Muscles
Multifidi Trigger Points
Symptom Area: Upper Back, Shoulder and Arm
Multifidi Trigger Points are explored here through their location and referred pain pattern. Muscle knots is an everyday term used for tender muscular spots; myofascial pain describes pain involving muscle and its surrounding connective tissue. Deep spinal stabilizer at every segmental level; key for low back resilience.
Where you feel it
When the Multifidi holds active trigger points, you usually notice it as abdominal pain, back of neck pain, bloating/nausea/abdominal cramps, irritable bowel and low back pain. Where the pain spreads: Local segmental pain, often felt as a 'spot' the patient can point to. What often sets it off: Acute low back episodes, disuse atrophy, chronic guarding.
Overview
Deep spinal stabilizer at every segmental level; key for low back resilience. Trigger points here are common in everyday and athletic populations and frequently contribute to the referred pain patterns described below.
Trigger point locations
Deep alongside the spinous processes.
Referred pain pattern
Local segmental pain, often felt as a 'spot' the patient can point to.
Palpation & testing
Palpate the muscle belly along its accessible course. Reproduction of the patient's familiar pain on palpation supports involvement.
Common causes
Acute low back episodes, disuse atrophy, chronic guarding.
Self-care & clinical treatment
Segmental motor control work, breathing retraining. Clinically: needling and graded loading.
Treatment protocol
For Multifidi, the general protocol applies: sustained pressure release on the taut band, then stretch and active movement in the newly gained range.
Position and palpation: Palpate the muscle belly along its accessible course.
Regional precaution for clinicians: Over the upper back and shoulder girdle the pleura lies immediately deep to thin muscle, so pneumothorax is the key risk; needling is performed tangentially or against a bony backstop (rib, scapula), never perpendicular to an intercostal space.
Primary Symptoms
Secondary Symptoms
Often confused with
These muscles cause the same primary symptoms, so they are checked together:
Related muscles in this region
Related articles
- Burning pain between the shoulder blades at the desk: the trigger points that cause it
- Low back pain that flares when you stand: a step-by-step quadratus lumborum treatment plan
- SI joint pain (base of the spine): which trigger points cause it and how to treat them
- Mid-Thoracic Back Pain: which trigger points cause it and how to treat them
- Bloating/Nausea/Abdominal cramps: which trigger points cause it and how to treat them
- Low Back Pain: which trigger points cause it and how to treat them
References
- • Travell & Simons — Myofascial Pain and Dysfunction
- • Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2013;43(9):620-34
- • The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2017;47(3):133-49
- • Effectiveness of trigger point dry needling for multiple body regions: a systematic review — J Man Manip Ther 2015;23(5):276-93
- • A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points — J Bodyw Mov Ther 2019;23(3):539-46
- • Physiologic effects of dry needling — Curr Pain Headache Rep 2013;17(8):348
- • Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm — J Pain Res 2019;12:1899-911
- • Myofascial trigger points then and now: a historical and scientific perspective — PM R 2015;7(7):746-61
- • Pertinent dry needling considerations for minimizing adverse effects — Int J Sports Phys Ther 2016;11(5):651-62
- • Adverse events associated with therapeutic dry needling — Int J Sports Phys Ther 2020;15(1):103-13
- • Lidocaine injection versus dry needling to myofascial trigger point: the importance of the local twitch response — Am J Phys Med Rehabil 1994;73(4):256-63
- • Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.) — Williams & Wilkins, Baltimore
Medically reviewed by: Marco Aruffo — physiotherapist since 2006, specialised in myofascial pain · Last reviewed:
