Multifidi on stretch with resistance Take Chest Pain SeriouslyĪccording to Renee Hartz, M.D., a retired cardiac and thoracic surgeon who is now a trigger point expert and medical director of The Chicago Center for Myofascial Pain Relief, it is always best to refer clients for a visit to their primary care physician if they present with chronic pain in the chest area. When harboring trigger points the latissimus dorsi can cause referred pain down the inside of the arm to the pinkie or a strong, almost stabbing pain into the mid-back to just about the medial edge of the inferior scapulae border. Finally, don’t even get me started on those pesky latissimus muscles, always overused by novice massage therapists when they work.The infraspinatus-a shoulder girdle muscle-can cause referred pain in the front of the arm and into the mid-back.The levator scapulae and serratus posterior superior can cause mid-back pain, but they arise from near the superior scapular border and end at the cervical vertebra.The scalenes are in the neck yet refer strong pain into the mid-scapular area.This is where the complete trigger point protocol guides clinical reasoning.
The untrained massage therapist might spend a whole hour working on the area where it hurts, but the pain will not go away until the source trigger points are identified and eliminated. Of these nine, five are not technically located in the mid-back.
Multifidi on stretch with resistance Source Trigger PointsĪccording to Travell and Simons, who co-authored Myofascial Pain and Dysfunction: The Trigger Point Manual, there are nine muscles that, when harboring trigger points, can cause pain into the mid back. What they taught is finding the source of the problem will offer the long-lasting relief we all seek. We need to follow the road map given to us by trigger point pioneers Janet Travell, M.D., David G. Pressing where the client feels pain may not be the technique to use if the goal is to get rid of the pain. That’s where we come in-but a bit more training is necessary. In this position the back and front of the upper torso are two key areas that are in direct opposition of each other during work.Īs a busy day goes on, and they continue to use the arms in front of the chest and lean over a desk, this leads to myofascial dysfunction and problems in muscles that can grow from a slight twinge of discomfort into burning, stabbing, aching, or just shadowing pain that they wish they could have someone just press an elbow into it to make it go away. To really get to the center of it all there may be a bit of detective work needed to find the true source of the problem.įor example, many of our clients spend all day in front of a computer hunched over. I’m sure we all have had clients who report feeling nagging pain or tension in their mid-back between or below the shoulder blades. Myofascial trigger points can cause many problems in muscles, including, but not limited to, referred pain, reduction in range of motion, weakness, loss of endurance, numbness, tingling and a host of other often-overlooked problems. The 7-Step Trigger Point Protocol for Chest and Mid-Back Pain