Trapezius trigger points.

The trapezius muscle is a large diamond shaped muscle in your upper and middle back and neck. It it responsible for both shoulder and neck movements. Trigger points in the upper portion of this muscle are the most common points to develop in the body. These trigger points most often occur due to poor posture, such as a slumped sitting posture. Trigger points in the upper portion of the traps will cause pain to refer into the neck, head, and into the temple. These points are one of the most common causes of headaches.

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Trigger points in the lateral pterygoid.

The lateral pterygoid muscle is involved in movement of the jaw. It can become become strained from chronic clenching of the jaw and grinding of the teeth. When this happened trigger points can form. This leads not only to pain and refered pain, but also dysfunctional joint mechanics. This muscle is a major player in TMJ dysfunction syndrome.

Trigger points in the medial pteragoyd muscle

The medial pteragoyd muscle is located on the inside of the jaw. It is responsible for jaw movements during talking and chewing. This muscle becomes over loaded from poor neck posture as well as stress resulting in grinding the teeth or excessive clenching of the jaw. Trigger points in this muscle will refer deep into the jaw and the tempomandibular joint producing “tmj dysfunction syndrome.

Trigger points in the multifidus muscle.

The multifidus muscle is a long muscle that travels the length of the spine. It has different actions on different parts of the spine. It extends and laterally flexes the cervical and lumbar spine, and rotates the thoracic spine. Trigger points in this muscle are common due to poor posture and bad movement mechanics. Trigger points in the lumbar area area are a common cause of low back pain. These lower points can also refer into the abdomen. Points that form in the cervical region will refer pain down the neck into the shoulder blade area.

The rectus femoris muscle is one of your quad muscles. It acts primarily to extend the knee but it also helps to flex the hip. This muscle is often overloaded from athletic activity, but it also can become chronically shortened from prolonged sitting. Trigger points will refer pain deep into the knee producing a deep ache felt into the joint.

the serratus anterior muscle is located on the side of the trunk. It attaches onto the ribs and the scapulae. This muscle assists in scapular motion and stability as well as assisting the movement of the ribs. Trigger points can form in this muscle due to poor shoulder posture. Once formed, these points will cause pain to be felt in the side, under the armpit, and down the inside of the arm. Once formed trigger points will not release on their own, they require a manual technique such as trigger point massage.

DeQuervain’s Disease

DeQ

Tendons are strong, fibrous bands of tissue connecting muscles to bones. Some tendons are covered by a protective, lubricated insulation called a “synovial sheath.” The two tendons on the thumb-side of your wrist that extend and abduct your thumb into a “hitchhiker” position are covered by a sheath. Normally, these tendons move freely within this covering, much like a sword sliding through a sheath. If these tendons and sheaths are forced to repetitively rub against the bones of your wrist, they can become painfully swollen. This condition is called De Quervain’s tenosynovitis.

The pain of De Quervain’s tenosynovitis may begin abruptly, but more commonly starts gradually and increases over time. The pain is provoked by movements of your thumb or wrist. In more severe cases, you may notice swelling on the outside of your wrist. Some patients complain of “catching” or a slight “squeaking” sound while moving their wrist.

Activities like gardening, knitting, cooking, playing a musical instrument, carpentry, walking a pet on a leash, texting, video gaming and sports like golf, volleyball, fly fishing and racquet sports are known triggers. The condition was once known as “Washer woman’s sprain,” since wringing out wet clothes can trigger the problem. Lifting infants or children by placing your outstretched finger and thumb beneath their armpit has led to the nicknames of “Mommy thumb” or “Baby wrist.”

The condition strikes women much more frequently than men. It typically affects middle- age adults and is more slightly common in African-Americans, patients with diabetes or rheumatoid arthritis may be at higher risk for this problem.

Many patients will experience resolution of their symptoms through conservative care, like the type provided in our office. You should avoid lifting, grasping and pinching movements, especially when your wrist is bent toward either side. You may need to find alternate ways to lift children and perform work, sport and leisure activities. Video game players and those who text should take frequent breaks and try to hold their wrists straighter. Avoid wearing tight wristbands. Applying ice to your wrist for 10 minutes every hour or performing an “ice massage” (freeze a paper cup filled with water, tear off the bottom to expose the ice, massage over the tendons in a figure-eight pattern for 6-10 minutes, taking breaks as needed) can provide relief.

Patients who have severe pain or swelling are less likely to respond to conservative care. These patients may require a cortisone injection to relieve their pain, however, surgery is rarely necessary. If you or someone you know is experiencing any of these symptoms, give our office a call.