Trigger Points – Pain in the upper back, index finger and thumb

Client’s Description

People complain about pain just inside of the shoulder blade, and in the thumb, and index finger. It doesn’t always create pain in the hand; sometimes it is tingling like it is “falling asleep” or “going numb.” Sometimes, they have pain or tingling when reaching out with the hands near shoulder level as when driving, or cutting hair.

The pattern does not usually occur in full, as illustrated, but as part of that pattern. As the illustration indicates, the pain. Tingling and “numbing” is most likely to occur in the areas of darkest red. When there are stiff, swollen hands, the sensations around the index finger and thumb are a greater focus, although the tension behind the shoulder is usually there. If I press into this muscle at the base of the neck, the client almost always describes sensation between the shoulder blades and down the arm.


These trigger points also create pain in the front of the chest and may produce shooting pains through the chest.

If you have chest pains, see your doctor first before looking at releasing these trigger points to relieve the symptoms.

There are exceptions, but people are usually not clear about how this occurred, It is most often created by breathing while leaning forward, as when one works on a laptop while sitting, as I am doing now. The scalenes go from being assistive breathing muscles to being the primary respiratory muscles as the lift the upper ribs and collarbone to inhale.

When they identify an activity, it usually involves an activity where they are seated with the arm in from of them as when they are driving with the arms at 10 & 2, working while slumped forward, rowing or activity that created heavy breathing. These muscles get involved in assisting with heavy breathing as when sprinting or climbing stairs. People with this problem complain of tingling in their hands while huffing and puffing. This can also be a sign of thoracic outlet syndrome.


Get Relief with Self Care.

This post has strategies for getting relief on your own. Explore how to change your activities, stretch and other strategies that relieve the pain associated with this trigger point.

Better Bodywork Through Shared Expertise.

This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.



This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.


Weekly Featured Post

Customize Your Desk Area
To Avoid Pain
While Working and Afterward

We spend a lot of time reading and working on our computers. Here is a simple guide for the more active, athletic body and one that needs more support. There are also suggestions for accessories that make your days at work (and afterward) more comfortable.


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.

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