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Shoulder Joint Pain Associated With Trigger Points

By
Dr. Alex Jimenez
-

Introduction

As the body’s most mobile joints, the shoulders are surrounded by muscles, tissues, and ligaments that help support the shoulders and the rotator cuff in mobility function, thus ensuring the shoulders remain in a stable, normal position. As a complex structure that is made up of three bones: the humerus (upper arm bone), the scapula (shoulder blades), and the clavicle (collarbone), the shoulders provide a wide range of motion without feeling pain. When injuries affect the muscles, tissues, and joints of the shoulders, they can potentially develop tiny knots along the muscle fibers and invoke pain-like symptoms on the upper extremities of the body. To that point, it affects not only the shoulders but also the arms and the hands. Today’s article looks at the infraspinatus muscle, how shoulder joint pain is associated with trigger points, and various treatments to manage trigger points related to the shoulder joint. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulder joints and the infraspinatus muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Is The Infraspinatus Muscle?

 

Do you feel stiffness along your shoulders or upper arms? Does it hurt when you rotate your shoulders? Or have you been experiencing a tingling or numbing sensation traveling down your arms? Many people who experience shoulder pain might be due to trigger points affecting their infraspinatus muscles. The infraspinatus muscle is a muscle that looks like a thick triangle that covers the front of the scapula. The infraspinatus is a part of the rotator cuff muscles or commonly referred to as SITS:

  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis

These four muscles provide the functionality to the rotator cuffs in the shoulders to allow the arms full range of motion. Studies reveal that rotator cuff activity from these muscles is crucial for normal shoulder motion. To that point, the infraspinatus plays a vital role by providing dynamic stability while producing external rotation at the shoulder. However, traumatic forces can affect the infraspinatus muscles causing lesions and other conditions to affect the shoulders and rotator cuffs, causing pain-like symptoms to the upper half of the body.

 

Shoulder Joint Pain Associated With Trigger Points

 

Since shoulder pain is the third most common musculoskeletal disorder, the underlying causes are rotator cuff disorders and referred pain in the neck. When traumatic factors begin to affect the shoulder muscles and the rotator cuff muscles, it can potentially lead to the development of myofascial pain syndrome or trigger points along the muscle fibers of the shoulders. Referred pain causes pain in one area of the body when in actuality is affecting the other side of the body. For trigger points associated with shoulder joint pain, studies reveal that myofascial pain from trigger points in the infraspinatus may give rise to referred pain in the arms, shoulders, or even the cervical spine in some patients. To that point, trigger point pain associated with the shoulder joint may mimic carpal tunnel symptoms around the wrist. When trigger points mimic other chronic conditions, it often makes it a bit harder to diagnose the symptoms. 

Treating Trigger Point Release On The Infraspinatus Muscle-Video

Trigger Point Release - Infraspinatus Muscle

Have you been dealing with pain-like symptoms in your wrist? Do you feel muscle stiffness when rotating your shoulders? Or have you been experiencing numbness or tingling sensations from the shoulders to the fingertips? If you have been experiencing any of these symptoms, it could be referred to pain from trigger point pain associated with the infraspinatus muscle on the shoulder joint. Trigger points form tiny nodules along the taut muscle fibers of the affected muscle area. The video above explains where the trigger points are located on the infraspinatus muscle on the scapula (shoulder blades) and how to release the trigger points. All is not lost, as various treatments can help manage trigger points associated with the shoulder joint. Studies reveal that chronic musculoskeletal disorders in the shoulder joint are often associated with myofascial trigger points, causing referred pain along the arm down to the fingertips. To that point, pain specialists incorporate and apply acupuncture or dry needling on the trigger point can help improve pain and disability for many individuals with shoulder pain.

Treatments Managing Trigger Points Associated With The Shoulder Joint

 

When many individuals are dealing with trigger point pain associated with the shoulder joint, they sometimes believe that it could be something that is affecting their heart. Now, why would the heart be associated with the shoulder joint? This is due to somato-visceral pain (the affected muscle is causing issues to the corresponding organ) that is causing referred pain to affect the heart. When patients go to their primary doctors, they go through an examination to see what the issue is, and this allows the doctor to go through a clinical process to come up with a diagnosis of what is going on, which in this case is trigger points associated with the shoulder joint. Once the doctor diagnoses the issue, they can refer their patients to a pain specialist like a chiropractor, massage therapist, or a physiotherapist to manage the trigger points in the affected muscle area. Chiropractors, massage therapists, and physiotherapists utilize various techniques to relieve trigger points from the infraspinatus muscle in the shoulder joints. Some of the available treatments that are used to manage trigger points associated with the shoulder joint include:

  • Stretching
  • Ice/Heat Compress
  • Spinal Adjustments
  • Acupuncture
  • Trigger Point Injection

 

Conclusion

The muscle known as the infraspinatus is part of the rotator cuff that works along the shoulder and looks like a thick triangle on the scapula or shoulder. This muscle helps the rotator cuff activity for normal shoulder motion by providing dynamic stability while performing external rotation on the shoulder. When traumatic factors affect the infraspinatus muscle, it can develop trigger points along the muscle fibers of the infraspinatus muscle and cause referred pain along the shoulders and down to the arms. Fortunately, various treatments available can manage trigger points and relieve the pain from producing more issues along the shoulder. To that point, many individuals can have normal shoulder function without pain.

 

References

Ha, Sung-Min, et al. “Selective Activation of the Infraspinatus Muscle.” Journal of Athletic Training, National Athletic Trainers Association, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3655748/.

Kamali, Fahimeh, et al. “Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger Point Therapy by Dry Needling in Overhead Athletes with Unilateral Shoulder Impingement Syndrome.” Journal of Sport Rehabilitation, U.S. National Library of Medicine, 30 Nov. 2018, pubmed.ncbi.nlm.nih.gov/29364040/.

Meder, Marek A, et al. “Reliability of the Infraspinatus Test in Carpal Tunnel Syndrome: A Clinical Study.” Journal of Clinical and Diagnostic Research : JCDR, JCDR Research and Publications (P) Limited, May 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5483796/.

Williams, Jeslin M, et al. “Anatomy, Shoulder and Upper Limb, Infraspinatus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 13 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK513255/.

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Recommended Chiropractic Supplements: Sciatica Clinic

By
Dr. Alex Jimenez
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chiropractor talking with attractive patient in t-shirt in clinic

Chiropractic treatment focuses on the musculoskeletal and nervous systems. As with all body systems, specific nutrients protect and increase their functional strength. Various chiropractic-recommended supplements can help in the treatment of musculoskeletal issues and help transform an individual’s health.

Recommended Chiropractic SupplementsChiropractic Education

Chiropractors study food-based supplements that are bio-available to cells and are easily absorbed by the body. These food-based supplements and vitamins are seen as food by the body. Supplements are used in detoxification to overcome nutritional deficiencies and enhance an individual’s diet by taking nutrients to optimum levels. Immune system health can also be strengthened by keeping the body resistant to diseases.

Functional Nutrition

Chiropractic medicine study’s all the building blocks of the body that, include:

Holistic nutrition teaches that the body heals from within, which is why healing the gut first, is essential to healing the rest of the body and maintaining health.

Recommended Chiropractic Supplements

Dietary supplements that directly impact the health of the musculoskeletal and the nervous system.

Potassium

  • Potassium is an important regulator of nerve impulses.
  • Electrochemical signals or action potentials use potassium and sodium to generate responses from cells in the nervous system.
  • Potassium is necessary for turning off nerve impulses and preventing the uncontrolled signaling of nerves.
  • Uncontrolled signaling can lead to movement disorders.

Calcium

  • Calcium is necessary for the regulation of the action potentials throughout the body.
  • Calcium helps initiate action potentials and helps the cells return to a normal state afterward.
  • Calcium contributes to the development of the nervous system helping guide the nerve cells.
  • Calcium is a major element of bone health to repair bones’ and facilitate regrowth.
  • The body will take the calcium from the bones if there is a calcium deficiency.

Vitamin D

  • One of the most important nutrients for bone health.
  • Vitamin D helps promote bone development and growth.
  • Facilitates calcium absorption helping the body process and absorb the calcium.
  • Increases the effectiveness of daily calcium.

Vitamin B12

  • A member of the B Complex.
  • B12 is essential to the function of the nervous system and the body’s metabolism.
  • B12 breaks complex carbohydrates into more simplistic glucose for basic functions.
  • B12 helps maintain the nerve insulator myelin, which is necessary for nerve transmission.
  • B12 deficiency has been linked to the loss of myelin and can lead to serious conditions like Alzheimer’s.
  • B12 shots deliver the nutrient directly to the bloodstream bypassing the absorption process necessary for oral supplements.

Vitamin K

  • Vitamin K helps balance and facilitate calcium absorption.
  • Vitamin K helps strengthen bones and increase bone density.
  • Often recommended for individuals with osteopenia and osteoporosis to help prevent fractures.

How To Choose Supplements

References

Lee, Mi Kyung, et al. “The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network.” Chiropractic & manual therapies vol. 26 7. 20 Feb. 2018, doi:10.1186/s12998-018-0175-1

Nguyen, Douglas L. “Guidance for supplemental enteral nutrition across patient populations.” The American journal of managed care vol. 23,12 Suppl (2017): S210-S219.

Pludowski, Pawel, et al. “Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence.” Autoimmunity reviews vol. 12,10 (2013): 976-89. doi:10.1016/j.autrev.2013.02.004

Song, Yong-Ak, et al. “Electrochemical activation and inhibition of neuromuscular systems through modulation of ion concentrations with ion-selective membranes.” Nature materials vol. 10,12 980-6. 23 Oct. 2011, doi:10.1038/nmat3146

Trigger Points Affecting The Rotator Cuffs

By
Dr. Alex Jimenez
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Introduction

The shoulder muscle functionality allows support and stability to the flexible joints in the body. The shoulders allow a full range of motion without feeling pain or discomfort, like throwing a ball or reaching an item on the shelf. The shoulders are also supported by many muscles, tendons, and ligaments surrounding the rotator cuffs that allow the shoulders to remain stable. The rotator cuffs consist of four muscle groups that allow the arms to be mobile. However, the range of motion from the shoulders and the rotator cuff can be prone to injuries and become unstable. To that point, the shoulders and their associated muscles are often the sites for many issues to develop. Today’s article looks at the supraspinatus muscles in the rotator cuffs, how trigger points affect the rotator cuffs and various therapies for rotator cuff injuries. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulders affecting the rotator cuffs and the supraspinatus muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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The Supraspinatus Muscles In The Rotator Cuffs

 

Do you feel stiffness along your shoulders? Does it hurt when you rotate them? Or have you been experiencing numbness and tenderness traveling your upper arm? Individuals experiencing these symptoms in their shoulders could be dealing with trigger points along the supraspinatus muscles. The supraspinatus muscle resides in the supraspinous fossa of the scapular spine and is superiorly located in the rotator cuff muscles. The supraspinatus muscle is associated with the other muscles that surround and support the rotator cuffs in the shoulder, which include:

  • Infraspinatus
  • Teres Minor
  • Subscapularis

These four muscles closely relate to the deltoid muscles to provide stability, movement, and rotation to the upper arm joint. When issues affect the shoulders or the rotator cuffs, it can cause the rotator cuff muscles to develop trigger points and other associated symptoms along the upper arm. 

 

How Trigger Points Affect The Rotator Cuffs

 

When the muscles of the rotator cuffs become injured, many issues may cause musculoskeletal complaints. Studies reveal that tendinopathy or tendon injuries are often characterized by pain in and around the tendons in the rotator cuffs and are associated with repetitive actions. When the supraspinatus muscle becomes overused due to repetitive motions, it can develop trigger points to affect the rotator cuffs. Studies reveal that local and referred pain symptoms reproduce active trigger points in the muscles surrounding the shoulders and rotator cuff that many individuals recognize as familiar pain. According to Dr. Janet G. Travell, M.D., the activation of trigger points associated with the supraspinatus muscles are activated from strenuous activities like carrying heavy objects, walking a large dog that is pulling the leash, or lifting an object above shoulder height with the arms outstretched. These strenuous activities allow the trigger points to form along the supraspinatus muscles and cause referred pain symptoms on the shoulders. 

 

Stretching The Supraspinatus Muscles- Video

Trigger Points - Stretching Supraspinatus

Have you been feeling stiffness along your shoulders? Do you feel tenderness in certain areas of your shoulders or arms? Or do you experience a numbing sensation running down your arms? If you have been experiencing these issues along your shoulders and upper arms, it could be due to trigger points associated with the supraspinatus muscles. Trigger points are small knots along the taut muscle band of any muscle group that can mimic any overlapping condition that can cause issues to the body. For example, shoulder pain is associated with trigger points along the supraspinatus muscle. The video above shows how to stretch the supraspinatus muscles to reduce future trigger points from forming along the rotator cuff muscles. Individuals who incorporate stretching exercises for shoulder pain associated with the supraspinatus can feel relief in their shoulders as the overall function is restored and the pain is reduced. 

Various Therapies For Trigger Points Associated With The Rotator Cuffs

 

The various therapies for trigger points associated with the rotator cuffs can help reduce the pain-like symptoms along the supraspinatus muscles. Studies reveal that exercises and manual therapy can help decrease pain along the supraspinatus muscles and increase shoulder muscle strength and function. Other treatments like chiropractic care can benefit many patients with shoulder pain or injuries that can help reduce pain, improve ROM (range of motion), increase flexibility, and even restore function to the joint. Depending on how severe the muscle injury is on the shoulders, chiropractors utilize various techniques to assess the pain and help address all the areas of the body to relieve the issue without using drugs.

 

Conclusion

The supraspinatus muscles are part of the rotator cuff muscle group and work alongside the shoulder muscles to provide mobility and a full range of motion to the upper arm without feeling pain. When strenuous activities or injuries occur to the shoulders or the rotator cuffs, it can cause myofascial pain syndrome or trigger points to develop along the overused muscles in the shoulders and cause pain-associated symptoms. This can affect the mobility of the shoulders and arms from going through a full range of motion. Various therapies are available to help reduce pain, restore functionality to the shoulders and surrounding muscles associated with trigger points, and can help improve motor function. Treatments for shoulder pain associated with trigger points can help prevent future issues from forming and improve shoulder functionality.

 

References

Hidalgo-Lozano, Amparo, et al. “Muscle Trigger Points and Pressure Pain Hyperalgesia in the Shoulder Muscles in Patients with Unilateral Shoulder Impingement: A Blinded, Controlled Study.” Experimental Brain Research, U.S. National Library of Medicine, May 2010, pubmed.ncbi.nlm.nih.gov/20186400/.

Jeno, Susan H, et al. “Anatomy, Shoulder and Upper Limb, Arm Supraspinatus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 7 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK537202/.

Spargoli, Guido. “Supraspinatus Tendon PATHOMECHANICS: A Current Concepts Review.” International Journal of Sports Physical Therapy, Sports Physical Therapy Section, Dec. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6253746/.

Şenbursa, Gamze, et al. “The Effectiveness of Manual Therapy in Supraspinatus Tendinopathy.” Acta Orthopaedica Et Traumatologica Turcica, U.S. National Library of Medicine, 2011, pubmed.ncbi.nlm.nih.gov/21765229/.

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Yoga and Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
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young businesswoman having online classes on laptop and stretching hands in lotus position on mat in

Chiropractic care focuses on whole-body health, restoring optimal body function, helping injuries heal/rehabilitate, and maintaining musculoskeletal health. Yoga is one of the most popular forms of fitness because it is not overly physically demanding but still increases flexibility and muscle tone, helps with weight loss, improves cardiovascular and circulatory health, and enhances breathing and energy levels. Yoga provides benefits that directly relate to chiropractic, making the treatment more effective.Yoga and Chiropractic

Yoga and Chiropractic

Yoga is an exercise focusing on mindfulness combined with deep stretches and focused breathing. Yoga focuses on balance, flexibility, and strength.

  • It helps to lower blood pressure and stress levels by releasing built-up tension.
  • It increases endurance and stamina.
  • It builds strength.
  • Helps to activate the body’s natural healing process.
  • It stretches the muscles, ligaments, and tendons, keeping them loose and flexible, enhancing chiropractic adjustments.

Chiropractic

Chiropractic is multi-faceted, restoring the wellness of the neuromusculoskeletal system that involves the nerves, muscles, and bones. It works holistically with the body’s natural processes to restore balance and overall health.

  • Realigns the spine.
  • Returns the natural shape of the body’s structure.
  • Clears interference from the nervous system.
  • Rejuvenates the body.

Customized chiropractic adjustments, spinal decompression, and traction treatment plans help shift spinal deformities back toward proper balance.

Strengthen Soft Tissues

Yoga and chiropractic work and strengthen all the:

  • Connective tissues
  • Muscles
  • Ligaments
  • Tendons
  • Increasing the strength of the joints throughout the body reduces stress and the risk of injury.

Promote Healing

Yoga and chiropractic:

  • Prepare the body for healing.
  • Stretch and elongate the body.
  • Release built-up tension and stress.
  • Activate the body for healing.

Prevent Injury

Yoga and chiropractic:

  • Maintain body alignment.
  • Increase balance.
  • Stretch and relieve tense muscles.
  • Ensure proper joint operation.
  • Make the body less susceptible to injury.

Educate Individuals About The Body

Chiropractors and yoga teachers can educate individuals on how the body works, maintaining muscle strength, teaching posture awareness, and nervous system function for a healthier life.

Yoga Body Flow

References

Biman, Saranga, et al. “Effects of yoga on stress, fatigue, musculoskeletal pain, and the quality of life among employees of the diamond industry: A new approach in employee wellness.” Work (Reading, Mass.) vol. 70,2 (2021): 521-529. doi:10.3233/WOR-213589

da Costa, Fernanda Mazzoni, et al.”“Effects of an intervention program with health education and hatha yoga on the health of professionals with musculoskeletal symptoms”” Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT vol. 18,2 114-124. 11 Dec. 2020, doi:10.47626/1679-4435-2020-492

Hawk, Cheryl, et al.” Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline” Journal of alternative and complementary medicine (New York, N.Y.) vol. 26,10 (2020): 884-901. doi:10.1089/acm.2020.0181

Kolasinski, Sharon L et al.” 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee” Arthritis care & research vol. 72,2 (2020): 149-162. doi:10.1002/acr.24131

www.nccih.nih.gov/health/providers/digest/use-of-yoga-meditation-and-chiropractic-by-adults-and-children-science

Urits, Ivan et al.” A Comprehensive Review of Alternative Therapies for the Management of Chronic Pain Patients: Acupuncture, Tai Chi, Osteopathic Manipulative Medicine, and Chiropractic Care” Advances in therapy vol. 38,1 (2021): 76-89. doi:10.1007/s12325-020-01554-0

It Could Be More Than Shoulder Pain

By
Dr. Alex Jimenez
-

Introduction

The body is a functional machine that requires many muscles, organs, ligaments, joints, and tissues that provide everyday movements. In the upper extremities, the head, neck, and shoulders have many muscles, ligaments, and tissues that work together with the nerve roots from the nervous system that provides sensory-motor function to make the fingers move, the shoulders rotate, and the head turns from side to side. When injuries or common issues affect the muscles in the head, neck, or shoulders, it can cause small nodules to form along the muscle fibers of the affected muscle area and cause referred pain in different locations of the body. Today’s article looks at the scalene muscles, how trigger points affect the scalene muscles while mimicking shoulder pain, and how to manage chronic pain associated with trigger points. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulders affecting the scalene muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Are The Scalene Muscles?

Have you been experiencing tingling sensations running down your fingertips? Do you feel stiffness when rotating your neck or shoulders? Or do you feel muscle soreness in your shoulders? Many individuals who are feeling any of these symptoms affecting their neck or shoulders could be dealing with trigger point pain along the scalene muscles. The scalene muscles play a crucial part in the head and neck as they are deep muscles positioned laterally on the cervical tract of the spine. These muscles have three different branches: the anterior, medius, and posterior, which play the role of being accessory breathing muscles while being an important contributor to head and neck movement. To that point, it allows stability to the cervical spine. The scalene muscles even help support and elevate the upper rib cage when a person is lifting, pulling, or carrying heavy objects. However, like most muscles in the body, the scalene muscles can be prone to injury and can develop issues that can affect the upper extremities of the body.

 

Trigger Points Affects The Scalene Muscles Mimicking Shoulder Pain

When common injuries like pulling a muscle when carrying a heavy object or even a traumatic injury like being involved in an auto accident can cause pain in the affected area, over time, if not treated, can cause various symptoms to overlap and affect the muscles. When the scalene muscles are affected by injuries, they can develop tiny nodules along the taut muscle fibers and become hyperirritable to the surrounding areas of the upper half of the body. This is known as trigger point pain and can mimic other chronic issues that affect different body areas. To that point, trigger points affecting the scalene muscles may mimic shoulder pain in the upper half of the body. Studies reveal that scalene myofascial pain is a regional pain syndrome that originates pain in the neck area and radiates pain down to the arm. Since trigger points mimic other chronic issues, it is often misdiagnosed as another neck pain associated with radiculopathy when the scalene muscles are affected. When this happens, the muscles become stiff and weak, causing a reduction in the range of movement. 

 

 

Studies reveal that when individuals suffer from acute whiplash-associated disorders, the local and referred pain can be elicited from active trigger points to reproduce neck and shoulder pain. This causes a higher disability that exhibits widespread pressure causing the muscles to be hypersensitive and reducing the cervical range of motion. Many individuals often complain about shoulder pain while rubbing the upper parts of their arms. The scalene muscle is affected by active trigger points, thus mimicking shoulder pain.

 

Scalenes Trigger Points-Video

Scalenes Trigger Points

Have you been feeling muscle stiffness in your neck or shoulders? Have you been experiencing a numbing sensation along your arms? Have you felt tenderness along your shoulders when you touch them? Many of these pain symptoms are associated with trigger points along the scalene muscles. The video above explains where the trigger points are located along the scalene muscles and how they are causing referred pain in the neck and shoulder areas. Many factors can lead to the causation of trigger point pain and overlap with other chronic issues that can affect the upper extremities of the body, using sleep as an example. Studies reveal that poor sleeping posture can affect the neck and shoulders, leading to muscle stiffness along the scalene muscles and developing trigger points over time. Fortunately, various ways to manage referred shoulder pain are associated with trigger points.

Management Of Chronic Shoulder Pain Associated With Trigger Points

 

Many individuals are referred to pain specialists that can alleviate trigger points along the scalene muscle to reduce the effects of shoulder and neck pain. When referred pain along the scalene muscles causes chronic shoulder pain associated with trigger points, many people often do various movements to alleviate the pain. However, it can cause more pain in the affected area and prevent relief from the neck and shoulders. Studies reveal that various treatments like physiotherapy, trigger point injections, manipulation of the cervical spine, or acupuncture can help relax and lengthen the muscle fibers associated with the scalene muscle. To that point, this allows the neck to extend further without pain and reduces the overlapping symptoms that affect the upper extremities of the body. 

 

Conclusion

The scalene muscles play a crucial part in the head and neck area as deep muscles are positioned laterally on the cervical tract of the spine. These muscles help elevate the upper chest and laterally bend the neck from side to side. When injuries affect the scalene muscles and form tiny nodules known as trigger points, it can cause referred pain to the shoulders and the neck. To that point, symptoms like numbing or tingling sensations can travel down the arms and fingers. Fortunately, available treatments can reduce the symptoms and manage myofascial trigger pain along the shoulders and neck associated with the scalene muscles. This allows a better range of motion to the neck and shoulder and prevents future trigger points from forming in the scalene muscles.

 

References

Abd Jalil, Nizar, et al. “Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases.” The Malaysian Journal of Medical Sciences : MJMS, Penerbit Universiti Sains Malaysia, Jan. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC3216145/.

Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Head and Neck, Scalenus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 16 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK519058/.

Fernández-Pérez, Antonio Manuel, et al. “Muscle Trigger Points, Pressure Pain Threshold, and Cervical Range of Motion in Patients with High Level of Disability Related to Acute Whiplash Injury.” The Journal of Orthopaedic and Sports Physical Therapy, U.S. National Library of Medicine, July 2012, pubmed.ncbi.nlm.nih.gov/22677576/.

Lee, Won-Hwee, and Min-Seok Ko. “Effect of Sleep Posture on Neck Muscle Activity.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5468189/.

Thapa, Deepak, et al. “Management of Chronic Shoulder Pain with Restricted Mobility – a Case Series.” Indian Journal of Anaesthesia, Medknow Publications & Media Pvt Ltd, Nov. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5125193/.

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Acute, Chronic, Alternating, and Bilateral Sciatica Clinic

By
Dr. Alex Jimenez
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A female physiotherapist giving diathermy treatment on the patient's back.

Sciatica is common and affects up to 40% of the general population. Different types include acute, chronic, alternating, and bilateral sciatica. The sciatic nerve comprises three specific nerve roots in the lower back. The three nerves originate in the L4 and L5 vertebrae and the sacrum, just below the vertebrae. The nerve then branches off and runs through the back of each thigh. Injury, compression, or irritation of these nerves can cause various symptoms, including numbness, tingling, electrical shooting pain, and muscle spasms in the low back, the leg, and the foot. Chiropractic care can realign the spine, relax the muscles, release compression and relieve sciatica.Acute, Chronic, Alternating, and Bilateral Sciatica Chiropractor

Acute, Chronic, Alternating, and Bilateral Sciatica

Acute

  • Acute pain can be brought on by sudden irritation to the nerves that have become pinched, compressed, or a combination.
  • Causes a constant burning or shooting sensation through the low back, buttocks, down the leg, and possible hip discomfort.
  • It becomes worse when sitting.
  • It can cause immediate and short-term pain lasting for 1-2 weeks.

Chronic

  • Chronic sciatica can last for months or years on and off or continuously.
  • It can be caused or worsened by inflammatory conditions like rheumatoid arthritis, injuries, infections, and spinal misalignment issues.
  • It can resolve but will come back without treatment or lifestyle and activity adjustments.

Bilateral

  • Sciatica typically takes place in one leg; it has been known to be bilateral and experienced in both legs.
  • This type of sciatica is rare but can occur from degenerative changes in the vertebrae and/or the discs at several spinal levels.
  • If there is pain in both legs, it is likely not a herniation but degenerative changes like spinal stenosis.
  • The symptoms can range from infrequent to irritating to severe and debilitating.
  • It could be a red flag symptom of cauda equina syndrome.
  • Weakness may be felt in the leg and foot, or a feeling of heaviness, making it difficult to lift the foot off the floor.

Alternating

  • Alternating sciatica affects both legs alternately. It is usually connected to bilateral sciatica that switches sides.
  • This type is rare and can result from degenerative problems in the sacroiliac joint, the joint connecting the spine to the hips, or sacroiliac arthritis.

Spinal Sources

Sciatica occurs when L4, L5, and/or S1 nerve roots are affected.

L4 Nerve Root

  • Pain in the hip, thigh, inner medial areas or the knee, and the calf.
  • Weakness in the thigh and hip muscles.
  • Reduced knee-jerk reflex.
  • Loss of sensation around the calf.

L5 Nerve Root

  • Pain in the buttock and the outer area of the thigh.
  • Weakness in the buttock and leg muscles.
  • Difficulty moving the ankle and lifting the big toe upward.
  • Loss of sensation between the big toe and the second toe.

S1 Nerve Root

  • Known as classic sciatica.
  • Pain in the buttock, back of the calf, and side of the foot.
  • Fatigue in the buttock and foot muscles.
  • Difficulty and discomfort raising the heel off the ground or walking on tiptoes.
  • Loss of sensation in the foot’s outer side, including the third, fourth, and fifth toes.
  • Reduced ankle-jerk reflex.

Chiropractic Care

Chiropractic care can directly address the root cause of the problem, treat the cause, and alleviate the symptoms. Chiropractic manipulation is recommended by the American College of Physicians as a first line of treatment for back pain before medication, muscle relaxants, injections, and surgery. Treatments to address sciatic nerve impingement:

Ice/Cold Therapy

  • Reduces inflammation and swelling.
  • Prepares the patient for massage and adjustments.

Therapeutic Tissue Massage

  • This therapy promotes muscle relaxation and lessens the muscle spasm/recoil response.

Ultrasound

  • Soothing heat created by sound waves penetrates the muscles, increases circulation, and relaxes the muscles to alleviate spasms, stiffness, and pain.

Transcutaneous Electrical Nerve Stimulation/Tens Unit

  • A muscle stimulation machine applies electrical impulses to relax the muscles and untangle muscle knots.

Spinal Manipulation

  • This process realigns the spine to move properly and restores vertebral health.

Stretches and Exercises

  • This ensures treatment will last once treatment has or is coming to an end.

Spinal Decompression

  • Pulls and stretches the body to release any compression on the nerve roots and infuse circulation back into the discs.

The pressure is taken off the sciatic nerve, and routine adjustments will retrain the muscles to maintain their re-alignment. The duration of treatment will vary based on the root cause of sciatica. Each treatment plan is tailored to the individual patient’s situation.

Severe and Complex Sciatica Syndromes

References

Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK507908/

Hernández C.P., Sanchez N., Navarro-Siguero A., Saldaña M.T. (2013) What is Sciatica and Radicular Pain?. In: Laroche F., Perrot S. (eds) Managing Sciatica and Radicular Pain in Primary Care Practice. Springer Healthcare, Tarporley. doi.org/10.1007/978-1-907673-56-6_1

Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.

Ngnitewe Massa R, Mesfin FB. Herniation, Disc. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK441822/

Ombregt L. The dural concept. In: A System of Orthopaedic Medicine. Elsevier; 2013:447-472.e4. doi:10.1016/b978-0-7020-3145-8.00033-8

Witenko, Corey, et al. “Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low-back pain.” P & T : a peer-reviewed journal for formulary management vol. 39,6 (2014): 427-35.

Wright R, Inbody SB. Radiculopathy and Degenerative Spine Disease. In: Neurology Secrets. Elsevier; 2010:121-130. doi:10.1016/b978-0-323-05712-7.00007-6

Trigger Points Associated With Levator Scapulae

By
Dr. Alex Jimenez
-

Introduction

The muscles in the body help provide motion and protect the skeletal joints from harm. Each muscle group has ligaments, tissues, and muscle fibers that retract, stretch, and contract the body while helping the host to do everyday movements, breath, digest food, stabilize, and even rest. When a person is dealing with pain from a traumatic event or making repetitive motions, it can affect the muscles over time. Factors like not drinking enough water, constantly looking down on the phones, and being hunched over can cause strain on the muscles, causing overlapping pain on top of other chronic issues that may develop. When the muscles begin to cause pain along the shoulders and neck, it can become a risk of developing trigger points in the levator scapulae muscles. Today’s article examines the levator scapulae muscles, how trigger points affect these muscles, and how treatments can help manage the trigger points on the levator scapulae muscles. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points associated with the neck and shoulders affecting the levator scapulae muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Is The Levator Scapulae?

Have you been dealing with pain along the neck or shoulders? Do you feel stiffness when turning your head from side to side? Or do you feel tenderness in the base of your neck and shoulders? Many individuals with shoulder and neck pain risk developing trigger points along the levator scapulae. The levator scapulae muscles originate from the posterior tubercles of the C1 through C4 vertebrae in the neck that is between the superior angle and the root of the scapulae spine. This superficial muscle’s primary function is to elevate the scapulae or the shoulder blades while working together with the trapezius and rhomboid muscles to assist the movement. The levator scapulae muscles also assist in providing neck extension, ipsilateral rotation, and lateral flexion. When pathologies like fibromyalgia, levator scapulae syndrome, or cervical myofascial pain begin to affect the levator scapulae muscles, the symptoms can potentially involve the shoulders and neck to cause referred pain to the upper extremities. 

 

How Trigger Points Affect The Levator Scapulae?

Many individuals with shoulder and neck pain have described radiating pain from their neck to their shoulders. Known as referred pain, the pain is located in one area of the body but in a different location. Studies reveal that when pain radiates from the neck and shoulders, any movements that are overstretching the levator scapulae can aggravate overlapping symptoms on the affected side. This allows small nodules to form along the levator scapulae muscle fibers, causing trigger points to affect the shoulder and neck muscles. 

 

 

Trigger point associated with the levator scapulae muscles causes the individual to have pain-like symptoms in the neck that causes muscle stiffness. This causes an emphasis on referred pain symptoms from the levator scapulae, like neck tension and restriction of range of motion on the neck. Studies reveal that pain over the superior angle of the levator scapulae is a common musculoskeletal disorder that is often accompanied by radiating pain on the neck, head, and shoulders. Some of the ways that trigger points form along the levator scapulae muscle can be due to ordinary factors like:

  • Stress
  • Posture
  • Over-exercising
  • Upper respiratory infections

Some of these factors above can shorten the levator scapulae muscle and restrict muscle movement to provide a full range of motion for the head and neck to turn. To that point, treatments are available to help loosen up and stretch the levator scapulae muscles to allow rotation and flexion on the neck and shoulders.

Trigger Points Anatomy On The Levator Scapulae- Video

Levator Scapulae - Trigger Point Anatomy

Have you been dealing with stress that is affecting your neck and shoulders? Have you been dealing with neck stiffness when turning your head? Or have you been feeling muscle tenderness between the neck and shoulders? Some of these symptoms are associated with trigger points affecting the levator scapulae muscles between the neck and shoulder. The video above overviews common trigger points and how they affect the levator scapulae, causing shoulder and neck pain. Since the levator scapulae muscles lay behind the trapezius muscle, studies reveal that trigger points or myofascial pain syndrome can cause hyperirritability in the muscle tissues and affect mobility functions in the nerve ends. Even though referred pain affects the neck and shoulder of the body, treatments are available to manage trigger points on the levator scapulae and relieve neck and shoulder pain.

Treatments To Manage Trigger Points On The Levator Scapulae

 

When there is trigger point pain affecting the levator scapulae, some common complaints that many individuals often complain about are neck and shoulder pain. However, various ways can alleviate the pain symptoms from the neck and shoulders while managing trigger points associated with the levator scapulae. Studies reveal that stretching the levator scapulae muscle in a seated position can improve muscle length along the levator scapulae and the cervical range of motion. Stretching the levator scapulae muscle can help reduce the pain along the levator muscle. To that point, it even helps reduce muscle imbalances and movement dysfunction along the cervical joints. Many individuals are referred to pain specialists like chiropractors by their doctors to reduce pain and functionality disability in the neck and realign the spine to loosen up the stiff muscles caused by subluxation. Realigning the cervical spine and stretching can reduce future trigger points and reduce pain symptoms from affecting the muscle.

 

Conclusion

The levator scapulae muscles in the body provide movement functionality to the neck and shoulders. The levator scapulae work together with the trapezius and rhomboid muscles to elevate the shoulder blades and assist with neck extension, ipsilateral rotation, and lateral flexion. When pathologies affect the levator scapulae muscles, they can develop trigger point pain along the muscle and cause neck and shoulder pain. The factors that cause trigger point pain can either be ordinary or traumatic and cause referred pain to the neck and shoulders. Fortunately, treatments like stretching and adjustments can help reduce the pain and loosen up stiff muscles along the levator scapulae. This will allow a cervical range of motion back to the neck and shoulder and elongate the levator scapulae.

 

References

Akamatsu, Flávia Emi, et al. “Trigger Points: An Anatomical Substratum.” BioMed Research International, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4355109/.

Henry, James P, and Sunil Munakomi. “Anatomy, Head and Neck, Levator Scapulae Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 13 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK553120/.

Jeong , Hyo-Jung, et al. “Stretching Position Can Affect Levator Scapular Muscle Activity, Length, and Cervical Range of Motion in People with a Shortened Levator Scapulae.” Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, U.S. National Library of Medicine, 4 Apr. 2017, pubmed.ncbi.nlm.nih.gov/28578252/.

Kulow, Charlotte, et al. “Levator Scapulae and Rhomboid Minor Are United.” Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft, U.S. National Library of Medicine, Aug. 2022, pubmed.ncbi.nlm.nih.gov/35367623/.

Menachen, A, et al. “Levator Scapulae Syndrome: An Anatomic-Clinical Study.” Bulletin (Hospital for Joint Diseases (New York, N.Y.)), U.S. National Library of Medicine, 1993, pubmed.ncbi.nlm.nih.gov/8374486/.

Disclaimer

Yogurt and Gut Health: Functional Sciatica Clinic

By
Dr. Alex Jimenez
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Happy healthy young woman enjoying a tub of fresh yogurt in the kitchen smiling as she looks aside in a low angle view

Yogurt is a dairy product made by the bacterial fermentation of milk. The bacteria used are called yogurt cultures, which ferment lactose, which is the natural sugar found in milk. This process produces lactic acid that causes milk proteins to curdle, giving yogurt its flavor and texture. It can be made from all types of milk. Although research is ongoing, the benefits of adding yogurt to one’s nutrition plan can improve overall health, including improved bone health, circulation, immune system function, and probiotics/healthy bacteria that improve digestion and gut health.

Yogurt and Gut Health: Functional Medicine TeamHealth Benefits

Yogurt comes from milk that varies; some are made from skim and fat-free, whereas whole milk is full-fat. Other nutrients include calcium, vitamin B-2, vitamin B-12, potassium, and magnesium. More research is needed, but there is some evidence that active cultures can help certain gastrointestinal conditions, including:

The benefits are thought to be due to the:

  • Changes in the microbiota of the gut.
  • The faster time food takes to circulate through the bowels.
  • Immune system improvement.

Feel Fuller

Yogurt is rich in protein and healthy fats, which makes it very filling. Both of these nutrients are key to feeling full for longer. A study found consuming high-protein Greek yogurt in the afternoon resulted in less hunger, increased fullness and delayed the need to eat before dinner.

Probiotics

  • Look for brands that say living cultures or contain active cultures.
  • Probiotics help regulate bowel movements, combat infections, and restore balance to the digestive system.
  • Different cultures are thought to have various benefits.

Choosing Options

  • Look for yogurts that are unflavored and low or no sugar.
  • Yogurt naturally contains about six to eight grams of sugar
  • Add toppings and fruit for flavor and sweetness.

Use in Recipes

  • Yogurt can be used as a substitute ingredient in a variety of recipes.
  • Plain yogurt can substitute for sour cream.
  • It can replace the fat, oil, and/or butter in muffin, brownie, or cake recipes.

Speak with a nutritionist and health coach to find out if yogurt would be beneficial. Nutritionists work with individuals to find the best foods for their body type, age, and health condition, explain how different foods impact the body, and what foods to avoid.

Functional Nutrition

References

Andoh, Akira. “Physiological Role of Gut Microbiota for Maintaining Human Health.” Digestion vol. 93,3 (2016): 176-81. doi:10.1159/000444066

Bull, Matthew J, and Nigel T Plummer. “Part 1: The Human Gut Microbiome in Health and Disease.” Integrative medicine (Encinitas, Calif.) vol. 13,6 (2014): 17-22.

Cleveland Clinic: “Which Yogurt is Right For You?” “Why — and When — You Should Include Probiotics in Your Diet.”

Jandhyala, Sai Manasa, et al. “Role of the normal gut microbiota.” World journal of gastroenterology vol. 21,29 (2015): 8787-803. doi:10.3748/wjg.v21.i29.8787

Le Roy, C.I., Kurilshikov, A., Leeming, E.R. et al. Yoghurt consumption is associated with changes in the composition of the human gut microbiome and metabolome. BMC Microbiol 22, 39 (2022). doi.org/10.1186/s12866-021-02364-2

Wu, Hsin-Jung, and Eric Wu. “The role of gut microbiota in immune homeostasis and autoimmunity.” Gut microbes vol. 3,1 (2012): 4-14. doi:10.4161/gmic.19320

Trigger Points Affect Posterior Cervical Muscles

By
Dr. Alex Jimenez
-

Introduction

The cervical spine has a casual relationship with the central nervous system as the brain and spinal cord works together to send neuron signals through the nerve pathways spread throughout the entire body. The cervical spine is part of the neck, where ligaments and muscles encompass the cervical joints to stabilize the head, neck, and shoulders. The neck has various muscles that support the head and can succumb to various injuries that can cause muscle strain and other associated symptoms that can affect the upper extremities of the body. Today’s article looks at the posterior cervical muscles, how trigger points affect the posterior cervical muscles, and how non-invasive treatments can help manage myofascial cervical pain. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with the neck affecting the posterior cervical muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Are The Posterior Cervical Muscles?

 

Have you been experiencing random headaches that affect your day? Do you feel any tension in your neck? Or do you experience stiffness and limited mobility when turning your neck? Most of these symptoms are associated with trigger pain affecting the posterior cervical muscle on the neck. The posterior cervical muscles function in the neck’s anatomic region while protecting the cervical spine. The muscles in the cervical spine form a triangle on the neck while providing functionality and movement to the neck, the head, shoulder, and upper back. Some of the muscles that work together with the cervical spine include:

  • Levator scapulae
  • SCM (Sternocleidomastiod)
  • Trapezius
  • Erector spinae
  • Deep cervical flexors
  • Suboccipitals
  • Semispinalis
  • Splenius

These muscles and soft tissues provide stability to the neck and work together with the tendons and ligaments to rotate, extend, and retract the head, neck, shoulders, and upper back. To that point, if the neck muscles become strained, it can lead to various issues that can cause pain to the neck and cervical spine.

 

How Trigger Points Affect The Posterior Cervical Muscles

 

Studies reveal that a musculoskeletal disorder known as cervical myofascial pain causes the surrounding muscles in the neck and shoulder regions to become tender to the touch and evoke pain in different areas of the body. When the posterior cervical muscle has become strained from various issues like poor posture, over-exercising, getting involved in an auto accident, or have suffered from a degenerative condition, it can cause the muscles to be overused, hypersensitive, and stiff while potentially being at risk of developing trigger points along the neck and shoulder muscles. Trigger points are a bit problematic as they are associated with referred pain and can be either latent or active as they create tiny nodules along the taut muscle fibers in the area. Research studies reveal that referred pain from cervical myofascial pain can be elicited by active trigger points on the affected muscle. To that point, the active trigger points can mimic other pain symptoms along the upper extremities, making diagnosing myofascial pain challenging. Thankfully there are ways to manage trigger point pain associated with the posterior cervical muscles along the neck and cervical spine.

Exercises For Neck & Shoulder Pain-Video

#012 Exercises for neck and shoulder pain caused by trigger points of myofascial pain syndrome

Have you been experiencing stiffness along the sides of your neck or on your shoulders? Do headaches make it impossible to get through an entire day? Or have you been feeling tightness along your jawline? Many people with neck pain and its associated symptoms could risk developing myofascial trigger pain along the posterior cervical muscles. Having myofascial trigger pain associated with the posterior cervical muscle and affecting the neck and upper extremities can cause many people to be miserable; however, there are many ways that people can utilize to relieve the pain along the posterior cervical muscles and manage myofascial cervical pain associated with the neck. The video above provides various neck and shoulder pain exercises correlating with myofascial trigger points. To that point, finding non-invasive available treatments to manage myofascial cervical pain can help reduce the effects of pain along the neck and posterior cervical muscles.

Non-Invasive Treatments To Manage Myofascial Cervical Pain

 

Many people suffer from neck pain associated with myofascial cervical pain; many factors can contribute to developing tiny nodules along the posterior muscles. Studies reveal that activities, whether work-related or for entertainment, can yield repetitive stress on the muscle groups that cause chronic tension in the muscle fibers to form trigger points. To that point, myofascial trigger pain causes the taut muscle bands to be hyper-sensitive and affect the muscle area. Many people suffering from myofascial trigger pain can utilize non-invasive treatments to manage myofascial pain associated with the posterior cervical muscle. Some of the treatments that help manage myofascial cervical pain include:

  • Acupuncture
  • Trigger point release therapy
  • Chiropractic care
  • Heat therapy
  • Exercise/stretching

Many of these treatments help release the trigger points from the affected muscles and help prevent them from re-occurring on the affected muscles along the upper extremities.

Conclusion

The neck has many muscles, ligaments, and tissues that help support the upper extremities of the body. When issues begin to affect the functionality of the neck muscles, it can lead to the development of myofascial trigger pain in the posterior cervical muscles along the neck to cause painful symptoms. This can lead to overlapping chronic issues like stiffness and tenderness in the upper extremities. Non-invasive treatments can help alleviate the pain and manage the symptoms caused by myofascial cervical pain in the upper extremities of the body. This allows the affected muscle to return to its functionality and prevents future issues from affecting the body.

 

References

Alghadir, Ahmad H, et al. “Efficacy of Combination Therapies on Neck Pain and Muscle Tenderness in Male Patients with Upper Trapezius Active Myofascial Trigger Points.” BioMed Research International, Hindawi, 10 Mar. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7085833/.

Fernández-de-Las-Peñas, César, et al. “The Role of Myofascial Trigger Points in Musculoskeletal Pain Syndromes of the Head and Neck.” Current Pain and Headache Reports, U.S. National Library of Medicine, Oct. 2007, pubmed.ncbi.nlm.nih.gov/17894927/.

Stathakios, James, and Michael A Carron. “Anatomy, Head and Neck, Posterior Cervical Region.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 27 July 2021, www.ncbi.nlm.nih.gov/books/NBK551521/.

Touma, Jeffrey, et al. “Cervical Myofascial Pain.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, www.ncbi.nlm.nih.gov/books/NBK507825/.

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Misaligned Uneven Shoulders Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
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Pleasant physiotherapy procedure in a military rehabilitation center, a friendly doctor conducts session to a military patient with modern apparatus

When the body is correctly aligned, the shoulders are the same height, and face forward. Uneven shoulders are when one shoulder begins to raise higher than the other. It usually starts with a slight difference but can turn into a more severe imbalance causing discomfort, tightness, and pain in the neck, shoulders, hips, and back. Chiropractic treatment can bring the body back into balance and alignment through various techniques and therapy modalities.Misaligned Uneven Shoulders Chiropractor

Misaligned Uneven Shoulders

Several factors can lead to uneven shoulders. Misalignments can be caused by:

  • Often the shoulder on the dominant side tends to be slightly lower.
  • Constantly using one hand or side for everything.
  • Carrying a heavy bag on the dominant shoulder.
  • Structural issues or muscular skeletal imbalances in other areas of the body.

For example, if the ankle or hip gets injured, it can cause an individual to bring their body out of alignment to adjust to how they position themselves and move. Other common causes include:

  • Overuse of the shoulders
  • Tight upper back muscles
  • Unhealthy posture
  • Uneven hips
  • Pinched nerve
  • Weak muscles
  • Flat feet
  • Sedentary lifestyle
  • Varying leg length
  • Osteoporosis
  • Scoliosis
  • Shoulder injuries
  • Incorrect sleeping position or sleeping on one side
  • Sports like tennis, golf, and baseball have an increased risk of causing misaligned, uneven shoulders and posture imbalances.

Symptoms

Uneven shoulders can result in discomfort, tightness, and stiffness in the neck, shoulders, and lower back.

  • Continued tightness and pulling in the higher shoulder.
  • Rounded shoulders
  • Headaches
  • Head misalignment
  • Hip misalignment
  • Shifting pelvis
  • Bursitis
  • Tendonitis

Chiropractor

A chiropractic massage and functional medicine team will bring the shoulders back into normal alignment.

  • Therapeutic myofascial release massage will release tension, relax the muscles, and increase flexibility.
  • Chiropractic adjustments
  • Spinal decompression therapy
  • Stretches and muscle-building exercises to balance the shoulders.
  • Lifestyle adjustment instructions for switching shoulders when carrying bags, using armrests, using the phone, using a mouse, and using ergonomic chairs.
  • Posture training includes learning to stay aware of one’s posture throughout the day when standing or sitting and completing regular activities.
  • Learning to use the non-dominant arm to balance the workload.
  • Incorporating relaxation, meditation, and breathing techniques to relieve stress, tension, and tightness.

Shoulder Pain Treatment

References

Burbank, Kelton M et al. “Chronic shoulder pain: part I. Evaluation and diagnosis.” American family physician vol. 77,4 (2008): 453-60.

Foroozan Mahmoodi et al. The effect of corrective exercises on the pain and degree of uneven shoulder deformity rsr.basu.ac.ir/article_625_en.html

Mayo Clinic Staff. (2017). Stress management. mayoclinic.org/healthy-lifestyle/stress-management/in-depth/relaxation-technique/art-20045368

Mitchell, Caroline, et al. “Shoulder pain: diagnosis and management in primary care.” BMJ (Clinical research ed.) vol. 331,7525 (2005): 1124-8. doi:10.1136/bmj.331.7525.1124

Pu Chu, Eric Chun, and Kevin Hsu Kai Huang. “Bridging the gap between observation and brace treatment for adolescent idiopathic scoliosis.” Journal of family medicine and primary care vol. 6,2 (2017): 447-449. doi:10.4103/jfmpc.jfmpc_52_17

Trigger Points Affecting The Neck & Splenius Muscles

By
Dr. Alex Jimenez
-

Introduction

The neck is the connector to the head and shoulders, allowing mobility and functionality to stabilize the head from dropping down. The neck is also part of the cervical spine, where many neuron pathways, ligaments, and muscles work with the central nervous system to provide sensory-motor signals to the brain. The neck muscles also work together with the shoulder and upper back muscles to function for the upper extremities. These are known as the splenius muscles and help support the cervical spine. However, like all muscles in the body, the neck can succumb to traumatic injuries or common factors that can cause the neck muscles to be overused, injured, and strained to cause the nerves to send out disruptive signals to the brain and issues to develop. Today’s article looks at the splenius muscles on the neck, how trigger points affect the splenius muscles, and how to manage neck pain associated with trigger points. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with neck pain affecting the splenius muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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The Splenius Muscles On The Neck

 

Have you been experiencing muscle pain in your neck? What about feeling tightness on the sides of your neck when you move your head from side to side? Or do random headaches seem to pop out of nowhere and affect your day? Most of these symptoms are associated with neck pain affecting the splenius muscles and can cause overlapping issues affecting the neck and the upper back. The splenius muscles are split into two muscle groups: the splenius capitis and the splenius cervicis. Both of the splenius muscles each have a job for neck functionality. The splenius capitis provides rotation and extension to the head, while the splenius cervicis provides rotation and extends to the cervical spine. The splenius capitis fibers are connected with the SCM (sternocleidomastoid) muscles that help move the head. The splenius cervicis encompasses the upper three cervical vertebrae and attach their muscle fibers to scapulae muscles. Even though these two muscles offer different functions, they could potentially be involved in injuries that can cause neck and upper back issues.

 

How Trigger Points Affect The Splenius Muscles

 

One of the most common complaints many people seem to be impacted is shoulder and neck pain. Various factors can cause an impact on the shoulders and neck due to overusing the splenius muscles connected to the neck and shoulders and developing trigger points associated with the splenius muscles. Studies reveal that trigger points or myofascial pain can make the splenius muscles hypersensitive and tender along the taut band of the splenius muscles. To that point, the splenius muscles become palpable and produce localized pain to other structures along the neck, shoulders, and head. Trigger points are a bit complex to diagnose because they mimic other chronic issues that affect the body and potentially involve many common symptoms that could happen daily. Studies reveal that common symptoms like headaches are associated with trigger points along the head, neck, and shoulder muscles. Since trigger points are challenging to diagnose, they can make the taut band of the musculoskeletal fibers and become either active or latent when pressure is on the affected area. To that point, causes tension occurs in the body’s head, neck, and shoulders. Fortunately, various ways to manage trigger point pain are associated with neck pain along the splenius muscles.

Trigger Points & Splenius Muscles- Video

Splenius Cervicis - Trigger Point of the Week

Have you been dealing with random headaches that randomly occur throughout the day? What about experiencing muscle stiffness and tenderness located on your neck and shoulders? Or have you been experiencing poor sleep throughout the night? Most of these symptoms are associated with trigger point pain associated with neck pain along the splenius muscles. The video above explains how trigger points affect the splenius muscles and some of the causes that lead to the development of trigger point pain along the splenius muscles. Many people dealing with trigger points associated with neck pain often explain to their doctors that they have been feeling muscle stiffness along their neck, causing limited mobility. Studies reveal that active myofascial trigger points along the neck and shoulder muscles elicited referred pain to contribute to symptoms of pain intensity, disability, and poor sleep quality to mechanical neck pain. To that point, many individuals try to incorporate various treatments to alleviate the symptoms and manage neck pain associated with trigger points.

Managing Neck Pain Associated With Trigger Points

 

Many people dealing with neck pain associated with trigger points along the splenius muscles often don’t realize that some causes affect how the muscles are used. Ordinary factors like poor posture, looking down at the phones, or leaning closer to any screens can cause strain on the splenius muscles. In contrast, traumatic factors like whiplash or auto accidents can inflict pain on the muscle fibers. Various ways to manage neck pain associated with trigger points are non-invasive unless the pain is severe. When a person goes to their primary doctor for a routine check-up, they describe the symptoms of pain affecting their bodies while the doctor examines them. Once the issue is diagnosed, many doctors will refer their patients to a pain specialist specializing in the matter. So say if a person is dealing with neck pain associated with trigger point pain along their splenius muscles that is causing them headaches, would be referred to a pain specialist like a chiropractor to relieve myofascial trigger pain along the splenius muscles that are suffering from spinal subluxation in the musculoskeletal system. Spinal adjustments allow the stiff muscles to become loose and even break up the adhesion of the trigger points on the muscle. Incorporating chiropractic care to treat neck pain associated with trigger points can bring back functionality to the body.

Conclusion

The neck allows the head to be mobile and help keeps it stable. As part of the cervical spine, the neck has many neuron pathways, ligaments, and muscles that work with the central nervous system to provide sensory-motor function. The muscles that provide functionality to the shoulders, neck, and upper back are called the splenius muscles. The splenius muscles consist of two groups: the capitis and cervicis, which have different jobs for neck functionality. However, like any muscle in the body may potentially be impacted by various issues that can cause neck and upper back issues. Common and traumatic issues can lead to the development of myofascial trigger pain along the neck muscles. To that point causes neck pain and disability to the neck. When this happens, various treatments are available to manage neck pain associated with myofascial pain and alleviate the symptoms, causing relief to the neck.

 

References

Chatchawan, Uraiwan, et al. “Characteristics and Distributions of Myofascial Trigger Points in Individuals with Chronic Tension-Type Headaches.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Apr. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6451952/.

Henson, Brandi, et al. “Anatomy, Back, Muscles – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 10 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK537074/.

Muñoz-Muñoz , Sonsoles, et al. “Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Individuals with Mechanical Neck Pain.” Journal of Manipulative and Physiological Therapeutics, U.S. National Library of Medicine, Oct. 2012, pubmed.ncbi.nlm.nih.gov/23158466/.

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

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Damaged, Injured Nerve Roots Sciatica Clinic

By
Dr. Alex Jimenez
-
African American man lying on massage table and receiving therapeutic rehabilitation massage in physical therapy center

Spinal nerves send motor, sensory, and autonomic signals between the central nervous system and the body and are part of the peripheral nervous system. They are essential for carrying information that controls body movements and sensations to the brain. When a nerve gets injured, compressed, or damaged, it can cause discomfort, increased sensitivity, numbness, muscle weakness, and pain.

Damaged, Injured Nerve Roots Chiropractor

Damaged Nerve Roots

Nerve root pain is often caused by other underlying conditions that have caused compression or damage to the nerve root. Causes of nerve root pain can include:

  • Herniated discs
  • Spinal injury
  • Spinal stenosis
  • Arthritis
  • Spondylosis
  • Spinal infection
  • Bone spurs
  • Inflammatory disease
  • Spinal tumors
  • Spinal cysts

Spinal nerves impacted by injuries or infection can lose their ability to control the body areas, lose their functional capacity, lose sensation, and die.

Spinal Imaging

Nerve damage can be diagnosed on a neurological exam and correlated with MRI and X-ray imaging. Conditions that MRI can identify include herniated discs, spinal cord compression or fracture, arthritic development, tumors, or cysts pressing on a nerve.

  • MRI images are obtained with a magnetic field and radio waves.
  • MRI shows spine images from the side/sagittal view and cross-sectional/axial views.
  • This allows the chiropractic doctor to see the vertebrae and discs and identify abnormalities.
  • The spinal cord is a gray area in the middle surrounded by the spinal fluid, which appears white.
  • Little white channels on either side of the spinal cord are where the nerve roots branch off.
  • X-rays can show the alignment of the bones along the spine and determine any narrowing or damage to the discs.

It is important to be evaluated and diagnosed for signs and symptoms of nerve injury as soon as possible, as nerve damage accelerates and worsens.

Function Restoration

Sometimes, the symptoms improve by themselves and do not require treatment. Nonetheless, physicians begin with conservative, non-surgical approaches to treat nerve root pain. Chiropractic and physical massage therapy involves specific movements, stretches, and exercises to keep the affected muscles and joints active, prevent stiffness and help restore function and feeling. Treatment can include:

  • Therapeutic massage
  • Manual adjustment/resistance treatment
  • Trigger point therapy
  • Instrument-assisted soft tissue therapy
  • Decompression
  • Traction
  • Joint stretching
  • Electrical stimulation
  • Ultrasound
  • Specialized exercise
  • Activity modification
  • Anti-inflammatory diet

Nerve Chiropractor

References

Liu, Yan, and Huan Wang. “Peripheral nerve injury-induced changes in the spinal cord and strategies to counteract/enhance the changes to promote nerve regeneration.” Neural regeneration research vol. 15,2 (2020): 189-198. doi:10.4103/1673-5374.265540

Menorca, Ron M G, et al. “Nerve physiology: mechanisms of injury and recovery.” Hand clinics vol. 29,3 (2013): 317-30. doi:10.1016/j.hcl.2013.04.002

Shehab, Safa Al-Deen Saudi. “Fifth lumbar spinal nerve injury causes neurochemical changes in corresponding and adjacent spinal segments: a possible mechanism underlying neuropathic pain.” Journal of chemical neuroanatomy vol. 55 (2014): 38-50. doi:10.1016/j.jchemneu.2013.12.002

Stoll, G, and H W Müller. “Nerve injury, axonal degeneration, and neural regeneration: basic insights.” Brain pathology (Zurich, Switzerland) vol. 9,2 (1999): 313-25. doi:10.1111/j.1750-3639.1999.tb00229.x

Ye, Xuan, et al. “Nerve fascicle transfer using a part of the C-7 nerve for spinal accessory nerve injury.” Journal of neurosurgery. Spine vol. 28,5 (2018): 555-561. doi:10.3171/2017.8.SPINE17582

Myofascial Trigger Pain On The Occipitofrontalis Muscle

By
Dr. Alex Jimenez
-

Introduction

Having headaches can affect anyone at any time, and various issues (both underlying and non-underlying) can play a part in the development. Factors like stress, allergies, traumatic events, or anxiety can trigger the causes of headaches to develop and can affect a person’s day-to-day schedule. Headaches can come in various forms and be the cause or symptom of other conditions. Many complain about headaches affecting their forehead, where the occipitofrontalis muscle resides, and explain to their doctors about a dull ache affecting them. To that point, the cause of the headache could affect them differently. Today’s article examines the occipitofrontalis muscle, how myofascial trigger pain affects this muscle, and ways to manage myofascial trigger pain associated with headaches. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with headache symptoms affecting the occipitofrontalis muscle. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Is The Occipitofrontalis Muscle?

Have you been experiencing unexplainable headaches that seem to affect your daily life? Do you feel muscle tension in your head or neck? Or do certain areas in your upper body seem tender to the touch? Many individuals suffer from headaches, and it could be due to myofascial trigger pain associated with the occipitofrontalis muscle. The occipitofrontalis muscle surprisingly plays an important part in the facial muscles. The occipitofrontalis muscle is the only muscle that can raise eyebrows, convey emotions, and provide non-verbal communication as part of its functionality to the head. The occipitofrontalis muscle has two different sections in the head that play different roles. Studies reveal that the occipital and frontal bellies have other actions but work together despite being connected to the galea aponeurotica. However, like all muscles in different body sections, various factors can affect the muscles to become tender and form multiple symptoms associated with pain.

 

How Does Myofascial Trigger Pain Affect The Occipitofrontalis?

When various factors begin to affect the occipitofrontalis muscle, it could potentially be at risk of developing myofascial trigger pain associated with headaches in the muscle. Studies reveal that myofascial trigger pain is a musculoskeletal disorder associated with muscle pain and tenderness that can be identified as latent or active. When the occipitofrontalis is affected by myofascial pain, it could potentially lead to tension-type headaches as a symptom. Studies reveal that headaches, especially tension headaches, are associated with trigger points in the head and neck muscles. Myofascial pain occurs when the muscles become overused and sensitive to the touch. The affected muscle then develops small nodules along the muscle fibers and can cause referred pain in a different body section. To that point, the affected muscle becomes hypersensitive due to an excess of nociceptive inputs from the peripheral nervous system, thus eliciting referred pain or muscle contraction. When this happens to the individual, they experience constant, throbbing pain in their forehead and try to find relief to diminish the pain.

Myofascial Exercises For Headaches-Video

Myofascial Exercises for Headaches & Migraines

Have you been feeling tension and pain in your neck or head? Do headaches seem to affect your daily activities? Does the slightest pressure seem to cause you pain in your muscles? Experiencing these symptoms may be a sign that you may have myofascial trigger pain associated with the head and neck that is causing headache-like pain along the occipitofrontalis muscle. The video above demonstrates various stretching exercises for headaches and migraines associated with myofascial trigger pain. Myofascial trigger pain associated with headaches can cause overlapping issues in the upper extremities of the body since myofascial trigger pain can mimic other conditions that affect the head and neck muscles. Known as referred pain, the underlying cause of pain affects a different body part than the actual location. Luckily, there are ways to manage myofascial trigger pain associated with headaches along the occipitofrontalis muscle.

How To Manage Myofascial Trigger Pain Associated With Headaches

 

There are many ways to manage headache symptoms associated with myofascial trigger pain along the occipitofrontalis muscle. Many people will take over-the-counter medicine to dull the pain, while others use a cold/hot pack to be placed on their forehead to relieve the tension caused by the headache. Those experiencing trigger point pain along the affected muscles that are not responding to the at-home treatments will go to a specialist that uses various techniques to manage myofascial trigger pain associated with headaches. Studies reveal that manual trigger point therapies for the head and neck may reduce the frequency, intensity, and duration of various headaches affecting the occipitofrontalis muscle. Other treatments that help manage myofascial pain associated with the occipitofrontal muscle include:

  • Chiropractic care: Spinal misalignment or spinal subluxation in the cervical spine can potentially lead to the development of myofascial trigger pain associated with muscle pain
  • Acupuncture: Dry needles are placed on the trigger points associated with the affected muscle to relieve pain
  • Hot/cold compress: Ice or heat packs are placed on the affected muscle to relieve tension.
  • Massage therapy: Deep tissue massage can relieve the inflamed area, reduce pain, and prevent trigger points from reemerging.

Utilizing these treatments can help prevent myofascial pain and manage headache symptoms associated with the muscle.

 

Conclusion

Headaches can affect anyone, and various issues can affect their development. Whether it is an underlying or non-underlying cause, multiple problems can trigger a headache to form and cause a dull ache in the affected muscle. One of the most common forms of headaches occurs in the occipitofrontalis muscle located in the forehead and near the base of the skull. The occipitofrontalis muscle is the only muscle that controls eyebrow movement, conveys emotions, and provides non-verbal communication as part of head functionality. However, like all muscles, the occipitofrontalis can become affected and potentially risk developing myofascial trigger pain. When this happens, the occipitofrontalis could develop tension-type headaches associated with myofascial trigger pain. Luckily available treatments are there to manage myofascial trigger pain associated with the occipitofrontalis muscle and alleviate headaches from the affected muscle.

 

References

Bérzin, F. “OCCIPITOFRONTALIS Muscle: Functional Analysis Revealed by Electromyography.” Electromyography and Clinical Neurophysiology, U.S. National Library of Medicine, 1989, pubmed.ncbi.nlm.nih.gov/2689156/.

Chatchawan, Uraiwan, et al. “Characteristics and Distributions of Myofascial Trigger Points in Individuals with Chronic Tension-Type Headaches.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Apr. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6451952/.

Falsiroli Maistrello, Luca, et al. “Effectiveness of Trigger Point Manual Treatment on the Frequency, Intensity, and Duration of Attacks in Primary Headaches: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Frontiers in Neurology, Frontiers Media S.A., 24 Apr. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5928320/.

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, www.ncbi.nlm.nih.gov/pmc/articles/PMC5561477/.

Pessino, Kenneth, et al. “Anatomy, Head and Neck, Frontalis Muscle – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 31 July 2021, www.ncbi.nlm.nih.gov/books/NBK557752/.

Disclaimer

Muscle Guarding After Strain or Injury Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
-
Woman doing exercises on simulator with rehabilitation specialist at the gym. Concept of physical therapy for strengthening and recovery. Idea of recovery after pregnancy

Individuals that have experienced a muscle strain, pull, spasm, etc., that has healed can begin to behave overly cautious, avoiding putting full weight on the area or using full motion out of fear of re-injuring it. This can and does strain other body areas because of the imbalance and awkward positioning. It also leads to anxiety, emotional distress, and decreased self-confidence in everyday movement. Adjustments, massage, and decompression therapy can maintain musculoskeletal health, and a chiropractor can help retrain individuals on healthy posture and confident movement. Muscle Guarding After Strain or Injury Chiropractor

Muscle Guarding

Muscles can be held in a position of readiness to act, like the stress response of fight or flight. When this happens, the muscles are partially contracted in preparation for action and is a form of muscle-guarding. But once the fight or flight passes, the muscles relax into their normal position. With injury muscle guarding, the fears and stresses after recovering from an injury can cause the injured and non-injured muscles to stay in the guarded/semi-contracted position. The longer the muscle guarding continues, fatigue begins to set in, decreasing function, restricting mobility, and making the body more vulnerable to damage and injury.

The Brain

The discomfort, pain, or just the thought reinforces the need to guard the area. The brain will find a way to move without causing pain and create compensating but unhealthy movement patterns that strain the other areas of the body. The body adapts to not using the formerly injured muscles and now relies on the other muscles to perform the functions in a non-relaxed state that can become normal, causing stiffness, soreness, tenderness, tendon tension, and pain.

  • An example is a hip strain, pull or spasm that has been treated and has healed, but the individual is fearful of another injury or going through the painful experience again and begins walking by shifting all their weight to the other side and steps with a limp or some abnormal motion that strains and/or injures the rest of the body.

Chiropractic Treatment and Retraining

Individuals experiencing muscle guarding can find help through chiropractic to retrain their muscles to return to their normal position and regain confidence in their movements. The body will be rebalanced by releasing and relaxing the tight muscles. Then therapeutic repetitive movements, specialized exercises, stretches, and relaxation techniques will help the individual relearn to use the muscles without fear.

Protective Muscle Guarding

References

Hanlon, Shawn et al. “Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding.” Journal of athletic training vol. 51,2 (2016): 111-7. doi:10.4085/1062-6050-51.3.06

Olugbade, Temitayo et al. “The relationship between guarding, pain, and emotion.” Pain reports vol. 4,4 e770. 22 Jul. 2019, doi:10.1097/PR9.0000000000000770

Prkachin, Kenneth M et al. “Pain behavior and the development of pain-related disability: the importance of guarding.” The Clinical journal of pain vol. 23,3 (2007): 270-7. doi:10.1097/AJP.0b013e3180308d28

Myofascial Trigger Pain On The Face

By
Dr. Alex Jimenez
-

Introduction

Everyone in the world has various expressions that reflect how they are feeling. From being excited, worried, sad, angry, and disgusted, facial expressions defy people who they are, what they eat, and how they look. Each of the different muscles that make up the face has other jobs to work at the various locations of the upper extremities. The muscles on the forehead and near the eyes help people see while opening, closing, and raising their eyebrows. The muscles around the nose help take in air to breathe. The muscles located in the jaw help people chew food and speak. The neck muscles help support the head and provide mobility. All these muscles have specific jobs, and when issues affect the upper body extremities, they can potentially lead to different problems. When environmental factors like stress, anxiety, or depression begin to affect the body, it can also affect its facial features, causing unwanted symptoms to develop. Today’s article focuses on myofascial trigger pain on the face, the signs and symptoms associated with myofascial facial pain, and how to manage myofascial facial pain. We refer patients to certified providers who specialize in musculoskeletal and oral treatments to aid individuals suffering from myofascial trigger pain affecting their facial muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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How Does Myofascial Trigger Pain Affect The Face?

Have you been experiencing pain-like symptoms in your jaw? What about feeling constant pressure around your nose or cheeks? Do you feel tenderness in certain body areas around your face? Many of these symptoms you are experiencing could potentially involve myofascial trigger pain affecting the facial muscles. Having myofascial trigger pain in the upper extremities of the body can be challenging, as studies reveal that myofascial pain syndrome is a muscular pain disorder that is often misunderstood as it involves referred pain from small, tender trigger pain within the muscle fibers causing pain in different locations of the body than the actual source. Myofascial trigger pain often mimics other chronic conditions that cause doctors to be confused when patients mention that they have been experiencing symptoms and it’s affecting their daily lives. For myofascial trigger pain affecting the face, studies reveal that facial pain associated with myofascial trigger pain can be classified in various ways that affect the nasal, orbital, and oral cavities, the temporomandibular joint, and the sinuses from underlying pathologies. Myofascial pain correlating with the face can have many trigger points that can make a person feel miserable and affect their daily lives.

 

Signs & Symptoms Associated Myofascial Facial Pain

Like the rest of the body, the face has numerous nerves that branched out from the brain in the central nervous system, providing sensory-motor functions to the muscles. The trigeminal nerves help give movement to the face, and when myofascial pain affects the facial regions, studies reveal that the causes can include:

  • Idiopathic factors
  • Trigeminal neuralgia
  • Dental problems
  • TMJ disorders 
  • Cranial abnormalities
  • Infection
  • Acute muscle injury
  • Stress and anxiety

These signs are associated with myofascial facial pain due to common overlapping symptoms affecting each muscle around the face. Some of the symptoms related to myofascial facial pain include:

  • Tingling sensations 
  • Throbbing pain
  • Headaches
  • Toothaches
  • Neck pain
  • Shoulder pain
  • Feeling stuffed up
  • Muscle tenderness

 

Chronic Facial Pain-Video

What is Chronic Facial Pain?

Have you been experiencing muscle tenderness in certain parts of your face? What about feeling stuffed up around the areas of your cheeks and nose? Or have you been feeling stiffness and pain along your jaw, neck, or shoulders? If you have been experiencing these pain symptoms, it could be facial pain associated with myofascial trigger pain. The video above overviews chronic facial pain and how it affects the head and neck. Research studies reveal that pain affecting the body for more than six months is considered chronic. Just like any other chronic pain symptoms in the body, chronic facial pain causes a neuropathic response to the central nervous system, making an injury hypersensitive and potentially involving associated symptoms from other chronic disorders. Myofascial dysfunction related to facial pain may become severe to activate trigger points along the facial muscle fibers, causing prickling sensations in the face. Luckily, there are available treatments for managing myofascial facial pain.

Management Of Myofascial Facial Pain

When managing myofascial pain associated with the face, many patients will go to their primary doctor and explain that they are experiencing pain and other symptoms that make them miserable. Doctors then examine the patient to see what is ailing them through a physical examination. Some doctors often utilize manual manipulation and other tools to diagnose that myofascial pain might be the cause. As stated earlier, myofascial pain associated with the face can be a bit complex as it can mimic other chronic conditions. Once the doctor diagnoses myofascial pain related to the face, they can refer their patients to pain specialists like chiropractors, physical therapists, physiatrists, and massage therapists to alleviate myofascial pain related to the face by examining where the causes are coming from. Pain specialists incorporate various techniques to relieve myofascial pain associated with the face:

  • Stretch & spray (Stretching the muscle and spraying a coolant spray to loosen tight muscles along the neck)
  • Putting pressure on the trigger point (This helps smooth out the affected muscle and fascia)
  • Gentle stretching exercises (Help strengthen the affected muscles)
  • Hot or cold compress (Helps relax the muscles and break up the adhesion from scar tissue)

Incorporating these treatments can help manage the symptoms associated with myofascial pain and can help alleviate muscle pain, thus preventing further issues from developing over time.

 

Conclusion

The facial muscles have specific jobs with different functions that help the body function properly. These jobs help various sections of the face by expressing how we feel, what we eat and taste, breath, and other jobs that define people. When issues begin to affect the upper extremities of the body, they can cause lead to different problems that affect the facial features of the face and cause unwanted symptoms to develop. This is known as myofascial pain and is often misunderstood,s since it can mimic other chronic conditions that affect the body. Different factors and symptoms associated with myofascial pain can become difficult to diagnose. Still, various techniques can help manage the symptoms over time to prevent further injuries from occurring on the face and the body.

 

References

Fricton, J R, et al. “Myofascial Pain Syndrome of the Head and Neck: A Review of Clinical Characteristics of 164 Patients.” Oral Surgery, Oral Medicine, and Oral Pathology, U.S. National Library of Medicine, Dec. 1985, pubmed.ncbi.nlm.nih.gov/3865133/.

Williams, Christopher G, et al. “Management of Chronic Facial Pain.” Craniomaxillofacial Trauma & Reconstruction, Thieme Medical Publishers, May 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC3052669/.

Yoon, Seung Zhoo, et al. “A Case of Facial Myofascial Pain Syndrome Presenting as Trigeminal Neuralgia.” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, U.S. National Library of Medicine, 25 Dec. 2008, pubmed.ncbi.nlm.nih.gov/19111486/.

Zakrzewska, J M. “Differential Diagnosis of Facial Pain and Guidelines for Management.” Define_me, July 2013, www.bjanaesthesia.org/article/S0007-0912(17)32972-0/fulltext.

Zakrzewska, Joanna M, and Troels S Jensen. “History of Facial Pain Diagnosis.” Cephalalgia : an International Journal of Headache, SAGE Publications, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5458869/.

Disclaimer

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Sciatica Specialist
STOP SUFFERING! We specialize in advanced non-surgical approaches in treating sciatica. Our focus is to stop the pain, remove the cause and prevent chronic recurrence of complex sciatica pain syndromes. We treat with advanced protocols and supportive care plans. Blessings - Dr. Alex Jimenez DC, MSACP, IFMCP, CIFM, ATN
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