Muscle spasms in neck, shoulders and arms are affected by fascia which is everywhere in our body. It is the solid lubricant that allows our various organs and muscles to move against one another without creating friction.
Not only is each of our muscles surrounded in fascia but each individual muscle fiber is also encased in this organic lubricant. When a muscle contracts the fascia allow the individual fibers to slide easily over one another.
The picture below is a close up of normal human muscle fibers. You can see how they overlay each other. The fascia glistens with moisture making it easy for contractions to take place.
As we age fascia begins to dehydrate losing its water content and lubricating ability. As this happens the fascia become stickier and instead of sliding against one another the muscle fibers start to stick together. The fibers get tighter and will cause muscle spasms in necks, shoulders and arms.
They eventually form knots; which everyone has likely had at one point in time. These are called adhesions and are also a common cause of left and right side neck pain and headaches.
There is no native mechanism in the body to fix muscle adhesions. Once they occur the body is powerless to fix them on its own. Adhesions also restrict a muscle from fully contracting.
When contracting the muscle fibers need to broaden and slide over each other. The adhesions restrict this motion just like a rusty hinge will make it hard to open a gate and many times stop it from fully opening.
It is estimated that a person loses about 30% of their muscle contraction when there is an adhesion. What does this mean? It means that you are weaker. Someone can perform muscle testing on you and muscle adhesions will show up as a muscle being weak. If you were simply lazy you can exercise the muscle to get stronger. If you have an adhesion you will get stronger once you have the adhesion removed.
As adhesions develop we are not necessarily feeling pain. Imagine you have a scale from 0-10 for the tightness of a muscle with zero being as loose as possible and 10 being as tight as possible.
You will not feel pain until you are at about a level 7.
Chronic myofascial pain will be experienced from about level 8 through 10 where you constantly feel the pain and muscle spasms in neck, shoulders and arms.
From 4-7 you won't feel pain but if someone presses on a muscle it will be tender or even painful. We have all had that experience when someone squeezes our shoulder for instance and it is tender. That sensation is the muscles beginning to tighten.
Below level 4 is where we want to be where the muscles are fairly loose and can absorb physical activity before becoming tight.
Trigger points can also cause muscle spasms in necks, shoulders and arms. They develop when you have neurological tightness and adhesions from dehydration of the fascia. Once the adhesion develops a trigger point is created at the spot of the adhesion. This trigger point will refer pain to another part of the body.
The picture below shows two trigger points in the pectoralis minor muscle which typically cause chronic shoulder pain and refer pain down the arm in the red highlighted areas.
We do not yet understand exactly how a trigger point works but they do have predictable patterns.
Janet Travell discovered this referred pain phenomena and has written a couple of books that layout the possible originating trigger points for each area that is experiencing referred pain.
How do you know if you have a trigger point related problem? If the doctor or therapist is probing the area of pain and cannot stimulate the same pain sensation then it is likely a trigger point related issue.
One example would be someone experiencing pain in the front of their shoulder. The therapist will probe the shoulder area trying to reproduce the pain sensation. If they are unable to that they can then check if it may be referred pain from a trigger point.
Travell's books will list the specific trigger points that are known to refer pain to the front of the shoulder. As the therapist probes each of those areas one will reproduce the pain sensation that the patient is experiencing.
The picture below shows two trigger points in the trapezius muscle which typically refer pain across the shoulder and up the neck to the base of the skull in the red highlighted areas.
Doctors continue to research the mechanism behind how trigger points cause muscle spasms in necks, shoulders and arms. Until this is understood we at least have the ability to pinpoint the muscle adhesion responsible for a patient's referred pain.
The important thing to understand with Myofascial Pain Syndrome is that it is 100% fixable. Any soft tissue injury involving muscles, tendons, ligaments and connective tissue can be fixed. The hardest part is accurately diagnosing the problem. A doctor or therapist experienced in soft tissue work should be able to determine whether your pain is muscle related. If it is many of the treatments can be performed at home by you.
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