Shoulder Pain From Deltoid Trigger Points

Deltoid trigger points cause lateral upper arm pain

Pain radiating from the back of the shoulder and down towards the elbow can be caused by posterior deltoid trigger points. Patients describe arm pain with activity especially reaching in front and above their heads. They can also experience pain when pulling towards their chest especially with their elbow elevated. The pain tends to radiate from the posterior shoulder or scapular region across the lateral shoulder and towards the elbow.

Deltoid trigger points can occur with acute trauma such as improper lifting, throwing, pulling, or yard work activities. Many patients experiences pain with chronic repetitive postures and activities. Slouching with the neck and shoulders leaning forward increases the stress and strain across the neck and upper back. Many patients over utilize their posterior shoulder or extensor muscles leading to repetitive trauma and tissue damage; eventually leading to a deltoid trigger point.

Diagnosis and Evaluation of Trigger Points

A proper diagnosis is always the key to the fastest and most efficient treatments. Deltoid trigger points are a differential diagnosis for a variety of shoulder injuries. 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, rhomboid trigger points, trapezius trigger points, teres minor, and 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 deltoid trigger points do not occur in single isolation. They are a part of the complex upper extremity movement patterns that place stress on multiple muscles with every shoulder motion. Eventually multiple 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 deltoid trigger points down the lateral arm similar to the patient’s symptoms and main complaint.

Conservative Treatments

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.

Medical Treatments

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.

Conclusion

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.