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Broadest muscle of the back and back pain
Last reviewed: 04.07.2025
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The latissimus dorsi muscle - m. latmimus dorsi extends the shoulder. It brings the arm to the body and pronates the abducted shoulder, lowers the raised arm; if the arms are fixed on a horizontal bar) it pulls the body towards them (when climbing, swimming).
- Origin: Angulus inferior scapulae (inconstant), spinous processes of the VII - XII thoracic vertebrae, fascia thoracolumbalis, crista iliaca, (IX) X - XII ribs.
- Attachment: Crista tuberculi minoris humeri
- Innervation: spinal nerves C4-C7 - brachial plexus - n. thoracodorsalis.
Diagnostics
The patient lies on his back, the shoulder is abducted at approximately 90, the hand is under the head or on a pillow. In this position of the patient, the latissimus dorsi muscle is in a semi-stretched state. With pincer palpation of the cords, pronounced local convulsive responses are observed, which, depending on which fibers are affected, can be easily observed along the edge of the scapula or in the lower thoracic and lumbar regions. Most often, trigger zones are localized in the middle portion of the uppermost fibers (in the area of the posterior edge of the axillary fossa). Less often, trigger zones are located in the middle part of the longest anterior fibers of the muscle.
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Referred pain
It is projected to the lower angle of the scapula and the surrounding area of the chest. The pain can also spread along the back surface and medial edge of the shoulder, forearm and hand along the ring finger and little finger. When asked to show the location of the pain, the patient describes a circle with the hand centered at the lower angle of the scapula. With a rare location of trigger zones in the middle part of the longest anterior fibers, the reflected pain is projected to the anterior surface of the shoulder and sometimes above the iliac crest.