Myofascial syndrome of the brachialis muscle

Anatomical reminder

Brachialis muscle anatomy

The muscle is inserted, above, on the humeral diaphysis in its anterior part and, below, on the proximal part of the ulna (cubitus).

Its only role is the flexion of the elbow.

Síndrome miofascial del músculo braquial

Description

Myofascial syndrome of the brachialis muscle
Myofascial syndrome of the brachialis muscle

Referred pain is primarily felt at the base of the thumb.
It should be noted that the brachialis muscle can also be responsible for compression of the sensory branch of the radial nerve giving paresthesias in the dorsal part of the thumb.

Diagnostic

The pain is exacerbated by extension of the elbow.
During compression of the distal 1/3 of the posterior part of the brachialis muscle, the onset of paresthesia in the thumb confirms compression of the superficial branch of the radial nerve.
The examination of the muscle is done after pushing the biceps brachii inwards. We find, on palpation, painful areas especially in the lower part of the muscle.

The triggering factors are repeated movements of elbow flexion or, in particular, when carrying heavy loads, arms bent.

Treatment

  • Stretch the elbow in full extension.
  • Infiltration with lidocaine followed by stretching.
  • Elbow flexion movements with pronated hand should be avoided.

 

Post operative chronic pain