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| Osteopathy |
The Pulled Muscle Causing Back or Neck Pain?
For most of us the 'pulled muscle' is an unlikely problem, though I commonly see people complaining of or having been diagnosed as the source of their neck pain or low back pain. This suggests that the 'diagnoser' is out of their depth on this subject. A pulled muscle is especially unlikely as the source of their back pain or neck pain. I admit this sort of pain may feel like a tear in the muscle causing muscular pain, but that tends not to be the reality of it.
These sorts of pains are invariably an irritation or 'locking' of the small facet joints at the rear of the spine, with associated local muscle spasm & pain. In the upper back, irritation of the costo vertebral or rib joints are another source of pain. These are often particularly sore when taking a deep breath. The main source of pain in these instances is from the joint and its enclosing capsule, giving sharp pain locally and/or referred pain to an associated area. The local muscular spasm pain is more of an 'ache'. When muscles are constantly contracted the flow of fluids in & out are restricted and you get a build up of metabolites (waste products) within the muscle, causing inflammation & irritation. The muscle is also being starved of nutrients, including oxygen and this is known as ischaemic muscle pain.
Pain in the upper back/chest, especially should be checked out by a 'primary health care professional' to establish if it is a musculo-skeletal problem or it is referred pain from one of the internal organs. Osteopaths are qualified to do this and incidentally I have seen more than one person who has had their gall bladder removed to find the pain has persisted. Once the rib joint problem was addressed, however, the pain disappeared!
Those that do 'pull' or tear muscles are usually high class athletes pushing the boundaries of human physical capability. The proverbial 'pulled hamstring' for example in a track athlete or footballer. You may have seen it on TV - they are completely unable to weight bear on the leg, as the hamstrings are the main hip extensors & knee flexor muscles and you cannot stand nup if you can't extend your hip.
There are a few exceptions that us 'mere mortals' may be unlucky enough to encounter, such as a snapped biceps tendon. In the upper arm, as the name suggest this muscle has two tendons (at the shoulder) and two bellies that join together at the lower single tendon that attaches to the upper forearm. It, therefore, flexes both shoulder and elbow. Uncommonly, the longer of the two upper tendons snaps under load, often causing great pain at the time. Also, a bruise may appear, that migrates down the arm with gravity, before dispersing. The muscle bellies appear 'bunched up' in a sort of 'Popeye' effect. Usually the shoulder is able to adapt and work around this and no effort is made to surgically re-attach the tendon. The shoulder may, however, be more prone to problems, such as, 'frozen shoulder' (adhesive capsulitis), 'impingement' or 'rotator cuff' problems. Regular stretching will prevent any such problems and if one has arisen, then manual treatment, such as, osteopathy would be appropriate, with prescribed stretches to support the treatment and aid recovery. Rarely surgery may be required with a severe rotator cuff muscle tear, but your osteopath can advise and refer when appropriate.
Another example, would be a partial or complete rupture of the Achilles Tendon. Reported to feel like being shot in the calf These usually need to be repaired surgically, if severe, and followed up with manual treatment for rehabilitation. If this sort of thing happens spontaneously (i.e. Without physical trauma), it indicates a weakness of the area or of the connective tissues in general. Causes include:- hereditary (genetic, postural, attitude toward exercise), lifestyle (i.e. 'Stress', fatigue, lack of stretching)), nutritional deficiencies (poor diet, quality of food or depleted nutritional status due to stress) and/or chronic dehydration (surprisingly common).
To sum up - pulled tendons & muscles occur only rarely and in the larger bellied muscles, not typically in neck & back muscles. These are multiple small bellied muscles, that work as a group and attach to the various boney prominences of individual vertebrae.
Muscle strain is another possibility
Common causes include:-
- Overdoing weights in the gym causes or just pushing yourself too hard can cause tiny micro-tears in the muscles. This occurs when there is tremor under load, pain and residual deep muscle ache for a day or two after. This is definitely not a case of - 'No pain, no gain'. Micro trauma to the muscles does not increase bulk and is detrimental to their health & efficiency.
- Excessive demand on unprepared muscles will similarly cause strain. Examples of this are poor lifting technique i.e. without bending knees, bracing yourself and with 'cold' muscles. Badminton commonly causes this sort of strain for the following reasons:- It is very popular with the 'middle aged' that often play once a week, do no other exercise in between, forget or don't bother to stretch before/after play. The same could be said for 'Sunday footballers', although a bad tackle may actually cause tearing (rupture), typically of the knee ligaments.
- Poor posture, such as, being slumped in a poorly designed car seat for hours. The curve of the lumbar spine doesn't appreciate being bent the wrong way for hours on end! For long trips - sit up properly, buy yourself a lumbar support cushion if necessary and take breaks. Also, being round shoulder throws the head in front of the line of gravity, so that the muscles at the back of the neck are having to work a lot harder to keep the head upright. These problems usually present as an ache in two bands either side of the spine. Although aggravated by poor posture, there are usually some underlying stiff vertebral joints, forcing the other areas of the spine to work harder. This is usually easily remedied with treatment and the right stretches if it's a long term problem.
- Maintaining an awkward position has a similar effect as above and can be treated likewise. Examples include working under the bonnet of a car or in a cramped space.
Andrew C. Woodhouse BSc (Hons) Ost
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