Back Muscles
Superficial Paraspinal Muscles
Location The paraspinal muscles are a group of muscles that run on each side along the spine. They are divided into two general categories; the superficial paraspinal muscles and the deep paraspinal muscles. As the name indicates, the superficial group lies on the surface and covers the deep paraspinal group of the muscles. In this section, we will be discussing the superficial paraspinal muscles. The superficial group consists of three different muscles lined up next to each other. They are called Spinalis, Illiocostalis, and Longissimus. All of these mussels originate at the base of the spine and run along the spine towards the head. Images below highlight the Spinalis muscle located closest to the spine and Longisimus forming the largest bulk of the superficial paraspinal muscles.
FunctionThe superficial paraspinal muscles are important for allowing us to walk upright since they help to support the spine in an upright position. When we are standing straight, these muscles are generally relaxed, but they will tighten up as we bend forward to tie our shoes or pick up an object from the floor. If they are too tight, the individual may experience pain in the lower back as the muscles are stretched over their limit. This is accompanied by limited ability to bend forward. If there is significant pain with even slight attempt to lean forward, which usually happens during acute back pain, the cause for the pain is usually spasm of the superficial paraspinal muscles. If the back pain only starts after the individual is already at least 1/3 of the way bending forward, the ligaments that attach the superficial paraspinal muscles to the base of the spine, are most of the time to blame. Additionally, the superficial paraspinal muscles are involved in bending our torso sideways, helping us with exhalation and moving the bowel. They are also recruited every time we sneeze or cough since they attach to the ribs. Back pain and the common coldMany people experience back pain or their existing back pain gets worse during a common cold. Back pain in this scenario develops mostly secondary to coughing and sneezing. Superficial paraspinal muscles, as well as Quadratus lumborum, which is another important back muscle, are one of the many muscles attaching to the ribs. When we cough or sneeze, the ribcage rapidly contracts. These repeated contractions over period of days lead to significant strain of the back muscles and can lead to a spasm.
Most characteristic pain caused by trigger points in superficial paraspinal musclesThe trigger points in the superficial paraspinal muscles cause the most characteristic pain in the lower back. Many people make the mistake searching for the source of the low back pain around the base of the spine where the pain is primarily perceived. While trigger points can be present in this area as well, more frequently than not, the real culprits are trigger points at the level of the lowest ribs. This is the area that sustains most stress. The area of the lowest ribs is where the more flexible thoracic spine transitions to less flexible lumbar spine. Depending on the distance from the spine, the trigger points around the lowest rib refer pain to the base of the spine, the entire buttock, but also upward, towards the scapulae. Tight feeling in the back muscles is generally a sign that back pain is near, even if there is no back pain at the moment. This is the case in the onset of severe debilitating back pain caused by lifting a pen from the floor or making a sudden movement. The muscles were already becoming tight over period of time. All it took was a wrong move that pushed them over the edge and triggered a protective muscle spasm. Repetitive lifting of heavy objects from the floor with poor technique is one of the main reasons for developing trigger points in the superficial paraspinal muscles. Particularly damaging is lifting something while being tilted to only one side which puts most of the pressure on one side of the back muscles. Location of trigger points & Acupressure tipsThere are generally recognized six trigger points in the superficial paraspinal muscles. As noted earlier, they are usually located slightly above or below the lowest rib. In reality, however, trigger points in the superficial paraspinal muscles can be present anywhere along the spinal column. Therefore it is imperative to search and massage all tender spots. The best way to massage these trigger points is to lean against the wall with a tennis or baseball ball between your back and the wall. You can also place the ball on the floor and lay down on the ball. A foam roller is not recommended to address these trigger points, because it cannot deliver the specific pinpoint pressure needed to address the specific tender area.
Summary
SymptomsBack muscles can become tight over their entire lengthThere are numerous TrPs that refer to a variety of pain patternsHypersensitive knots can be present in any location along the back musclesTrigger points in these muscles can cause aching pain when asleepIndividuals usually feel stiff when trying to bend forward Location of trigger pointsTrigger points are usually located 1-3 inches to the side of the spineMost frequent location is slightly above and below the lowest ribSearch the entire area from the mid-back to the sacrum Pain radiationGenerally downward to the lower back and the buttocks
Causes for development of trigger pointsPicking up heavy objects is a major causeLifting something suddenlyLifting objects with the body not centeredBending to one side repeatedlyWhiplash injuries
Trigger points self-acupressurePlace the ball between the wall/bed & the backFind the tender area in the back musclesMove the ball horizontally over the tender spotDo not move the ball over the spineFind a new tender spot slightly above or belowRepeat rolling back & forth over the tender areaMassage all tender spots on both sides of the spine
General recommendationsMove ball over the tender area 15-20 timesFind a new spot & repeat the processApply this massage at least 2-3 x a daySeveral short daily sessions are preferableDo not apply very strong pressureIncorporate into HOME TREATMENT PROTOCOL
Acupressure
