Coroacobrachialis Trigger Points
The coracobrachialis muscle can radiate pain from the lateral shoulder and down the arm to the back of the hand or middle fingers. The pain can present slowly over time or immediately with acute injury or trauma. Symptoms can range anywhere from mild pain in the back of the upper arm and shoulder, to pain radiating down to the arm and wrist. Some people experience pain in the back of the hand especially when extending the middle or little fingers. Some people describe difficulty bending the elbow or when reaching behind their back. Many experience pain when reaching above their head and shoulders.
The coracobrachialis muscle originates on the coracoid process of the scapula and inserts on the brachium. Any muscle that utilizes the anterior shoulder for either forceful movement or stabilization can aggravate the symptoms. It is very common to experience increase dull and sharp pain with push-ups, climbing, throwing motions, golf, tennis, lifting, pull-ups, rock climbing, or stretching.
Reproduction of symptoms is always a hallmark and goal for any of evaluation and treatment. Being able to reproduce the radiating pain from the coracobrachialis trigger point that reproduces the patient symptoms helps both the patient and provider in the diagnosis and corresponding treatment.
A proper diagnosis is always the key to the fastest and most efficient treatments. Differential diagnosis is to be considered with anterior shoulder, arm, hand, and wrist pain can include a variety of tissue injuries. Thoracic outlet syndrome often follows the same pain pattern but affects the entire hand. Frozen shoulder causes increased shoulder pain and limited range of motion during both passive and active shoulder abduction. Nerve entrapment such as cubital tunnel in carpal tunnel syndrome affect different aspects of the fingers and hand. The short head of the bicep originates on the coracoid process of the scapula, similar to the coracobrachialis. Bicipital tendonitis should always be considered for localized pain on the coracoid process. Several rotator cuff sprains and strains such as supraspinatus tendinitis, rotator cuff joint capsule sprains, AC joint sprains, and shoulder bursitis should also be considered.
Several muscle, tendon, and shoulder ligament injuries that can radiate pain from the shoulder and down the arm including cervical disc, lower cervical nerve impingement, cervical facet sprains, cervical joint capsule sprains, trapezius sprains, anterior trapezius trigger points, pectoralis major, pectoralis minor, teres major trigger points; along with supraspinatus tendinosis, shoulder impingement syndrome, and anterior shoulder sprains.
Orthopedic testing will evaluate internal joint cartilage and ligament tissue damage. Palpation of the shoulder muscles and tendon insertions can find mild pain and injuries in multiple muscle groups.
Many times coracobrachialis trigger points do not occur in single isolation. They are a part of the complex dysfunction of the upper extremity movement patterns, which places stress on multiple muscles with every shoulder movement. Eventually several muscles begin to break down and experience tissue damage.
Palpation throughout the shoulder muscles will provide invaluable information for the additional muscles that have been injured throughout time. Palpation should reproduce radiating pain from the coracobrachialis trigger points down the lateral shoulder and posterior arm similar to the patient’s symptoms and main complaint.
Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.
When these treatments are incorporated into a treatment plan patients heal faster and are less likely to have long-term pain or soft tissue fibrosis or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.
NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options. Pain management is not usually required unless stronger medications or joint injections are required for treatment.
MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. NCV testing may be utilized in cases that also involve muscle, sensory, or reflex loss.
Cervical spinal disc bulges and herniations onto the spinal cord or nerve root produce different symptoms and location of symptoms. Your chiropractor, physical therapist, occupational therapist, or physician will evaluate your condition and make a proper diagnosis and treatment recommendations. Ask them any questions you might have about your injury.
The upper extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.
Many therapeutic exercises can help restore proper strength and endurance to the elbow flexor muscles. Isometric exercises are often the initial treatment exercises. Followed by single plane rubber band exercises for elbow flexion, extension, pronation, and supination movements. Dynamic exercises involving stability ball push-ups can be performed on the wall or floor. The more unstable of the surface the more effort and stabilization is required of all the upper extremity muscles.
Push-ups on a stability ball enhances neuromuscular learning throughout the neck, scapula, shoulder, upper arm, and lower our muscles. Additional strength exercises can be found on the arm and shoulder strengthening pages.
Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.