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Splenius Cervicis Trigger Points

Theodore Levarda

Understanding and Treating Splenius Cervicis Muscle Pain

The splenius cervicis muscle is located in the neck region. It is one of the muscles of the splenius group, which also includes the splenius capitis muscle. The splenius cervicis muscle is located in the upper back and neck and runs from the spinous processes of the upper thoracic vertebrae (T3-T6) to the transverse processes of the cervical vertebrae (C1-C3). It connect the upper back to the neck by pulling on the cervical vertebrae from the thoracic vertebrae.

The main function of the splenius cervicis muscle is to extend, rotate, and laterally flex the head and neck. This muscle is active during movements such as looking up, turning the head to the side, or looking over the shoulder. It also helps to stabilize the head and neck during activities such as walking or running.

Pain or tension in the splenius cervicis muscle can be caused by poor posture, stress, car accidents, and overuse, and can lead to conditions such as headaches, neck and shoulder pain, and upper back pain.

Key Points

  • The splenius cervicis muscle helps extend, rotate, and laterally flex the neck.

  • Pain can be caused by poor posture, stress, car accidents, and overuse.

  • Symptoms include pain in the neck, head, and upper back.

  • Treatments include stretching, myofascial release, and trigger point therapy via acupuncture and dry needling.

  • Acupuncture and dry needling are effective treatments to relieve splenius cervicis pain.

Splenius cervicis muscle

Splenius Cervicis Location

The splenius cervicis muscle is situated in the neck and upper back region. It lies deep to the serratus posterior superior, rhomboids, and trapezius muscles, making it less accessible without moving these superficial muscles aside. On the other hand, it is superficial to parts of the erector spinae and semispinalis muscles, which run along the spine. This positioning allows the splenius cervicis to play a crucial role in the extension, rotation, and lateral flexion of the head and neck, while also stabilizing these movements during various activities. Understanding its anatomical location helps in accurately diagnosing and treating associated pain and dysfunction.

Splenius Cervicis Pain Symptoms

  • Upper Thoracic Back Pain

  • Back of Head Pain

  • Back of Neck Pain

  • Double/Blurry/Jumpy Print Vision

  • Headaches or Migraines

  • Temple and Eyebrow Pain

  • Temporal Headache (Temples)

Splenius Cervicis Action

Unlaterally:

  • Rotate head and neck to same side

  • Laterally flex head and neck to same side

Bilaterally:

  • Extend head and neck

Splenius Cervicis Origin

  • Spinous processes of T-3 to T-6 in the thoracic spine (upper back)

Splenius Cervicis Insertion

  • Transverse processes of C-1 to C-3 cervical spine (neck)

Perpetuating Factors for Splenius Cervicis Trigger Points

  • Car accident (impact stress)

  • Postural stress

  • Falling asleep in bad neck position

  • Excessive rotation/extension of neck

  • Cold drafts and air conditioning directly on the back of the neck

Causes of Splenius Cervicis Pain

Postural Stress

Postural stress occurs when the head and neck are held in improper positions for extended periods. Activities such as working at a desk with the head turned or slouched forward can lead to strain in the splenius cervicis muscle. Improving posture and ergonomics can help alleviate this stress.

Impact Stress

Impact stress, such as from car accidents or sudden falls, can cause significant strain on the splenius cervicis muscle. Whiplash injuries are a common source of trigger points in this muscle, leading to pain and restricted movement. Immediate and appropriate treatment can prevent chronic issues.

Activity Stress

Activity stress involves repetitive or strenuous activities that overwork the splenius cervicis muscle. This includes lifting heavy objects with poor form or engaging in activities that require frequent neck rotation or extension. Proper technique and regular breaks can mitigate this type of stress.

Environmental Stress

Environmental stress, such as exposure to cold drafts or air conditioning, especially when the muscles are fatigued, can activate trigger points in the splenius cervicis muscle. Keeping the neck warm and avoiding sudden temperature changes can help prevent these trigger points.

Splenius cervicis trigger points

About Splenius Cervicis Trigger Points

The splenius cervicis often has two trigger point locations - upper and lower. The upper splenius cervicis trigger point is usually found between C-3 and C-4 and lateral to the spinous process. The lower trigger point is found lateral to the spinous process of C-7 around the middle of the muscle. Since this muscle is deep to other posterior neck muscles it is not always possible to palpate it.

Pain from the upper splenius cervicis trigger point often radiates upward to the occiput, diffusely through the cranium, and intensely to the back of the orbit, causing a deep "ache inside the skull." For the lower trigger point around mid-muscle, pain is referred downward to the shoulder girdle and the angle of the neck.

Trigger points in the splenius cervicis muscle can cause symptoms such as headaches and neck pain, often accompanied by blurring of vision on the same side. These points are typically activated by sudden overloads, like whiplash, or prolonged positions that strain the neck, such as forward, crooked postures. The upper trigger points in the muscle can cause pain behind the eye, while lower points may refer pain to the base of the neck.

Differential diagnosis is important to distinguish trigger point pain from other conditions, such as spasmodic torticollis or other cervical dysfunctions. Identifying and treating these trigger points can significantly reduce pain and improve neck mobility.

Splenius Cervicis Trigger Point Referral Pattern

  • Pain in neck, eye, or temple area

  • The upper trigger point can refer pain to the lateral eyebrow radiating to the temporal region

  • The lower trigger point can refer locally to the posterior neck

Differential Diagnosis

Trigger points in the splenius cervicis muscle can mimic other conditions, including:

  • C-2/4/5 dysfunction

  • Whiplash syndrome

  • Trigger points with overlapping referral zones:

    • Levator scapulae

    • Upper trapezius

    • Temporalis

    • Masseter

    • Semispinalis cervicis

    • Suboccipitals

    • Sternocleidomastoid.

Associated Trigger Points

  • Splenius capitis

  • Erector spinae muscles

Splenius Cervicis Synergists

  • Neck extension: Semispinalis, trapezius, levator scapulae

  • Neck rotation: Opposite trapezius, SCM, posterior cervicals

Splenius Cervicis Antagonists

  • Neck extension: SCM, longus colli, anterior scalene

  • Neck rotation: SCM, upper trapezius, opposite posterior cervicals

Biomechanics of Splenius Cervicis Muscle Pain

The splenius cervicis muscle plays a crucial role in various neck movements, including extension, rotation, and lateral flexion. When these movements are performed repetitively or with poor posture, they can lead to strain and overuse injuries. The biomechanics of these movements involve complex interactions between the splenius cervicis and other neck muscles, which can be disrupted by improper form or excessive stress.

For instance, activities that require frequent neck rotation, such as driving or using a computer with an improperly positioned monitor, can cause the splenius cervicis muscle to become overworked. This overuse can lead to the development of trigger points, which are hyperirritable spots within the muscle that can cause pain both locally and in referred areas. Additionally, sudden movements or accidents, such as whiplash from a car accident, can acutely strain the splenius cervicis muscle, leading to significant pain and dysfunction.

A 2015 study examined muscle activity changes around the neck during flexion and extension in 24 college students. Results showed significant increases in muscle activation, particularly in the sternocleidomastoid (SCM), splenius capitis, and splenius cervicis muscles during neck flexion. These findings suggest the importance of avoiding prolonged neck flexion postures to prevent muscle strain and pain.

Understanding the biomechanics of the splenius cervicis muscle is essential for diagnosing and treating the pain associated with it. By identifying the specific movements and postures that contribute to the muscle's strain, targeted treatments can be developed to address the underlying causes of pain.

Splenius Cervicis Pain Treatments

Acupuncture

Acupuncture is an effective treatment for relieving pain in the splenius cervicis muscle. By inserting fine needles into specific acupoints, acupuncture helps to release muscle tension, improve blood circulation, and promote the body's natural healing processes. This treatment can significantly reduce pain and discomfort caused by trigger points in the splenius cervicis muscle.

Dry Needling

Dry needling is another valuable treatment for splenius cervicis pain. This technique involves inserting thin needles directly into the trigger points within the muscle, causing a twitch response that helps to release muscle tightness and alleviate pain. Dry needling can be particularly effective for addressing the myofascial trigger points that are often responsible for splenius cervicis muscle pain.

Other Treatments

In addition to acupuncture and dry needling, treatments for splenius cervicis pain may include stretching and strengthening exercises, myofascial release, and ergonomic adjustments to improve posture and reduce strain on the neck muscles. A comprehensive treatment plan that combines these approaches can provide significant relief and improve overall muscle function.

Corrective Actions for Splenius Cervicis Pain

Corrective actions for managing splenius cervicis pain involve addressing the underlying causes of muscle strain and implementing daily self-care practices. Postural adjustments are essential; maintaining an erect posture with minimal twisting and turning of the head and neck can help prevent the activation of trigger points. Ergonomic adjustments, such as positioning computer monitors at eye level and using supportive chairs, can also alleviate strain on the neck muscles.

Patients should avoid activities that perpetuate muscle strain, such as carrying heavy loads with poor posture or sleeping in awkward positions. Regular stretching and strengthening exercises tailored to the neck and upper back muscles can help maintain flexibility and prevent the recurrence of trigger points. Additionally, using appropriate pillows to support the neck during sleep and wearing clothing that protects the neck from cold drafts can further reduce the risk of muscle pain.

Splenius Capitis and Cervicis

The splenius cervicis muscle lies laterally and caudally to the splenius capitis. Both muscles share similar attachments, with the splenius cervicis connecting to the spinous processes of the T3 to T6 vertebrae and the splenius capitis attaching to the mastoid process of the skull. These muscles work together to facilitate head and neck movements, such as extension and rotation.

Synergists of the splenius cervicis and capitis for head and neck extension include the semispinalis capitis and cervicis muscles, while antagonists include the anterior cervical muscles and the sternocleidomastoid. For rotation, synergists include the ipsilateral levator scapulae and contralateral upper trapezius, among others. These interactions highlight the importance of maintaining balance among these muscle groups to prevent overuse and strain injuries.

Patients with trigger points in the splenius cervicis may experience pain in the neck, cranium, and eyes, often described as a "stiff neck." Active rotation of the head and neck is typically limited by pain, although less so than with levator scapulae involvement. Proper diagnosis and treatment of trigger points in both the splenius cervicis and capitis muscles are crucial for effective pain management and restoring full neck mobility.

Conclusion

Understanding the splenius cervicis muscle and its associated trigger points is crucial for effective treatment and pain management. Acupuncture and dry needling can significantly reduce pain and improve muscle function. If you experience persistent pain or discomfort in the splenius cervicis area, seeking professional help from a qualified practitioner is essential for proper diagnosis and treatment.

Frequently Asked Questions about Splenius Cervicis Trigger Points

How do you release a splenius cervicis trigger point?

To release a splenius cervicis trigger point, targeted treatments such as acupuncture or dry needling are effective. These techniques involve inserting fine needles at specific points in the splenius cervicis muscle to relieve pain and reduce muscle tension.

Can you get knots in your splenius cervicis muscle?

Yes, knots, or myofascial trigger points, can develop in the splenius cervicis muscle due to stress, overuse, or injury. These knots can cause pain and restrict movement in the neck and upper back.

What are the symptoms of a tight splenius cervicis?

Symptoms of a tight splenius cervicis muscle include neck pain, headaches, and discomfort when turning or tilting the head. In some cases, pain may also be referred to the eye or shoulder.

Where are trigger points in the neck?

Trigger points in the neck are commonly found in the splenius cervicis muscle and other posterior neck muscles. These points can refer pain to the occiput, cranium, and behind the eyes, as well as down to the shoulder girdle.

How do you relax a tight splenius cervicis?

To relax a tight splenius cervicis muscle, treatments like acupuncture, dry needling, massage, and applying heat can be beneficial. Additionally, correcting posture, reducing stress, and avoiding activities that strain the neck can help.

What is the fastest way to release trigger points in the splenius cervicis?

The fastest way to release trigger points in the splenius cervicis is through acupuncture and dry needling. These modalities can offer rapid relief by targeting specific points to reduce muscle tightness and alleviate pain quickly.

Over to you

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