Pain radiating down the arm
Some interesting facts that might help you…
Pain down the arm is a common symptom in my clinic, understandably so when we look at the anatomy of the arm, specially at its complexity at the shoulder joint.
Pain in the arm presents itself in different ways, sometimes felt on the top half of the arm, sometimes only on the forearm, both, on the hand, etc.
In order to have an all around understanding of pain down the arm, we need to talk about trigger points. You can have a look at one of my previous posts explaining what trigger points are here. In summary, trigger points are hyperirritable spots within a taut band of skeletal muscle. These trigger points cause pain when active, pain that can be local or refer onto a different part of the body; this last point (referred pain) is where we’re focusing on this post.
There are, of course, other different causes for pain felt down the arm (like for example injury) but we’ll focus on trigger points as they encompass a lot of the most common causes.
Let’s have a look at which muscles have their trigger point referral pain pattern down the arm.
Pain down the arm is a common symptom in my clinic, understandably so when we look at the anatomy of the arm, specially at its complexity at the shoulder joint.
Pain in the arm presents itself in different ways, sometimes felt on the top half of the arm, sometimes only on the forearm, both, on the hand, etc.
In order to have an all around understanding of pain down the arm, we need to talk about trigger points. You can have a look at one of my previous posts explaining what trigger points are here. In summary, trigger points are hyperirritable spots within a taut band of skeletal muscle. These trigger points cause pain when active, pain that can be local or refer onto a different part of the body; this last point (referred pain) is where we’re focusing on this post.
There are, of course, other different causes for pain felt down the arm (like for example injury) but we’ll focus on trigger points as they encompass a lot of the most common causes.
Let’s have a look at which muscles have their trigger point referral pain pattern down the arm.
Muscles that refer pain down the arm…
Active Trigger Points are known to cause pain and/or referred pain in a specific, recognisable pattern. What does this mean? It means that the pattern of pain caused by trigger points is the same or very similar in every person.
The legend Dr Janet Travell (1901-1997) discovered Trigger Points and their pain patterns and extensively documented it in what we could call maps of pain patterns.
These maps of pain patterns help identify and treat the origin cause of the pain. This is where clinical massage therapists knowledge and ability to identify these patterns comes into play.
See picture above for an example of a pain pattern map for the Piriformis muscle, a muscle located in the gluteal area. The “x” marks where the muscle is located and the area in red marks where the pain is felt. When a client comes presenting with pain in that pattern we will be looking at assessing and treating that muscle. There are of course other muscles that refer pain in the same area and have very similar map patterns and that’s where the fun relies for a clinical massage therapist, how fast can I find and release the right one? It’s an art in itself.
Muscles that refer pain down the arm…
Active Trigger Points are known to cause pain and/or referred pain in a specific, recognisable pattern. What does this mean? It means that the pattern of pain caused by trigger points is the same or very similar in every person.
The legend Dr Janet Travell (1901-1997) discovered Trigger Points and their pain patterns and extensively documented it in what we could call maps of pain patterns.
These maps of pain patterns help identify and treat the origin cause of the pain. This is where clinical massage therapists knowledge and ability to identify these patterns comes into play.
See picture above for an example of a pain pattern map for the Piriformis muscle, a muscle located in the gluteal area. The “x” marks where the muscle is located and the area in red marks where the pain is felt. When a client comes presenting with pain in that pattern we will be looking at assessing and treating that muscle. There are of course other muscles that refer pain in the same area and have very similar map patterns and that’s where the fun relies for a clinical massage therapist, how fast can I find and release the right one? It’s an art in itself.
As mentioned above, trigger points in a muscle can cause pain locally (where the muscle is) or refer pain to a different part of the body.
Trigger points and restrictions in the arm muscles can cause local pain in the arm as well as contribute to the development of other conditions, like for example tennis elbow.
It gets more interesting though as trigger points and restrictions in muscles located on the shoulder blade (supraspinatus, infraspinatus, subscapularis, teres m&M) also refer pain into different parts of the arm and in different patterns of course, some of them reaching all the way down to the hand.
It doesn’t stop here, with other two very important muscles when it comes to treating pain down the arm, located in the neck and chest.
First one located in the neck, the scalens. Trigger points in this muscle group can refer pain down the arm all the way down to the hand.
Second one located in the chest, pectorals minor. Trigger points in this muscle can also refer pain dow the arm.
Now that you have a better understanding of where arm pain comes from, you might be asking yourself why do these muscles develop trigger points to begin with and also how do you know which muscle is the one causing the problem, so let’s answer these two questions.
As mentioned above, trigger points in a muscle can cause pain locally (where the muscle is) or refer pain to a different part of the body.
Trigger points and restrictions in the arm muscles can cause local pain in the arm as well as contribute to the development of other conditions, like for example tennis elbow.
It gets more interesting though as trigger points and restrictions in muscles located on the shoulder blade (supraspinatus, infraspinatus, subscapularis, teres m&M) also refer pain into different parts of the arm and in different patterns of course, some of them reaching all the way down to the hand.
It doesn’t stop here, with other two very important muscles when it comes to treating pain down the arm, located in the neck and chest.
First one located in the neck, the scalens. Trigger points in this muscle group can refer pain down the arm all the way down to the hand.
Second one located in the chest, pectorals minor. Trigger points in this muscle can also refer pain down the arm.
Now that you have a better understanding of where arm pain comes from, you might be asking yourself how do you release these trigger points, why do these muscles develop trigger points to begin with and also how do you know which muscle is the one causing the problem, so let’s answer these three questions.
How do you release trigger points?
We covered that during a clinical massage session, one of the work areas of focus is the release of Trigger Points.
Trigger points are released in a very effective way by direct steady pressure on them over a period of time, normally a few seconds (see picture below for an example). There are of course other ways of releasing them, some of them quite complex, but we will be not covering these today.
When steady pressure is applied over time, the muscle fibres that were stuck in contraction let go and return to their natural relaxed state.
Tissue responds well to patience, the slower the better. Regardless of what we’re treating, tissue also responds better when the therapist has taken the time, and has the knowledge to take their client into parasympathetic nervous system mode or deep relaxation (this is the mode in which our body restores and repairs itself. We lose time spent in this mode due to stress and the constant demanding and fast-paced society we live in)
For this reason at inside our treatments are holistic and deeply relaxing at the same time as being specific and goal oriented.
How do you release trigger points?
We covered that during a clinical massage session, one of the work areas of focus is the release of Trigger Points.
Trigger points are released in a very effective way by direct steady pressure on them over a period of time, normally a few seconds (see picture below for an example). There are of course other ways of releasing them, some of them quite complex, but we will be not covering these today.
When steady pressure is applied over time, the muscle fibres that were stuck in contraction let go and return to their natural relaxed state.
Tissue responds well to patience, the slower the better. Regardless of what we’re treating, tissue also responds better when the therapist has taken the time, and has the knowledge to take their client into parasympathetic nervous system mode or deep relaxation (this is the mode in which our body restores and repairs itself. We lose time spent in this mode due to stress and the constant demanding and fast-paced society we live in)
For this reason at inside our treatments are holistic and deeply relaxing at the same time as being specific and goal oriented.
Why do Trigger Points develop?
Trigger points and restrictions in these muscles develop for different reasons, some of them being diet&hydration, stress&anxiety, postural imbalances&restrictions in other structures, injury, etc.
It’s therefore important to gather information about any previous injuries, any other areas of pain, stress levels, etc. It is also very helpful to identify the problem, to carry out a postural assessment and, if need be, a range of motion assessment of the affected joint (active, passive and resisted) and both joint above and below it.
This last point takes us to the next questions…
Why do Trigger Points develop?
Trigger points and restrictions in these muscles develop for different reasons, some of them being diet&hydration, stress&anxiety, postural imbalances&restrictions in other structures, injury, etc.
It’s therefore important to gather information about any previous injuries, any other areas of pain, stress levels, etc. It is also very helpful to identify the problem, to carry out a postural assessment and, if need be, a range of motion assessment of the affected joint (active, passive and resisted) and both joint above and below it.
This last point takes us to the next questions…
How do you know which muscle is the one causing the problem?
The assessment and consultation mentioned above is the first step that will point us in the right direction to correctly identify what the problem. These are tools that a good therapist must be using.
Now, this is where it gets fun and where not many therapists and definitely no conventional medicine doctor or convectional practitioner will have into consideration, Trigger Points referred pain pattern, the key to solve a great deal of pain!
How do you know which muscle is the one causing the problem?
The assessment and consultation mentioned above is the first step that will point us in the right direction to correctly identify what the problem. These are tools that a good therapist must be using.
Now, this is where it gets fun and where not many therapists and definitely no conventional medicine doctor or convectional practitioner will have into consideration, Trigger Points referred pain pattern, the key to solve a great deal of pain!