Trigger point or nerve involvement

[Som3a]

I have recently been working with a client presenting with an upper trapezius and supra scap strain. His latissimus dorsi has an area close to the teres major that acts like a trigger point and refers "pins and needles" down into the elbow and down to the hand. My client experiences quite an intense sensation that feels like nerve involvement to him.

Any comments would be helpful.

 

[lena]

Pins and needles definitely sounds like nerve involvement... TrP referral pain doesn't cause that kind of reaction. Speed of the sensation is also important... nerve discomfort usually starts right away after the nerve is irritated while TrP pain usually spreads over time with pressure on the TrP.

Now you could be striking the radial nerve, but usually it's protected quite well by the triceps and teres major so I don't think it's that, but you'd have to rule it out.

What could be occurring, and what I find with some of my treatments, is while working the lateral boarder of the scapula you might be discovering a tight pectoralis on the anterior aspect of the shoulder which is causing a type of thoracic-outlet symptom to the arm. Usually to work the lateral scapula we need to protract the scapula posteriorly to access those muscles, which in turn puts pressure on the anterior aspect. If the pec is tight it will strap down on the brachial plexus causing the neurological short-circuit. Try treating the chest and anterior shoulder to see if it reduces or removes the discomfort.

Hope that helps, please post any updates here.

Steve

 

[Igggy]

Lats and teres can compress the cutaneous nerve, which hooks up with the ulnar (?) nerve and can cause the nerve referral pattern you mention. Best to avoid direct compression on the irritated nerve if you can, but provide MFR and stretching until parethesia lessens, then return to usual techniques to continue loosening the rotator cuff and lats.

 

[Beckiie]

tp or nerve involvement

Thank you for replying, Steve.

I am quite certain it is not thoracic outlet syn. But I will definately consider the possibilty of radial nerve involvement.

Thank you again for your help!

 

[Greg0rz]

Trigger point or nerve involvement

I believe the cutaneous nerve is exactly it!

Thank you for your help muscle squisher! I have had this question posted in three different sites for over a month now and just recently posted on this site! This is only the second reply I have received and it is VERY appreciated![/u]

 

[Citizen of the Cosmos]

consider also the axillary nerve as primary site of compression, and double-crush syndrome = pressure over axilla causing compression/referral from brachial nerve bundle as it passes under pec minor. Any pressure to the scapula/ribcage can examassageplanetate symptoms of pectoralis minor syndrome, even if it's not the primary site of nerve irritation.