Trigger points in the infraspinatus often cause pain even when you are at rest, as well as interfering with your daily activities and sleep. You may experience a deep ache in the front of your shoulder or deltoids that feels deep in the joint. It can be similar to bursitis.
Pain can spread down your arm past the elbow and to the top and thumb side of your forearm and hand. It can even include the fingers and thumb. This pain can be similar to a C5-C6 cervical issue or carpal tunnel syndrome.
In fact, some studies have found that a third of patients with suspected of carpal tunnel syndrome and EMGs negative for carpal tunnel have infraspinatus trigger points. Others have observed generally that treating infraspinatus trigger points reduces symptoms of carpal tunnel syndrome.
You may also experience significant pain on the inside border of your shoulder blade or pain extending up the side of your neck. Infraspinatus trigger points can contribute to symptoms of mechanical neck pain, post-mastectomy pain, office and industrial workers, or those with a medical diagnosis of subacromial impingement syndrome.
Infraspinatus trigger points contribute to shoulder girdle fatigue, weakness of grip, loss of should mobility and increased underarm sweating. Common compaints include:
- I can't reach my back pocket
- I can't fasten my bra behind my back anymore
- I can't reach into the back seat of my car
- I have to put my coat on one sleeve at a time
- I can't play overhead sports
If your infraspinatus trigger points are on your dominant side you may have difficulty with reaching your head to comb, brush or dry your hair, brush your teeth, apply makeup or shave facial hair. However, if the trigger points are on your non-dominant side, you may not notice even moderate restrictions unless you make movements that are unusual for you.
If you have infraspinatus trigger points you may find that sleeping on the involved side is painful. However, sleeping on the uninvolved side can also cause problems. The pressure of your upper body may cause pressure on the 'good' side and activate trigger points in the infraspinatus on that side. In addition, the upper, painful arm falls forward, causing a prolonged stretch of the infraspinatus, re-activating the originally painful side. Some people find that they need to sleep in a reclined position until their infraspinatus trigger points moderate.
Note that a similar mechanism can occur during surgery. Trigger points in the infraspinatus and other muscles can be activated by sustained pressure or awkward positions during surgery.
Patients who have suffered a stroke and are paralyzed in the shoulder girdle on one side experience significant pain. This is because various muscles develop trigger points on the affected side, including the infraspinatus, supraspinatus, subscapularis, trapezius, levator scapula, rhomboids and deltoids. If the muscles are not spastic, they respond well to individual treatment of trigger points.