Spine myofascial pain syndromes

Spine myofascial pain syndromes

According to my injury classification system, Spinal myofascial syndromes is considered level 2, as per the two structures compromised, alignment and muscle/tendon layers. Despite the several location types of spinal myofascial syndromes, the predisposing factors that influenced and lead to the development of this conditions, share a common biomechanical and neurological pattern of dysfunction.

The alignment of the spine and pelvis are key structures involved and responsible for maintaining the health and resilient of the soft tissue support. Most spinal muscles have their origin attachment in the adjoining appendicular regions and the inserted point on the spinal units. Their corresponding tendons are used as powerful leverages to aid on the required movement. Therefore, when the spine/pelvis complex is misaligned, this lack of mobility of the joint, makes the muscle support system having to compensate and contract harder in attempt to maintain the overall movement which eventually overload the muscle support system leading to the appearances of several spinal muscle injuries. Also, muscle hypertonicity and trigger points activities are common conditions seen because of an increased neurological input from a spinal misalignment dysfunction maintaining the corresponding muscles with an increased tone and leading to spams.


Spinal myofascial pain can be extremely painful as per the concentration of nerve receptors accumulated on muscles. Generally, patients initially report a localised sharp pain in the muscle involved with associated referred neurological patterns throughout the body.

Spinal muscle injuries and the corresponding level of dysfunction

Quadratus lumborum Strain; Causes pain on the lateral side of the abdomen with occasional refereed patters of pain towards the buttocks. Misalignments of the last rib, lumbar spine, and pelvis predisposed for the development of this condition.


Thoracolumbar fascia injury: Due to the several muscles that attached in this structure, this condition can be debilitating depending on the level of injury, patients have difficulty in walking, sitting for long periods and upper body twisting movements. Pelvic misalignment is a common predisposing factor for the development of this injury as per the extensive attachment points it shares with this structure.


Latissimus dorsi Syndrome; Is a muscle that has a widespread attachment points at several spinal units and the thoracolumbar fascia and inserts at the level of the shoulder. Hypertonicity in this muscle causes a significant trigger point referred patterns of pain towards the scapula and the whole inner arm and last two fingers. Lower thoracic, lumbar and pelvic misalignments could predispose to this syndrome

Scapulocostal Syndrome; is a condition that causes trigger points activity with patterns of referred pain towards the neck and upper extremity. Is generally associated with mid back thoracic misalignment dysfunction causing certain scapulothoracic muscles to become hypertonic and spastic. In my clinical experience T3/4 dysfunction is the common segment associated with this syndrome.


Gluteus Maximus/Medius pain syndrome; is a condition that cause significant trigger point activities and a widespread refereed pattern of pain towards the lower extremity. Pelvic and L5-S1 misalignments are common segments responsible for the development of this condition.


Multifidus and Erector Spinae Strain; These muscles are situated deeper in the spine and are responsible for controlling in the intrinsic spinal movements. Therefore, injuries in theses muscles may cause an important deep pain with possible referred patterns of pain along the spinal column. There might be a significant restriction in motion, incapacitating mainly the rotational movements.




Clinical evaluation of the spinal alignment and specific orthopaedic tests to pinpoint the location of the injured muscle/tendon.


Anterior – posterior (AP) and lateral  spinal views are an essential imaging to check the different patterns of spinal misalignments that contributed to the muscle injuries.


Locate the exact injury point; Allows the treatment to be more specific during the application of the treatment modalities, in addition aids to identify the type of tendinopathy (tendinitis or tendinosis) and the corresponding appropriate treatment care.

Identify the extent of tissue damage and the presence of scar tissue; Provides valuable information regarding prognosis and the application of friction soft tissue modalities to aid on scar tissue removal.


Treatment Protocol

 Specific  Spinal adjustments  followed by a rehabilitation regime to strengthen the entire soft tissue support.

Application of Low-level Laser and PEMF to aid on the cellular level of heling as well as improving the microcirculation for the area.

Friction soft tissue therapy helps to reduce dysfunctional scar tissue

Dry needling may be used to improve local blood flow and to reduce the deep muscle tension.

Specific selected essential oil application to enhance healing

Depending on level of misalignment and chronicity a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.

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