Latissium Dorsi Trigger Points

Latissimus Dorsi Trigger Point

The origin of the latissimus dorsi muscle is the spinous processes of vertebrae T7-T12, thoracolumbar fascia, iliac crest, inferior 3 or 4 ribs and inferior angle of scapula, and the insertion is located on the floor of intertubercular groove of the humerus. The muscle is innervated by thoracodorsal nerve.

Trigger points in the latissimus dorsi cause pain in the mid back, below the shoulder blade. They also refer pain to the lower back and stomach. Additionally, they cause pain along the inside of the arm, all the way to the fourth and fifth fingers of the hand. Pain in the fingers, with no numbness, is usually due to the latissimus dorsi. The diagrams below show the path of the referred pain as it travels from the trigger points along the back of the arm.

People often feel the burning behind the shoulder blade when slouching at a computer or sleeping on their shoulder. Reaching in front of them and lifting a gallon of milk out of the top shelf causes sharp radiating pain.

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.

Treatment for shoulder injuries often requires a variety of exercises, stretches, conservative treatments, medical treatments, and home therapies. Shoulder injuries can become chronic if the appropriate steps are not taken.

Elbow injuries often occur in people with severe or chronic shoulder injuries. People begin trying to alter their shoulder motions to protect it. Unfortunately these altered body mechanics tend to overwhelm the muscles and tendons around the elbow. People often develop a secondary cubital tunnel syndrome, tricep tendonitis, medial epicondylitis, pronator teres syndrome, double crush, carpal sprains, wrist tendinitis, de quervain's tendonitis, lateral epicondylitis, finger extensor strains, or carpal tunnel syndrome.

Treatment for elbow injuries can be extensive if the tendinosis is severe. Mild strains can be treated at home with PRICE, home stretches, and exercises. Don’t wait for damage to both the shoulder and elbow to seek treatment and therapy.

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. Pain radiating in the hand is one symptom; along with numbness, weakness, fatigue, loss of sensation, or reduced reflexes. 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.

Many people do have arthritis or degenerative changes in their shoulder, elbow, wrist, finger, or thumb joints. Arthritis does not mean you will always have pain in the joints. Degenerative arthritis means the structural Integrity of the bones have changed which alters its gliding, sliding, and hinging motions. The more severe the arthritic changes the easier it becomes to aggravate the joint and produce pain.

Osteoarthritis and rheumatoid arthritis will also slow healing and recovery time. Fortunately arthritic changes does not mean you will always have pain. Future pain will not necessarily be from the arthritis. People with severe shoulder arthritis can have no pain in their day to day activities. In fact many times people blame their arthritis pain on tendinosis or tendonitis of the shoulder stabilizing tendons that attach around the shoulder joint. Conservative treatment can improve shoulder pain; and people will have dramatically less pain with their work and home activities.

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 arm muscles. Additional strength exercises can be found on the arm and shoulder strengthening pages.

Our Chandler Chiropractic and 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.