The Erector Spinae Group

Pointer Plus The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The nine (9) muscles of the Erector spinae group are deep back muscles. They include the Iliocostalis Lumborum, Iliocostalis Thoracis, Iliocostalis Cervicis, Longissimus Thoracis, Longissimus Cervicis, Longissimus Capitis, Spinalis Thoracis, Spinalis Cervicis, and Spinalis Capitis.

Iliocostalis Lumborum

The Iliocostalis Lumborum is a deep muscle of the back.

Anatomical Attachments:

• Origin: Attaches to the body of the sacrospinalis in the lumbar region.
• Insertion: Attaches to the inferior margins of the angles of the inferior six or seven ribs.

Action: Collectively, extends, laterally flexes and rotates the spinal column, and laterally moves the pelvis.

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Nerve Supply: Posterior rami of spinal nerves.

Nerve Entrapment: Entraps the dorsal rami of the spinal nerve. Individuals complaining of this nerve entrapment may have symptoms of decreased or increased sensitivity or pain to the skin of the back.

Vascular supply: Intercostal and lumbar arteries.

• Primary: The pain is referred inferiorly from the lumbar spinal region into the sacrum to the mid-buttock and frequently will refer into the lateral or posterior hip of the side which is affected with the active TrPs.
• Satellite or associated triggers: Quadratus lumborum, Latissimus dorsi, Serratus posterior inferior, and Serratus posterior superior.

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Trigger Point Signs and Symptoms: Pain in the low back, in the buttock and abdomen.

Trigger Point Activating and Perpetuating Factors: Sudden overload of the back, bending and twisting while lifting an object, acceleration/deceleration injury of the low back, prolonged riding in a car or a plane.

Differential Diagnosis: Degenerative disc disease, (Segmental, Subluxation, Somatic dysfunction) Lumbar Radiculopathy (Bulging Prolapsed, Herniated Disc), Sacral nerve compression, Spinal nerve entrapment, Spinal cord cancer, Acceleration/Deceleration injury, Sprain/Strain of the low back, Intervertebral or Vertebral stenosis, Hip pointer, Osteoporosis, Osteoarthritis, Rheumatoid arthritis, Tumor, Ankylosing spondylitis, Iliac aneurysm, Vertebral compression fracture, Subacute meningitis, Lumbar spine Hyperlordosis, Scoliosis, Polymyalgia rheumatica, Fibromyalgia, Polymyositis, Systemic lupus erythematosus, Cauda equina, Prostate cancer, Ovarian cancer, Cervical cancer, Pelvic inflammatory disease, Pregnancy, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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