Your Pain Pattern,
What Aggravates It,
The Underlying Anatomy
How to Get relief,
Want to skip ahead?
Here’s a link to my post about
getting relief on your own.
How People Describe This Pain Pattern
People complain of stiffness, tightness, and pain in their mid-back. They almost always make this awkward move where they reach back to touch the lower ribs on that side. Often, they complain about how it stiffens their lower back. They may even refer to it as low back pain as they touch the lower ribs. At times, they complain of how it extends up to the outside of the shoulder blade.
It bothers them when they are cycling or pulling weeds. This, unlike other low back problems, seems to be connected to breathing deeply while bending forward. This pain tends to ache. In contrast, most low back pain feels sharp and fragile.
Because of its involvement in breathing, this often hurts when people sneeze or cough.
For many, this trigger point refers forward to the abdomen. In my experience, people talk about how it wraps around to the front. However, most trigger point research cites it as referring forward and a little downward through the abdomen.
This pain pattern is particularly bothersome on the right, where appendix pain flares up. Most of my clients have already contacted their physician to check for gastrointestinal issues. If they have not, I refer them out to have it checked and avoid working in the abdomen until we confirm it is safe.
How You Activate and Intensify This Pain Pattern
Deep Breathing While Bent Forward
The muscle that creates this pain, iliocostalis thoracis, helps depress the ribs in deep breathing. It gets to be a more likely problem in clients over 45. In the mid-40s, the sacroiliac joint starts to fuse, and the low back muscles typically atrophy. Typically, cycling is more appealing at this age as it is less painful and injury-prone than running.
Awkward Reaching and Twisting
This pain pattern also bugs people when they are reaching and twisting. This mid-back muscle helps to extend and twist the back. Combined with deep breathing, it can create an ache. Awkward and imbalanced reaching and twisting can be the activity that jams a joint and starts it all.
The Musculoskeletal Anatomy Behind Your Pain
This section of the erector spinae ties the lateral angles of the ribs to the lower cervicals and pelvis. Read more in this post about iliocostalis.
Getting Relief on Your Own
This post has strategies for getting relief on your own. Explore how to change your activities, stretch, ice, and more to relieve the pain associated with this trigger point.
Therapy Notes for Massage and Bodywork
Through Shared Expertise
This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.
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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written materials and instructed classes since the mid-90s. This includes anatomy, trigger points, cranial, and neuromuscular.
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*This site is undergoing significant changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and include more patterns with better self-care. Meanwhile, there may be formatting, content presentation, and readability inconsistencies. Until we get older posts updated, please excuse our mess.