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The Rotatores is a deep muscle of the back.
Anatomical Attachments: Authors' note: Among leading authors, there appears to be a contradiction as it pertains to the Rotatores.
According to “Gray’s Anatomy, 28th Edition”, and Travell and Simons “Myofascial Pain and Dysfunction
The Trigger Point Manual Vol. 2”, the paired Rotatores occur from the sacral triangle to the spinous process of C2,
with the cervical Rotatores being absent in a percentage of the population. Warfel in “The Head Neck and Trunk,
Fourth edition”, states that there are only eleven (11) pairs of Rotatores, which are located in the
thoracic spine region. Regardless, while there is disagreement on how many pairs and how many segments the
Rotatores connect, there is an agreement that each pair of Rotatores originates at the transverse processes
of an inferior vertebral segment and insert to the spinous process of the superior vertebral segment of the spine.
Action: Extends and rotates the vertebral column.
Nerve Supply: Posterior rami of the thoracic nerves. Vascular supply: Muscular branches of the posterior intercostal arteries. Trigger Point Signs and Symptoms: Pain in thoracic region, restriction of spinal motion and activity. Trigger Point Activating and Perpetuating Factors: Prolonged sitting for hours, acceleration/deceleration injury, bending and twisting of the back when muscles are fatigued or chilled, trauma. Differential Diagnosis: Fibromyalgia, Degenerative disc disease, (Segmental, Subluxation, Somatic dysfunction) Spinal Radiculopathy (Bulging Prolapsed, Herniated Disc), Spinal osteoarthritis, Sprain/Strain syndrome, Scoliosis, Tumors of the cervical, thoracic or lumbar spine, Military neck (Absence of normal cervical spine lordosis), Cervical Spine Hyperlordosis, Thoracic Spine Hyperkyphosis, Scoliosis, Intervertebral or Vertebral stenosis, Ankylosing Spondylitis, Rib Subluxation (Slipping Rib Syndrome), Dissecting aortic aneurysm, Subacute meningitis, Polymyalgia rheumatica, Polymyositis, Cauda equina, Systemic lupus erythematosus, Osteoporosis, Osteoarthritis, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.
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