Your Pain Pattern,
What Aggravates It,
The Underlying Anatomy
How to Get Relief,
How People Describe This Pain Pattern
People complain of stiffness, tightness, and pain in their mid-back. Almost always, they do 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 bent forward. It tends to be aching. This is different from most low back pain which feels sharp and fragile.
Because of its involvement in breathing. this often hurts when people sneeze or cough, as well.
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 cite it as referring forward and a little downward through the abdomen.
This pain pattern is particularly bothersome when it is on the right, where appendix pain flares up. Most of my clients will 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 have confirmation it is safe to do so.
How You Activate and Intensify This Pain Pattern
Deep Breathing While Bent Forward
The muscle that creates this pain, iliocostalis thoracis, helps to 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 muscles of the low back typically atrophy. This is at an age when cycling also becomes a less painful – and therefore more appealing – form of cardio.
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 and taught about anatomy, trigger points, and cranial therapies since the mid-90s.
*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 will include more patterns with better self-care. In the meanwhile, there may be inconsistencies in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.