Chest Pain - Trigger Points in Pectoralis Muscles
Millions of people with chest pain are admitted as emergency cases every year, only 1 in 5 of these folk are actually diagnosed with a heart attack or an episode of unstable angina
Chest or Breast pain can be extremely worrying and there are indeed some types of chest pain that should signal an immediate trip to the emergency room.
If you do experience pressure, discomfort or pain in the central of your chest or in the arms, back, jaw, neck or abdomen — possibly accompanied with a cold sweat, a feeling of nausea, sudden fatigue, light headedness or a shortness of breath, and this last for at least 5 minutes — you should be calling for an ambulance or getting yourself to the emergency room for a check.
These symptoms may be a sign of a myocardial infarction or heart attack. If so, fast intervention and treatment could be essential to save heart muscle.
The good news is that whilst Millions of people with chest pain are admitted as emergency cases every year, only 1 in 5 of these folk are actually diagnosed with a heart attack or an episode of unstable angina - a strong warning that a heart attack may soon occur.
In a smaller number of cases, chest pain could signify other potentially life-threatening problem, such as a blood clot in the lungs (pulmonary embolism) or a tear in the inner layer of the aorta (aortic dissection).
In some cases chest pain is caused by regular angina. This condition occurs when a part of the heart isn't receiving sufficient oxygen-rich blood required during periods of physical exertion or emotional stress.
In a large number of cases, trigger points in the pectoralis major muscle may the cause.
These trigger points may typically cause pain and painful symptoms that can mimic quite closely some of the symptoms often associated with heart failure such as pain in the centre of the chest and diffuse pain through the shoulder and down the arm.
Only once correct medical advice has been sought to ensure the absence of any serious underlying conditions, should you then proceed to investigate the presence and effect of trigger points.
Please see the video above for more information regarding chest pain and trigger points, and when to visit a trigger point therapist.
Pectoralis Muscle Anatomy
Often referred to as pecs, the pectoralis muscles attach to the bones of the upper arm and shoulder. These muscles are used for a wide variety of arm actions, including flexion, extension, and rotation. Injuries to these muscles are becoming increasingly common.
The pectoralis major muscle has two main divisions. The clavicular division begins at the sternum and inserts into the lateral lip of the bicipital groove. It is innervated by the medial pectoral nerve. The latissimus dorsi muscle is stretched between the pectoralis major muscle tendon and the tendinous band.
The pectoralis minor muscle starts from the third through the fifth ribs and extends diagonally up the chest. It depresses the shoulder blade and helps to stabilize the shoulder complex. In addition to these functions, the pectoralis minor helps elevate the ribs for inspiration. It is also innervated by the medial pectoral and cervical nerves.
Common Injuries to Pectoralis Muscles
Pectoralis major strains vary from minor discomfort to complete ruptures. While some minor strains may be cured with rest and cold therapy, a complete tear requires surgical repair. The recovery period after surgery is dependent on the degree of damage, the ability of the patient to heal, and the amount of rest needed.Injuries to the pectoralis major muscle can be caused by a sudden trauma, such as a fall, or chronic overuse. Over time, the muscles can become tight and painful, leading to chronic problems. Some of the symptoms of a pectoralis strain include pain in the chest area and a rounded posture. In addition, stopping movement can weaken the muscles. If the pain persists, a physical therapist may be able to help.
The pectoralis major muscle can be damaged by a variety of factors, including acute trauma, chronic overuse, and muscle strain. A pectoralis strain is classified into three grades based on the severity of damage. The most common grade is grade II, which describes a partial tear. Grade III is the most severe and results in a complete rupture.
The pectoralis major muscle is also vulnerable to injuries to its tendons, which attach to the humerus. In addition to minor strains, a complete tear may cause discomfort in the chest area, and in some cases, pain and weakness in the arm. If the muscle strain is complete, a fusion of the tendon and muscle is necessary. Infusions may also provide temporary relief, but the tissue may eventually deteriorate.
A complete tear of the pectoralis major tendon may require surgery, depending on the degree of damage. The resulting condition will require rest and rehabilitation. For patients who are not able to undergo surgery, nonsurgical treatment is often the best option. Nonsurgical treatments may include cold therapy, NSAIDs, and steroid injections. It is important to avoid strenuous activity for several weeks after the injection, as the steroid may weaken the tissue and may lead to a complete tear.
The recovery time after a pectoralis muscle tear depends on the degree of damage, the ability of patients to heal, and the amount of rest needed. Most patients will need long-term physical therapy, manual therapy or strengthening exercises after surgery.