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Management of Muscle Injury and Myofascial Pain Syndromes-Chapter 6

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Management of Muscle Injury and Myofascial Pain Syndromes-Chapter 6

[Book]

Meridel I Gatterman

Lateral view of the sternocleidomastoid muscle illustrating the typical locations of trigger points (*). Anterior view of the scalenes. All three scalenes are seen on the right of the patient; the posterior scalene and ghosted-in middle scalene are seen on the left. The (*) indicate typical locations of trigger points. Trigger points (*) in the scalene muscles refer pain (x) anteriorly to the chest, laterally to the upper extremity, and posteriorly to the medial scapular border and adjacent interscapular region. Brachial plexus entrapment from swollen scalene muscles produces numbness and tingling (o) in the ulnar distribution, affecting the fingers, hand, and forearm. Posterior view of the right trapezius. The (*) indicate locations of typical trigger points. Trigger points (*) in the upper trapezius fibers (lateral view) characteristically refer pain (x) along the posterolateral aspect of the neck, behind the ear, and to the temple. Trigger points (*) in the middle trapezius refer pain (x) medially to the spinous processes and laterally to the top of the shoulder. Trigger points (*) in the lower fibers refer pain (x) mainly to the neck, suprascapular, and intrascapular region. Posterior view of the right levator scapula. The trapezius muscle has been ghosted in. The (*) indicate locations of typical trigger points. Trigger points (*) in the levator scapulae refer pain up the neck, into the shoulder, and along the vertebral border of the scapulae. Posterior view of the right splenius capitus. The trapezius muscle has been ghosted in. The (*) indicate locations of typical trigger points. Trigger points in the splenius capitus (*) refer pain (x) to the vertex of the head. Posterior view of the right splenius cervicis. The (*) indicate locations of typical trigger points. Trigger points (*) in the suboccipital muscles refer pain (x) from the occiput to the orbit. Lateral views of the right masseter. A, The temporalis has been ghosted in. B, The superficial head of the masseter has been ghosted in. The (*) indicate locations of typical trigger points. Trigger points (*) in the masseter muscle refer pain (x): A, from the superficial portion to the eyebrow, maxilla, mandible anteriorly, and to the eyebrow; B, from the mid-portion of the superficial layer to the mandible; and C, from the deep layer to around the temporomandibular joint. Right lateral view of the temporalis and masseter muscles. The masseter muscle has been ghosted in with the typical location of trigger points (*) in the temporalis muscle indicated. Views of the right lateral and medial pterygoids. A, Lateral view with the mandible partially cut away. B, Posterior view of the lateral and medial pterygoids with the cranial bones cut away and illustrating typical locations of trigger points (*). Anterior view of the neck illustrating the two bellies of the digastric muscle and the fibrous loop that attaches to the hyoid bone. Trigger points (*) in the posterior belly of the digastric muscle refer pain (x) to the upper part of the SCM. Trigger points in the anterior belly of the digastric muscle project pain into the lower incisor teeth refer pain to the lower incisors. Muscles of the rotator cuff. A, Posterior view showing the supraspinatus, infraspinatus, and teres minor. B, Anterior view showing the subscapularis, illustrating the typical location of trigger points (*). Sites of the seven most common pairs of trigger points noted in fibromyalgia patients. Comparison of Myofascial Pain and Fibromyalgia Syndromes Comparison of Trigger Points and Tender Points

Meridel I Gatterman

Bonnie L McDowell

Meridel I Gatterman

[Book]

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