Scalenus posterior muscle hypertrophy is a condition where the scalenus posterior—a small but important deep neck muscle—becomes enlarged or overdeveloped beyond its normal size. This change is typically the body’s response to stress, overuse, or compensation for imbalances in the neck or upper back. When it becomes too bulky, it can cause discomfort, pain, or neurological symptoms by pressing on nearby nerves or blood vessels.
Anatomy of the Scalenus Posterior Muscle
Understanding the basic anatomy of the scalenus posterior muscle is essential. Here, we break down its structure and function in simple terms.
Location and Structure
The scalenus posterior is one of the deep muscles of the lateral aspect (side) of the neck. It lies behind or deep to other neck muscles and is part of the group known as the scalene muscles. These muscles help support and stabilize the neck while allowing movement and assisting in breathing.
Key Components of the Muscle’s Anatomy
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Location:
The muscle is located in the deep lateral neck, extending from the cervical spine (the neck portion of the vertebral column) to the upper part of the first rib. -
Origin (Where it Starts):
The scalenus posterior muscle typically originates from the posterior tubercles (small bony prominences) of the transverse processes of the lower cervical vertebrae (often around C5 to C7). -
Insertion (Where it Ends):
It inserts onto the upper surface of the first rib. This connection is important because the muscle helps lift the rib during forced inhalation. -
Blood Supply:
The muscle is supplied by small branches of the nearby arteries, including branches from the vertebral and deep cervical arteries. Good blood flow is vital for muscle function and healing. -
Nerve Supply:
The scalenus posterior is innervated (supplied with nerves) by cervical spinal nerves. While the phrenic nerve mainly passes through the scalene muscles (especially near the anterior and medius scalene), the nerve supply for the posterior portion usually comes from the lower cervical spinal nerves.
Functions of the Scalenus Posterior
The scalenus posterior muscle plays several key roles:
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Neck Stabilization:
It helps maintain the stability of the cervical spine during movements of the head and neck. -
Assisting in Neck Flexion:
It helps bend the neck forward slightly when the head moves. -
Lateral Flexion (Side Bending):
The muscle aids in bending the neck to the side, allowing you to tilt your head. -
Neck Rotation:
Although less pronounced than other neck muscles, it contributes to turning the head or neck. -
Elevation of the First Rib:
During deep or forced inspiration (when you breathe in deeply), it helps lift the first rib. This function is vital in increasing the lung capacity during heavy breathing. -
Facilitating Postural Control:
By working with surrounding muscles, it contributes to the fine motor control needed to maintain posture and support the weight of the head.
Types of Scalenus Posterior Muscle Hypertrophy
In clinical practice, muscle hypertrophy may not be classified into rigid “types” as one might see with tumors or other conditions. However, based on causes and presentation, hypertrophy of the scalenus posterior can be broadly categorized into:
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Primary (Isolated) Hypertrophy:
Occurs when the scalenus posterior muscle enlarges on its own, often due to overuse in specific activities or sports. -
Secondary (Compensatory) Hypertrophy:
Happens when another muscle in the neck or upper back is weakened or injured. The scalenus posterior may take on extra work to compensate, leading to its enlargement over time. -
Exercise-Induced Hypertrophy:
Seen in individuals who regularly engage in strenuous or specialized neck training (for example, some athletes or weightlifters). -
Pathological Hypertrophy:
In some cases, hypertrophy may be linked with other conditions such as myofascial pain syndrome or inflammatory processes. This type is not just due to exercise but arises in the context of underlying disease.
Each “type” is defined by its underlying cause, the patient’s history, and the way symptoms present.
Causes of Scalenus Posterior Muscle Hypertrophy
There are many factors that can contribute to this condition. Here are 20 potential causes:
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Repetitive Neck Movements:
Continuous or repetitive movements in the neck, especially in certain sports or occupations, can cause overuse. -
Poor Posture:
Sitting or standing with an improper posture for long periods can strain the neck muscles. -
Occupational Stress:
Jobs that require prolonged use of a computer, driving, or awkward postures may lead to muscle overuse. -
Heavy Lifting:
Tasks that involve lifting heavy objects can put extra stress on neck muscles. -
Athletic Training:
Intense training regimens involving neck stabilization exercises can cause adaptive muscle growth. -
Trauma or Injury:
Past neck injuries, whiplash, or other trauma can lead the muscle to overcompensate. -
Compensation for Weak Surrounding Muscles:
Weakness in adjacent muscles of the neck or shoulder can force the scalenus posterior to work harder. -
Cervical Spine Disorders:
Conditions such as cervical spondylosis or disc herniation may alter neck mechanics, leading to muscle hypertrophy. -
Myofascial Pain Syndrome:
A chronic pain condition affecting the fascia (connective tissue) may lead to muscle tension and hypertrophy. -
Inflammation and Infection:
Local inflammation or infection can sometimes cause reactive changes in muscle size. -
Stress and Tension:
Emotional stress often results in physical tension in the neck muscles. -
Repetitive Sports Movements:
Sports such as boxing, wrestling, or martial arts may involve repetitive neck motion. -
Congenital Abnormalities:
Some people are born with structural differences that make their neck muscles more prone to hypertrophy. -
Anatomical Variations:
Natural variations in muscle size and attachment can predispose the muscle to enlarge under stress. -
Post-Surgical Changes:
Changes in neck musculature after surgery on the cervical spine might lead to compensatory muscle changes. -
Obesity:
Extra weight may place additional strain on the neck muscles. -
Ergonomic Factors:
Poorly designed workstations or vehicles can contribute to chronic neck muscle strain. -
Referred Pain from Other Conditions:
Issues like temporomandibular joint (TMJ) disorders can alter muscle use patterns in the neck. -
Neurological Conditions:
Certain nerve compression syndromes can lead to abnormal muscle activity and growth. -
Overcompensation from Injury in the Shoulder/Upper Back:
Problems in adjacent areas may force the scalenus posterior to work harder than normal.
Symptoms Associated with Scalenus Posterior Muscle Hypertrophy
When the scalenus posterior muscle enlarges, it may cause a variety of symptoms. Here are 20 signs and symptoms to watch for:
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Neck Pain:
Persistent aching or sharp pain in the lateral neck. -
Stiffness:
Reduced flexibility and tightness in the neck muscles. -
Limited Range of Motion:
Difficulty moving your neck fully or turning your head side to side. -
Shoulder Pain:
Pain that radiates into the shoulder area. -
Headaches:
Tension headaches that originate from the neck muscles. -
Numbness or Tingling:
Sensations in the arms or hands due to nerve compression. -
Muscle Spasms:
Sudden, involuntary contractions in the neck. -
Weakness in the Neck:
A feeling of weakness or fatigue in the neck muscles. -
Pain on Touch (Tenderness):
Sensitivity when pressing on the affected area. -
Pain During Breathing:
Discomfort during deep or forced inhalation because the muscle helps lift the first rib. -
Radiating Pain:
Pain spreading into the upper back or scapular region. -
Swelling:
Mild swelling or inflammation in the region of the hypertrophied muscle. -
Postural Changes:
Noticeable changes in the way you hold your neck or head. -
Muscle Fatigue:
Early fatigue during activities that require neck movement. -
Cervical Stiffness:
A general sensation of stiffness in the cervical spine area. -
Voice Changes:
Occasionally, pressure on nearby nerves might affect the voice in subtle ways. -
Difficulty Swallowing:
Rarely, if the muscle enlargement compresses nearby structures, swallowing may become difficult. -
Dizziness:
A sensation of lightheadedness related to altered neck muscle function. -
Sleep Disturbances:
Discomfort that disrupts sleep patterns. -
Visual Disturbances or Light Sensitivity:
Although less common, some patients report blurred vision or sensitivity to light if nearby neural pathways are affected.
Diagnostic Tests for Scalenus Posterior Muscle Hypertrophy
When your doctor suspects scalenus posterior muscle hypertrophy, several diagnostic tests may be recommended to rule out other conditions and to confirm the diagnosis. Here are 20 tests and examinations that might be used:
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Clinical Physical Examination:
A detailed exam to assess neck movement, tenderness, and muscle bulk. -
Medical History Review:
Discussing symptoms, occupation, and past injuries. -
Palpation of the Neck:
The doctor manually feels the neck muscles for tenderness or enlargement. -
X-Ray Imaging:
Basic radiographs to view bone alignment and rule out cervical spine issues. -
Computed Tomography (CT) Scan:
Offers detailed cross-sectional images of the neck’s anatomy. -
Magnetic Resonance Imaging (MRI):
Provides high-definition images of soft tissues including muscles and nerves. -
Ultrasound Imaging:
A noninvasive method to examine muscle structure and any abnormal thickening. -
Electromyography (EMG):
Measures electrical activity in muscles to assess function. -
Nerve Conduction Studies (NCS):
Determines if nerves near the muscle are compressed or dysfunctional. -
Muscle Biopsy:
In rare cases, tissue may be sampled to evaluate for underlying pathology. -
Blood Tests:
To look for signs of inflammation or infection. -
Provocative Maneuver Tests:
Specific movements to see if symptoms are reproduced during physical examination. -
Posture Analysis:
Evaluation of head and neck posture to uncover contributing factors. -
Range of Motion Testing:
Measures how far the neck can move in different directions. -
Strength Testing:
Assessing muscle strength in the neck and shoulder region. -
Myofascial Trigger Point Assessment:
Identifies small, tender spots in the muscle that may be causing pain. -
Scalene Muscle Compression Test:
A specific test to determine if the enlarged muscle is compressing nearby structures (such as in thoracic outlet syndrome). -
Dynamic MRI:
Imaging while the neck is in motion to evaluate changes in muscle size during activity. -
Bone Scan:
To rule out any underlying bony abnormalities contributing to muscle stress. -
Functional Assessments:
Evaluations that look at breathing and nerve function during movement.
Non-Pharmacological Treatments
Many patients benefit from treatments that do not involve medications. Here are 30 non-pharmacological treatment options that may help manage scalenus posterior muscle hypertrophy:
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Physical Therapy:
Guided exercises to strengthen and stretch the neck muscles. -
Massage Therapy:
Professional massage to relieve muscle tension and improve blood flow. -
Stretching Exercises:
Daily routines that gently stretch the neck muscles to reduce tightness. -
Postural Correction:
Techniques to improve your sitting and standing posture. -
Heat Therapy:
Warm compresses or heating pads to relax tight muscles. -
Cold Therapy:
Applying ice packs to reduce inflammation and pain. -
Ergonomic Adjustments:
Changing your work or home environment to reduce strain on the neck. -
Chiropractic Care:
Spinal manipulation to improve alignment and relieve muscle stress. -
Acupuncture:
Insertion of fine needles at specific points to reduce pain and improve circulation. -
Yoga:
Gentle yoga poses to increase strength, flexibility, and relaxation. -
Pilates:
Focused core and neck exercises to improve overall stability. -
Posture Braces or Supports:
Using devices that support proper alignment of the neck. -
Mindfulness and Relaxation Techniques:
Practices such as deep breathing or meditation to reduce muscle tension. -
Trigger Point Therapy:
Targeted treatment of tight spots within the muscle. -
TENS (Transcutaneous Electrical Nerve Stimulation):
Electrical stimulation to ease pain and improve muscle function. -
Biofeedback:
Techniques to help you learn to control muscle tension consciously. -
Manual Therapy:
Hands-on techniques performed by a trained therapist. -
Active Release Techniques:
A specialized form of manual therapy to break up adhesions in muscle tissue. -
Myofascial Release:
Stretching the fascia (connective tissue) around the muscle to improve mobility. -
Balance and Coordination Exercises:
Activities designed to improve overall neuromuscular control. -
Education on Self-Care:
Learning about safe movement and proper lifting techniques. -
Water Therapy (Hydrotherapy):
Exercising in water to reduce load on the neck and joints. -
Alexander Technique:
Movement re-education to reduce unnecessary muscle tension. -
Neck Traction:
Using devices that gently stretch the neck to alleviate pressure. -
Functional Movement Training:
Tailored programs to improve the daily function of neck and shoulder muscles. -
Breathing Exercises:
Exercises focusing on diaphragmatic breathing can indirectly help relieve neck muscle strain. -
Cervical Mobilization Exercises:
Gentle maneuvers to increase range of motion in the neck. -
Self-Massage Techniques:
Simple techniques you can perform at home to relieve localized tension. -
Lifestyle Modifications:
Adjustments such as reducing screen time and taking regular breaks during work. -
Stress Management Programs:
Programs that integrate counseling, relaxation, and exercise to control stress-induced muscle tension.
Medications (Drugs) Used in Treatment
While non-pharmacological strategies are often first-line, doctors may sometimes use medications to relieve symptoms. Below are 20 drugs that may be recommended:
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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):
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Ibuprofen
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Naproxen
These help reduce pain and inflammation.
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Acetaminophen (Paracetamol):
Often used for pain management when NSAIDs are contraindicated. -
Muscle Relaxants:
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Baclofen
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Cyclobenzaprine
To help ease muscle spasms.
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Tizanidine:
Another muscle relaxant that reduces muscle tone. -
Corticosteroids (Oral or Injection):
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Prednisone
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Methylprednisolone
Useful in reducing inflammation in severe cases.
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Local Anesthetics:
Injections (such as lidocaine) may be used for temporary relief of localized pain. -
Anti-Epileptic Drugs:
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Gabapentin
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Pregabalin
Sometimes used when nerve pain is present.
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Topical Analgesics:
Creams or patches containing lidocaine or diclofenac for localized pain relief. -
COX-2 Inhibitors:
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Celecoxib
For those who may not tolerate traditional NSAIDs.
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Selective Serotonin Reuptake Inhibitors (SSRIs):
In some cases, to help manage chronic pain through neuromodulatory effects. -
Tricyclic Antidepressants:
Such as amitriptyline, sometimes used for nerve pain. -
Vitamin D and Calcium Supplements:
Prescribed in cases where deficiency may contribute indirectly to musculoskeletal pain. -
Antioxidant Supplements:
Such as magnesium to relax muscles if levels are low. -
Botulinum Toxin Injections:
Used in select cases to reduce muscle overactivity. -
Local Corticosteroid Injections:
Targeted injections to reduce inflammation directly at the site. -
Opioid Analgesics:
Short-term use may be considered in severe cases not responding to other therapies, though generally avoided due to risk of dependency. -
Anti-Inflammatory Nutraceuticals:
Supplements like curcumin may be recommended as an adjunct. -
Alpha-2 Adrenergic Agonists:
In some cases, agents that reduce nerve signaling may be utilized. -
Neuropathic Pain Agents:
Such as duloxetine, when nerve compression contributes to pain. -
Combination Medications:
Drugs that include both analgesic and muscle relaxant properties may be prescribed as needed.
Note: Not every patient will require all these medications. Treatment is tailored to individual needs and should be prescribed by a qualified healthcare professional.
Surgical Options
Surgery is usually considered only when conservative measures do not provide adequate relief or when there is significant compression of nerves and blood vessels. Here are 10 surgical procedures or interventions that might be considered for severe or refractory cases:
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Scalenectomy:
Removal of all or part of the scalene muscle to reduce compression in the thoracic outlet. -
Partial Resection of the Scalenus Posterior:
A targeted removal to decrease muscle bulk. -
Thoracic Outlet Decompression:
Surgery aimed at relieving compression on the nerves and blood vessels as they exit the neck. -
Neurolysis:
Surgical release of nerves that are entrapped by the hypertrophied muscle. -
Vascular Decompression:
Procedures to relieve pressure on arteries or veins in the neck region. -
Cervical Decompression:
If cervical spine issues contribute, surgical decompression may be undertaken. -
Microdiscectomy:
Although primarily for disc issues, this may be combined with other procedures when nerve roots are compressed. -
Endoscopic Scalene Procedures:
Minimally invasive methods to reduce muscle bulk or free compressed structures. -
Robotic Assisted Scalene Resection:
Newer techniques using robotic systems to perform precise muscle reduction. -
Combined Procedures:
In complex cases, a combination of muscle resection and nerve decompression may be performed.
Surgical intervention is generally reserved for cases where non-surgical treatments have not led to improvement or if vital structures are compromised.
Preventions to Avoid Scalenus Posterior Muscle Hypertrophy
Preventing scalenus posterior muscle hypertrophy focuses on reducing repetitive strain and maintaining a healthy neck. Here are ten prevention strategies:
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Maintain Good Posture:
Regularly check and correct your posture while sitting, standing, and working. -
Ergonomic Workstation:
Adjust your computer, chair, and desk to promote proper neck alignment. -
Regular Stretching:
Incorporate neck and shoulder stretches into your daily routine. -
Strengthening Exercises:
Build balanced muscle strength around the neck and upper back. -
Take Frequent Breaks:
If you work at a desk, take short breaks every 30–60 minutes. -
Avoid Prolonged Repetitive Movements:
Change positions often and avoid overuse of neck muscles. -
Proper Lifting Techniques:
Use correct form when lifting heavy objects to lessen neck strain. -
Use Supportive Pillows:
Choose pillows that maintain the natural curve of your neck during sleep. -
Manage Stress:
Engage in stress-reducing activities as stress can lead to muscle tension. -
Regular Exercise:
Maintain a consistent exercise routine that includes aerobic activity, stretching, and strength training.
When to See a Doctor
It is important to seek professional medical advice when symptoms interfere with daily life or worsen over time. Consider seeing a doctor if you experience:
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Persistent or worsening neck pain that does not respond to rest or home treatments
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Numbness, tingling, or weakness in the arms or hands
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Pain that radiates into the shoulder, upper back, or down the arm
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Difficulty breathing or swallowing
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Noticeable changes in posture or range of motion
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Signs of inflammation such as swelling, redness, or warmth in the neck region
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Headaches or visual disturbances linked to neck tension
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A sudden or traumatic injury involving the neck
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Failure of conservative measures to relieve symptoms
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Concerns about compressive symptoms that may indicate nerve or blood vessel involvement
Early evaluation and treatment can prevent further complications and lead to a more effective recovery.
Frequently Asked Questions (FAQs)
Below are some of the most common questions about scalenus posterior muscle hypertrophy, answered in plain language:
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What is scalenus posterior muscle hypertrophy?
It is the enlargement of the scalenus posterior muscle in the neck, often caused by overuse, poor posture, or compensation for other weakened muscles. -
What causes the muscle to become hypertrophied?
Common causes include repetitive activities, poor ergonomics, heavy lifting, chronic stress, injury, and even underlying neck conditions. -
What symptoms should I look for?
Symptoms include neck pain, stiffness, headaches, tenderness in the lateral neck, and sometimes numbness or tingling in the arms. -
How is the condition diagnosed?
A combination of physical examination, imaging tests (such as X-rays, CT scans, and MRIs), and sometimes nerve or muscle studies are used to diagnose the condition. -
Can poor posture really affect my neck muscles?
Yes, prolonged poor posture can lead to muscle strain and overuse, resulting in hypertrophy and pain. -
What non-drug treatments are available?
Options include physical therapy, massage, stretching, ergonomics, yoga, acupuncture, and other techniques to relieve muscle tension. -
When should I consider medications?
Medications such as NSAIDs, muscle relaxants, or corticosteroids may be recommended if pain and inflammation are significant and do not improve with non-drug measures. -
Do I need surgery for this condition?
Surgery is typically a last resort when conservative treatment fails or if nerve or blood vessel compression becomes severe. -
How can I prevent this muscle from becoming enlarged?
Preventative measures include maintaining good posture, regular stretching and strengthening exercises, ergonomic adjustments, and stress management. -
Is this condition common among athletes?
Yes, especially in sports or activities that involve repetitive neck movements or heavy lifting, athletes may be at a higher risk. -
Can stress affect my neck muscles?
Absolutely. Physical and emotional stress can lead to muscle tension and contribute to hypertrophy. -
How long does recovery take with non-surgical treatments?
Recovery times vary, but many patients see improvements within a few weeks to months with consistent therapy and lifestyle changes. -
What should I expect from physical therapy?
Therapy is designed to reduce pain, improve neck function, and teach you ways to prevent future strain. This can include stretching, strengthening, and manual treatments. -
Are there any home remedies that can help?
Yes, regular stretching, use of heat or ice packs, correcting your posture, and taking breaks during long periods of sitting can help. -
Is scalenus posterior hypertrophy a sign of a more serious condition?
While it is often due to overuse or poor posture, in some cases it may be associated with other underlying cervical or nerve conditions. A proper evaluation by a healthcare professional is important.
Conclusion
Scalenus posterior muscle hypertrophy is an overgrowth of a deep neck muscle that plays an important role in neck movement and breathing. Whether caused by overuse, poor posture, injury, or other factors, understanding its anatomy, causes, symptoms, and treatment options can help you manage and prevent discomfort.
Through non-pharmacological treatments like physical therapy, ergonomics, and lifestyle changes—and, when necessary, medications or even surgical interventions—most patients find relief and improved function. It is essential to be aware of your symptoms and seek professional help when they persist or worsen.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members
Last Update: April 13, 2025.
