified providers who specialize in chest pain therapies to aid many people suffering from trigger point pain affecting the pectoralis major muscles. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., takes note of this information as an educational service only. Disclaimer

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The Pectoralis Major Muscles In The Chest

Have you been experiencing unexplainable chest pains that mimic heart issues? Do you feel muscle stiffness near your clavicle? Or do your chest muscles feel tenser and sorer than usual? Many of these issues affecting the chest could result from trigger points associating with the chest along the pectoralis major muscles. The pectoralis major is the superior and largest muscle in the chest wall’s front area. This muscle looks like a thick fan that surrounds the clavicle and works with the chest and arms to provide mobility and power to the upper body. Studies reveal that the pectoralis major muscle plays an important role in upper limb movements. To that point, it can help with the adduction and medial rotation of the arm, according to the book by Dr. Travell, M.D. “Myofascial Pain and Dysfunction,” the pectoralis muscle works with the rest of the chest muscles while being assisted by the teres major and minor muscles, the anterior and posterior deltoid muscles, the subscapularis muscles, and the tricep muscles. The pectoralis major muscles can also be affected by multiple issues affecting the chest and the rest of the upper half of the body.

Trigger Point Pain Associated With The Chest

When the pectoralis major muscles are affected by various issues, they can mimic other chronic conditions that are causing referred pain in different body areas. This is known as trigger point pain, and it can cause overlapping risk profiles on the pectoralis major muscles that can affect the chest. Trigger points are slightly difficult to diagnose as many factors, like repetitive motions or lifting heavy objects, can cause the affected muscles to develop tiny knots along the muscle fibers and cause pain-like symptoms. Many people with chest pains often complain that something is affecting their heart as they place their hands on their chest and gently rub the affected area. However, when their doctors examine them, the issue is not their hearts but their chest muscles. Studies reveal that trigger points affecting the affected muscle can mimic issues like cardiovascular dysfunction in the heart. To that point, active trigger points in the pectoralis major muscle can cause somato-visceral pain to the heart, mimicking cardiovascular issues like paroxysmal arrhythmia. It can also cause visceral-somatic pain where the heart suffers from cardiovascular problems affecting the pectoralis major muscles.

Trigger Point Therapy On The Pectoralis Major-Video

Trigger Point Therapy - Pectoralis Major

Have you been dealing with chest pains that cause you to hunch over? Does your chest seem to feel tight when you stretch? Or have your chest muscles feel tender to the touch? These pain symptoms are caused by trigger points affecting the pectoralis muscles. Trigger points are generated when a person overuses their muscles from daily activities or succumbs to muscle injuries that cause referred pain in different body areas. So trigger points affecting the pectoralis major muscle may cause chest pains. The video above explains the pectoralis muscles and where the trigger points are located that cause referred pain to the shoulders and the rest of the upper half of the body. Trigger points associated with the chest along the pectoralis major muscles can be treatable through various treatments and techniques that can reduce the symptoms and prevent trigger points from forming along the affected muscle in the future.

Ways To Manage Trigger Points On The Chest

When trigger points affect the pectoralis major muscles, they can invoke chest pain-like symptoms that resemble a cardiovascular disorder. Fortunately, pain specialists like chiropractors, massage therapists, and physiotherapists can utilize various techniques to help reduce the pain caused by trigger points. Studies reveal that when local and referred pain affects the pectoralis major muscle, multiple massage treatments targeting the trigger points can help alleviate the symptoms causing chest pains. Another way people can manage trigger points is by stretching the pectoralis major muscle to relieve tension and soreness in the chest. Incorporating various stretching techniques to alleviate chest pain can help loosen up the stiff muscles and warm them up before a vigorous workout. This allows the pectoralis muscles to provide optimal output on a person’s health and wellness.

Conclusion

The pectoralis major is a thick fan-shaped muscle located on the chest. This muscle works with the shoulders and upper half of the body while protecting the heart and the lungs from various injuries and chronic conditions. When these muscles become affected by injuries or chronic conditions, they can develop trigger points along the chest, causing referred pain to the pectoralis major muscles. This can lead to somato-visceral and visceral-somatic pain symptoms in the chest and make many individuals miserable. Luckily pain specialists who can help manage trigger points along the affected muscle utilize various techniques to reduce the symptoms and prevent trigger points from forming in the affected muscle again. This allows the individual to continue with their daily activities without worrying about chest pains.

References

Haładaj, Robert, et al. “Anatomical Variations of the Pectoralis Major Muscle: Notes on Their Impact on Pectoral Nerve Innervation Patterns and Discussion on Their Clinical Relevance.” BioMed Research International, Hindawi, 2 Apr. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466946/.

Moraska, Albert F, et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.” American Journal of Physical Medicine & Rehabilitation, U.S. National Library of Medicine, Sept. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561477/.

Simons, David G. “Cardiology and Myofascial Trigger Points: Janet G. Travell’s Contribution.” Texas Heart Institute Journal, U.S. National Library of Medicine, 2003, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC152827/.

Solari, Francesca, and Bracken Burns. “Anatomy, Thorax, Pectoralis Major Major.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 26 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK525991/.

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

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Muscle Twitching Chiropractor: Sciatica Clinic

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Chiropractor stretches a female patient leg. Male physiotherapist is helping woman stretching his leg in exercise room

Nerves control muscle fibers. Muscle twitching is an involuntary contraction of the muscle fibers. When individuals play sports/work out vigorously or for a long time, they may experience muscle twitching and can often see and/or feel the twitches happening. The most worked-out muscles are likely to twitch, which includes the biceps, thighs, and calves, but twitches can occur in any muscle. Chiropractic care, massage therapy, and functional medicine can help relax the muscles, improve circulation, restore function, and train individuals to prevent future episodes.

Table of Contents

Muscle Twitching

A muscle twitch often occurs after intense physical activity or a hard workout because the muscle or muscles have been overworked, and there is hyper-excitability of the nerve/s that makes the muscle/s continue to contract.

A muscle twitch that can be seen is called fasciculation.
A muscle twitch that cannot be seen is called fibrillation.
If there is pain or the twitching is prolonged, it is a muscle spasm.

Causes

The most common causes include the following:

Intense exercise and rigorous physical activity build up lactic acid in the muscles.
Dehydration is a very common factor for shaky muscles.
Vitamin D and calcium deficiencies could cause muscle spasms in the hand, calves, and eyelids.
Using caffeinated products to increase physical performance.
Not enough or a lack of healthy sleep.
Anxiety or stress.
Certain medications like estrogen and corticosteroids.
Nicotine and tobacco use.

Physical Activity/Exercise

Intense exercise and physical activity can cause muscle fatigue.
Muscle fatigue triggers twitching and cramping in overworked muscle fibers.
Electrolytes play a role in muscle contraction.
Electrolyte loss and imbalances within muscle fibers through sweating can lead to twitching.

Dehydration

Muscle mass comprises 75% water.
Water carries nutrients and minerals to muscles to support function.
Not being properly hydrated can cause twitching and cramping.

Vitamin D Deficiency

Nerves need vitamin D to relay messages to and from the brain to the body’s muscles.
A vitamin D deficiency can cause muscle weakness and twitching.

Magnesium Deficiency

Magnesium deficiency is known as hypomagnesemia.
Magnesium plays a role in maintaining nerve and muscle health.
Magnesium helps transport calcium across cell membranes to support nerve and muscle function.
A magnesium deficiency can cause twitching anywhere in the body, including the face.

Causes of magnesium deficiency include:

Poor diet
Diarrhea
Drinking too much alcohol
Not addressing magnesium deficiency can increase the risk of cardiovascular disease.

Caffeine

Caffeine is a stimulant.
Drinking too much coffee, tea, or energy drinks can cause fasciculation.

Not Enough Sleep

Brain chemicals or neurotransmitters transmit information from the brain to the nerves that control muscle contraction.
Sleep deprivation can affect how neurotransmitter receptors work.
This means excess neurotransmitters can build up in the brain.
Lack of sleep can affect neurotransmitter function.
A common site of fasciculation tiredness occurs in the eyelids.

Anxiety and Stress

Experiencing psychological stress or high anxiety levels can cause excess muscle tension.
This can lead to muscle twitching.
Muscle fasciculation caused by stress can occur anywhere in the body.

Certain Medications

Certain medications can lead to involuntary muscle twitching.
The reaction can be a side effect due to interactions with other medications.
Individuals should discuss side effects and medication interactions with their doctor when taking a new medication.

Chiropractic Care

Chiropractors are experts on the musculoskeletal system and have many techniques to treat muscle fasciculation and spasms. It often depends on the cause/s, and specific treatment varies on a case-by-case basis. Common chiropractic treatments include:

Massage therapy
Heat and ice therapy
Manual manipulation
Joint adjustments
Ultrasound
Stretches to keep the muscles flexible
Exercises to strengthen the muscles
Nutritional recommendations

Fasciculation

References

Bergeron, Michael F.. Muscle Cramps during Exercise-Is It Fatigue or Electrolyte Deficit?. Current Sports Medicine Reports July 2008 – Volume 7 – Issue 4 – p S50-S55 doi: 10.1249/JSR.0b013e31817f476a

Gragossian A, Bashir K, Friede R. Hypomagnesemia. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500003/

Küçükali, Cem Ismail, et al. “Peripheral nerve hyperexcitability syndromes.” Reviews in the neurosciences vol. 26,2 (2015): 239-51. doi:10.1515/revneuro-2014-0066

Maughan, Ronald J, and Susan M Shirreffs. “Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining.” Sports medicine (Auckland, N.Z.) vol. 49, Suppl 2 (2019): 115-124. doi:10.1007/s40279-019-01162-1

Miller, Kevin C et al. “Exercise-associated muscle cramps: causes, treatment, and prevention.” Sports health vol. 2,4 (2010): 279-83. doi:10.1177/1941738109357299

Riebl, Shaun K, and Brenda M Davy. “The Hydration Equation: Update on Water Balance and Cognitive Performance.” ACSM’s health & fitness journal vol. 17,6 (2013): 21-28. doi:10.1249/FIT.0b013e3182a9570f

Myofascial Trigger Pain Affecting The Thumb Muscles

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

Table of Contents

Introduction

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

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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

Trigger Finger & Trigger Thumb - Everything You Need To Know - Dr. Nabil Ebraheim

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.