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The body is a functional machine that requires many muscles, organs, ligaments, joints, and tissues that provideΒ everyday movements. In the upper extremities, the head, neck, and shoulders have many muscles, ligaments, and tissues that work together with the nerve roots from the nervous system that provides sensory-motor function to make the fingers move, the shoulders rotate, and the head turns from side to side. When injuries or common issues affect the muscles in theΒ head,Β neck, orΒ shoulders, it can cause small nodules to form along the muscle fibers of the affected muscle area and cause referred pain in different locations of the body. Todayβs article looks at the scalene muscles, how trigger points affect the scalene muscles while mimicking shoulder pain, and how to manage chronic pain associated with trigger points. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulders affecting the scalene muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only.Β Disclaimer
Have you been experiencing tingling sensations running down your fingertips? Do you feel stiffness when rotating your neck or shoulders? Or do you feel muscle soreness in your shoulders? Many individuals who are feeling any of these symptoms affecting their neck or shoulders could be dealing with trigger point pain along the scalene muscles. TheΒ scalene musclesΒ play a crucial part in the head and neck as they are deep muscles positioned laterally on the cervical tract of the spine. These muscles haveΒ three different branches: the anterior, medius, and posterior, which play the role of being accessory breathing muscles while being an important contributor to head and neck movement. To that point, it allows stability to the cervical spine. The scalene muscles even help support and elevate the upper rib cage when a person is lifting, pulling, or carrying heavy objects. However, like most muscles in the body, the scalene muscles can be prone to injury and can develop issues that can affect the upper extremities of the body.
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When common injuries like pulling a muscle when carrying a heavy object or even a traumatic injury like being involved in an auto accident can cause pain in the affected area, over time, if not treated, can cause various symptoms to overlap and affect the muscles. When the scalene muscles are affected by injuries, they can develop tiny nodules along the taut muscle fibers and become hyperirritable to the surrounding areas of the upper half of the body. This is known asΒ trigger point painΒ and can mimic other chronic issues that affect different body areas. To that point, trigger points affecting the scalene muscles may mimic shoulder pain in the upper half of the body.Β Studies revealΒ that scalene myofascial pain is a regional pain syndrome that originates pain in the neck area and radiates pain down to the arm. Since trigger points mimic other chronic issues, it is often misdiagnosed as another neck pain associated with radiculopathy when the scalene muscles are affected. When this happens, the muscles become stiff and weak, causing a reduction in the range of movement.Β
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Studies revealΒ that when individuals suffer from acute whiplash-associated disorders, the local and referred pain can be elicited from active trigger points to reproduce neck and shoulder pain. This causes a higher disability that exhibits widespread pressure causing the muscles to be hypersensitive and reducing the cervical range of motion. Many individuals often complain about shoulder pain while rubbing the upper parts of their arms. The scalene muscle is affected by active trigger points, thus mimicking shoulder pain.
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Have you been feeling muscle stiffness in your neck or shoulders? Have you been experiencing a numbing sensation along your arms? Have you felt tenderness along your shoulders when you touch them? Many of these pain symptoms are associated with trigger points along the scalene muscles. The video above explains where the trigger points are located along the scalene muscles and how they are causing referred pain in the neck and shoulder areas. Many factors can lead to the causation of trigger point pain and overlap with other chronic issues that can affect the upper extremities of the body, using sleep as an example. StudiesΒ revealΒ that poor sleeping posture can affect the neck and shoulders, leading to muscle stiffness along the scalene muscles and developing trigger points over time. Fortunately, various ways to manage referred shoulder pain are associated with trigger points.
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Many individuals are referred to pain specialists that can alleviate trigger points along the scalene muscle to reduce the effects of shoulder and neck pain. When referred pain along the scalene muscles causes chronic shoulder pain associated with trigger points, many people often do various movements to alleviate the pain. However, it can cause more pain in the affected area and prevent relief from the neck and shoulders.Β Studies revealΒ that various treatments like physiotherapy, trigger point injections, manipulation of the cervical spine, or acupuncture can help relax and lengthen the muscle fibers associated with the scalene muscle. To that point, this allows the neck to extend further without pain and reduces the overlapping symptoms that affect the upper extremities of the body.Β
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The scalene muscles play a crucial part in the head and neck area as deep muscles are positioned laterally on the cervical tract of the spine. These muscles help elevate the upper chest and laterally bend the neck from side to side. When injuries affect the scalene muscles and form tiny nodules known as trigger points, it can cause referred pain to the shoulders and the neck. To that point, symptoms like numbing or tingling sensations can travel down the arms and fingers. Fortunately, available treatments can reduce the symptoms and manage myofascial trigger pain along the shoulders and neck associated with the scalene muscles. This allows a better range of motion to the neck and shoulder and prevents future trigger points from forming in the scalene muscles.
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Abd Jalil, Nizar, et al. βScalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases.β The Malaysian Journal of Medical Sciences : MJMS, Penerbit Universiti Sains Malaysia, Jan. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC3216145/.
Bordoni, Bruno, and Matthew Varacallo. βAnatomy, Head and Neck, Scalenus Muscle.β In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 16 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK519058/.
FernΓ‘ndez-PΓ©rez, Antonio Manuel, et al. βMuscle Trigger Points, Pressure Pain Threshold, and Cervical Range of Motion in Patients with High Level of Disability Related to Acute Whiplash Injury.β The Journal of Orthopaedic and Sports Physical Therapy, U.S. National Library of Medicine, July 2012, pubmed.ncbi.nlm.nih.gov/22677576/.
Lee, Won-Hwee, and Min-Seok Ko. βEffect of Sleep Posture on Neck Muscle Activity.β Journal of Physical Therapy Science, The Society of Physical Therapy Science, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5468189/.
Thapa, Deepak, et al. βManagement of Chronic Shoulder Pain with Restricted Mobility β a Case Series.β Indian Journal of Anaesthesia, Medknow Publications & Media Pvt Ltd, Nov. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5125193/.
Professional Scope of Practice *
The information herein on "It Could Be More Than Shoulder Pain" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*
Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.
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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*
email: coach@elpasofunctionalmedicine.com
Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182
Licensed as a Registered Nurse (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
Compact Status: Multi-State License: Authorized to Practice in 40 States*
Presently Matriculated: ICHS: MSN* FNP (Family Nurse Practitioner Program)
Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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