II. Trigger Points: Head and Neck

  1. Paraspinous Neck Muscles
    1. Refer pain to occiput
    2. Symptoms include retro-orbital Headache
    3. Muscle Components
      1. Splenius cervicis Muscle
      2. Semispinalis cervicis Muscle
      3. Rotatores cervicis Muscles
      4. Multifidus Muscle
  2. Upper Trapezius
    1. Refer pain to neck and temporal forehead
  3. Sternocleidomastoid
    1. Associated with Otalgia and possibly Vertigo
    2. Associated with increased Lacrimation and Coryza
  4. Clavicle Musculature
    1. Referred pain across forehead and behind ear
  5. Sternal Musculature
    1. Referred pain into occiput, cheek and periorbital
    2. Mimics Sinusitis
  6. Splenius Capitis (cervical paraspinous Muscle)
    1. Referred Retro-orbital or temporal-orbital pain
    2. Symptoms include vertex Headache
  7. Peri-auricular Muscles
    1. Referred pain to teeth and jaw
    2. Muscle Components
      1. Temporalis Muscle
      2. Masseter Muscle
      3. Medial Pterygoid Muscle
      4. Lateral Pterygoid Muscle

III. Trigger Points: Shoulder, Thorax, and Arm

  1. Anterior Serratus Muscle (lateral to Breast)
    1. Referred pain to lateral chest and Scapula border
    2. Related to decreased chest expansion
    3. May result in perceived Dyspnea
  2. Pectoralis Major Muscle and Pectoralis Minor Muscle
    1. Referred pain to Breast and ulnar arm
  3. Levator Scapulae Muscle (lateral Neck)
    1. Referred pain to base of neck
    2. Associated with neck stiffness
    3. Follows cervical Whiplash injury
    4. Associated with Mood Disorders
  4. Infraspinatus Muscle (lower Scapula)
    1. Referred pain to Shoulder joint and down upper arm
    2. Mimics Cervical Radiculopathy
  5. Supraspinatus Muscle (upper Scapula)
    1. Referred pain to middle deltoid and elbow
    2. Mimics Cervical Radiculopathy

IV. Trigger Points: Back and Buttock

  1. Quadratus Lumborum Muscle (above iliac crest)
    1. Referred pain to low back
  2. Iliocostalis Muscle (lateral paraspinous Muscle)
    1. Referred pain to lower quadrant of Abdomen
    2. Referred pain to buttock
  3. Gluteus Maximus Muscle
    1. Referred pain to Sacrum and inferior buttock

V. Trigger Points: Thigh, Leg and Foot

  1. Quadriceps Femoris (anterior thigh quad Muscles)
    1. Rectus femoris referred to Patella and distal thigh
    2. Vastus intermedius referred to upper thigh
    3. Vastus medialis referred to medial knee
  2. Biceps Femoris (Hamstring Muscles)
    1. Referred pain to calf
  3. Gastrocnemius (superficial posterior calf)
    1. Referred pain to calf and foot instep
  4. Soleus (deep posterior calf)
    1. Referred pain to heel and to sacroiliac joint

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