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The trigger points in the upper quadratus lumborum, for instance, are very close to the kidneys and poorly administered treatment (particularly injections) may lead to kidney damage. Likewise, treating the masseter muscle may damage the salivary glands superficial to this muscle.
The quadratus lumborum muscle originates by aponeurotic fibers into the iliolumbar ligament and the internal lip of the iliac crest for about 5 centimetres (2.0 in). It inserts from the lower border of the last rib for about half its length and by four small tendons from the apices of the transverse processes of the upper four lumbar vertebrae.
Symptoms of a myofascial trigger point include: focal point tenderness, reproduction of pain upon trigger point palpation, hardening of the muscle upon trigger point palpation, pseudo-weakness of the involved muscle, referred pain, and limited range of motion following approximately 5 seconds of sustained trigger point pressure. [2]
There is an extensive number of muscle groups that surround the floating ribs such as the external oblique, quadratus lumborum, latissimus dorsi, levator costarum, external intercostals, serratus posterior inferior, lumbocostal ligament, iliocostalis, longissimus thoracis, and the costodiaphragmatic pleural recess. A hypermobile floating rib ...
The superior lumbar (Grynfeltt-Lesshaft) triangle is formed medially by the quadratus lumborum, laterally by the posterior border of internal abdominal oblique muscle, and superiorly by the 12th rib. The floor of the superior lumbar triangle is the transversalis fascia and its roof is the external abdominal oblique muscle.
Myofascial release (MFR, self-myofascial release) is an alternative medicine therapy claimed to be useful for treating skeletal muscle immobility and pain by relaxing contracted muscles, improving blood and lymphatic circulation and stimulating the stretch reflex in muscles.
Treatment is usually weekly or bi-weekly, and up to 6 sessions may be necessary to relieve tenderness in the area. [4] The most invasive method for treating iliocostal friction syndrome is the surgical resection of the floating ribs, [ 2 ] which excises the outer two-thirds of the rib while the individual is under anesthesia. [ 3 ]
Dry needling for the treatment of myofascial (muscular) trigger points is based on theories similar, but not exclusive, to traditional acupuncture; both acupuncture and dry needling target the trigger points, which is a direct and palpable source of patient pain. [1]