Acupuncture for Deltoid Pain
A person with deltoid pain
Acupuncture for Deltoid Trigger Points: The Complete Guide to Understanding and Treating Deltoid Pain
Do you experience shoulder pain or limited range of motion in your arm? The deltoid muscle could be the culprit. This muscle is an important part of the shoulder joint. It is a common site for trigger points and pain, especially among athletes and those who engage in repetitive arm movements. In this comprehensive guide, we'll delve into the anatomy of the deltoid muscle, its three distinct fiber types, and how acupuncture and dry needling can offer relief for deltoid muscle pain.
Anatomy of the Deltoid Muscle
Origin
The deltoid origin comes from three different points: the lateral one third of the clavicle, acromion, and the spine of the scapula. These origins give rise to three distinct sets of muscle fibers: anterior, middle, and posterior.
Insertion
The deltoid insertion is at the deltoid tuberosity. All fibers of the deltoid muscle converge to insert into the deltoid tuberosity on the humerus, forming a broad, triangular muscle.
Muscle Action
All fibers:
Abduct shoulder
Anterior fibers:
Flex shoulder
Medially rotate shoulder
Horizontally adduct shoulder
Posterior fibers:
Extend shoulder
Laterally rotate shoulder
Horizontally abduct shoulder
The deltoid muscle is a powerhouse of arm and shoulder movements. The anterior fibers are primarily responsible for shoulder flexion and internal rotation and are located on the front side of the shoulder. The middle fibers mainly abduct the arm, while the posterior fibers are primarily involved in shoulder extension and external rotation. All three sets of fibers assist in arm abduction.
Other names for the deltoid muscles (delts):
Anterior deltoid:
Anterior delt
Front deltoid
Front delt
Front delts
Clavicular deltoid
Lateral deltoid:
Lateral delt
Middle deltoid
Middle delt
Posterior deltoid:
Posterior delt
Rear deltoid
Rear delt
An image of the deltoid muscle
Function of the Deltoid Muscle
The deltoid muscle is not just an anatomical showpiece; it's a functional dynamo. Whether you're lifting a bag, throwing a ball, or even waving, your deltoid muscle is hard at work. It plays a pivotal role in almost all shoulder movements and is particularly engaged during activities that require lifting the arm to the side or front.
Because of its involvement in various activities, the deltoid muscle is often subjected to overuse and strain, leading to deltoid muscle strains or trigger points. Activities like weightlifting, swimming, or even prolonged typing can put stress on the deltoid, leading to discomfort or pain.
The deltoid muscle is a complex structure that consists of three distinct sections: the anterior (front or clavicular fibers), lateral (middle or acromial fibers), and posterior (back or spinal fibers) fibers. Each of these sections plays a unique role in arm movement and stabilization. When all three sections contract together, they assist in lifting the arm past the initial 15 degrees of abduction.
During the process of arm abduction, the anterior and posterior fibers of the deltoid muscle are crucial for stabilizing the arm. Meanwhile, the lateral section aids in elevating the arm from 15 to 100 degrees. Beyond arm movements, the deltoid muscle also has a role in ambulation or walking. Specifically, the anterior deltoid collaborates with the pectoralis major to flex the arm, while the posterior deltoid works in tandem with the latissimus dorsi to extend the arm.
Another key function of the deltoid muscle is its role in stabilization, particularly when carrying heavy objects. For instance, during activities like dead-lifting or carrying weights with arms fully adducted, the deltoid muscle prevents the downward displacement of the glenohumeral joint. It also generates compensatory force during the arm's abduction, enhancing overall joint stability.
The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and the subscapularis) help the deltoid with the initial 0 to 15 degrees of shoulder abduction and then help stabilize the shoulder when abducting past 15 degrees.
Understanding the intricate functions and anatomy of the deltoid muscle can offer insights into the causes of deltoid pain and how treatments like acupuncture and dry needling can effectively target specific trigger points for relief.
Deltoid Trigger Points
Indications
Back of Arm Pain
Back of Shoulder Pain
Front of Arm Pain
Common indications for deltoid trigger points include localized pain in the affected part of the deltoid muscle, which can be severe and sharp or sudden pain in quality. Symptoms often include deltoid pain, deltoid muscle pain, and deltoid strain.
Signs and Symptoms
Difficulty abducting shoulder to horizontal
Deep pain in deltoid area
Localized pain in the anterior, middle, or posterior part of the deltoid muscle is a common symptom. This pain can be sharp, stabbing, or even a dull ache, affecting your ability to move your arm freely. It may also be difficult to lift the affected shoulder.
Perpetuating Factors
Direct trauma like from sports or bumping into something
Falling on outstetched arm
Intramuscular injection (like a vaccine)
Muscle weakness with impaired strength and range or motion
Repetitive strain from overuse or excessive lifting
Activities that involve repetitive arm movements, heavy lifting, or sudden impact, like in certain sports, can exacerbate these trigger points. Even everyday activities like carrying a heavy bag on one shoulder can contribute to deltoid pain.
Deltoid Trigger Point Referral Pattern
The anterior deltoid trigger point (TrP) refers to anterior and middle deltoid
The middle deltoid trigger points refer locally and into adjacent fibers
The posterior deltoid trigger point refers locally to back of the shoulder
Unlike many other muscles, the pain from deltoid trigger points is generally localized and does not cross the elbow or refer to distant areas. The pain is usually confined to the anterior, middle, or posterior part of the muscle, depending on the trigger point's location.
Differential Diagnosis
Rotator cuff tear
Bicipital tendonitis
Subacromial/subdeltoid bursitis
Glenohumeral joint arthritis
It's crucial to differentiate deltoid pain from other conditions like rotator cuff tears, subdeltoid bursitis, and impingement syndrome. Misdiagnosis can lead to ineffective treatment and prolonged discomfort.
Associated Trigger Points
Infraspinatus
Pectoralis major
Biceps brachii
Other rotator cuff muscles
Deltoid trigger points often develop as satellites from key trigger points in other muscles, especially the infraspinatus, another muscle in the shoulder region. The pectoralis major and biceps brachii muscles also commonly have trigger points along with the deltoid muscle.
Deltoid trigger points commonly accompany rotator cuff injuries.
Synergists and Antagonists
The deltoid muscle doesn't work in isolation. The anterior fibers work synergistically with muscles like the pectoralis major and biceps brachii, while the posterior fibers act in concert with muscles like the latissimus dorsi and triceps brachii. Since the deltoid muscle performs many shoulder actions there is a long list of synergists and antagonist muscles depending on the action. Understanding these relationships is crucial for effective treatment and rehabilitation.
Acupuncture and Dry Needling for Deltoid Pain
Acupuncture and dry needling are effective treatments for deltoid trigger points. These modalities can relieve localized deltoid pain, improve range of motion, and enhance overall shoulder function. They are particularly beneficial for those who have experienced deltoid muscle pain due to overuse or trauma.
A 2022 review on acupuncture for shoulder pain found that more research supports the use of acupuncture as a shoulder pain treatment.
A 2021 study showed that dry needling of trigger points in the shoulder provided relief for up to a week after each visit.
Conclusion
Understanding the intricate anatomy and function of the deltoid muscle is essential for diagnosing and treating deltoid pain effectively. Acupuncture and dry needling offer promising avenues for relief and recovery. If you're experiencing symptoms related to the deltoid muscle, consider scheduling an appointment with us at Morningside Acupuncture for a comprehensive treatment plan tailored to your needs.
Over to you
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Sources:
Travell, J. G., Simons, D. G. (1993). Myofascial pain and dysfunction: The trigger point manual. London: Lippincott Williams & Wilkins.
Biel, A., & Dorn, R. (2010). Trail guide to the body: A hands-on guide to locating muscles, bones and more. Boulder, CO: Books of Dicovery.
Janda, Vladimír. “Muscle Function Testing.” (1983).
Elzanie A, Varacallo M. Anatomy, Shoulder and Upper Limb, Deltoid Muscle. [Updated 2023 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537056/
Shoulder Pain and the Potential Role of Acupuncture: A Narrative Review of Clinical Practice and Treatment Guidelines Perspect Integr Med. 2022;1(1):3-9. Published online September 22, 2022 DOI: https://doi.org/10.56986/pim.2022.09.002
Pai, M. Y. B., Toma, J. T., Kaziyama, H. H. S., Listik, C., Galhardoni, R., Yeng, L. T., Teixeira, M. J., & Ciampi de Andrade, D. (2021). Dry needling has lasting analgesic effect in shoulder pain: a double-blind, sham-controlled trial. Pain reports, 6(2), e939. https://doi.org/10.1097/PR9.0000000000000939
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