The scalenus posterior muscle is one of three scalene muscles in the neck. A strain in this muscle can cause pain, restricted movement, and discomfort in the neck and shoulder area. This guide explains the structure and function of the muscle, the types of strains, causes, symptoms, diagnostic methods, a wide range of treatments (both non-medication based and medicinal), when surgery might be needed, and steps for prevention.
Anatomy of the Scalenus Posterior Muscle
Understanding the anatomy of the scalenus posterior muscle helps explain why strains occur and how they affect your body.
Structure and Location
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Location:
The scalenus posterior muscle is located on the side of the neck. It is part of the group of scalene muscles that extend from the cervical spine (the neck vertebrae) to the first two ribs. -
Structure:
This muscle is slender and fibrous. It works together with the scalenus anterior and medius muscles to support neck movement and stabilize the cervical spine.
Origin and Insertion
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Origin:
The origin refers to where the muscle attaches to bone. For the scalenus posterior, the origin is typically found on the transverse processes (small bony projections) of the upper cervical vertebrae (around C2 to C7). -
Insertion:
The insertion point is where the muscle attaches to another bone. In this case, the muscle usually attaches to the upper surface of the third rib, although variations can occur.
Blood Supply
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Blood Vessels:
The muscle is supplied by small branches of the vertebral and deep cervical arteries. Adequate blood flow is important for nutrient delivery and healing.
Nerve Supply
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Nerves:
The nerve supply comes primarily from the cervical spinal nerves. These nerves control muscle contraction and help transmit signals to and from the brain.
Key Functions
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Neck Movement:
Helps in rotating and bending the neck. -
Shoulder Stabilization:
Assists in keeping the shoulder stable during movement. -
Assisting Respiration:
Works alongside other muscles to raise the first two ribs during deep breathing. -
Postural Support:
Contributes to maintaining an upright head and neck posture. -
Sensory Feedback:
Participates in providing proprioceptive feedback (sense of body position). -
Movement Coordination:
Aids in the smooth coordination of head and neck movements.
Types of Scalenus Posterior Muscle Strains
While muscle strains are generally classified by severity, scalenus posterior muscle strain can also be categorized by the nature or timing of the injury.
Common Classifications
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By Severity (Grades):
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Grade I (Mild):
Minor stretching or small tears in muscle fibers, with minimal loss of strength. -
Grade II (Moderate):
More significant tearing leading to pain and a noticeable decrease in movement. -
Grade III (Severe):
A complete tear of the muscle, leading to severe pain and loss of function.
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By Onset:
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Acute Strain:
Occurs suddenly, often related to a specific injury or overuse. -
Chronic Strain:
Develops over time, often due to repetitive strain or poor posture.
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By Associated Conditions:
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Isolated Strain:
Occurs solely in the scalenus posterior muscle. -
Combined Neck Injury:
Occurs together with injuries to neighboring muscles, nerves, or other soft tissues.
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Causes of Scalenus Posterior Muscle Strain
Multiple factors can contribute to a strain in this muscle. Here are 20 potential causes:
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Poor Posture:
Sitting or standing with a forward head posture can strain the neck muscles. -
Repetitive Movements:
Repeatedly moving the neck, such as during long computer work or driving. -
Heavy Lifting:
Overstraining the neck muscles during heavy lifting or physical labor. -
Sports Injuries:
Sudden movements or impacts during sports like football, rugby, or tennis. -
Trauma:
Sudden blows or accidents that jolt the neck. -
Whiplash:
Rapid back-and-forth movement of the neck from car accidents. -
Overuse:
Extended periods of strain from activities like prolonged texting. -
Stress:
Increased muscle tension as a result of chronic stress. -
Improper Ergonomics:
Poor desk setup or seating can lead to sustained neck tension. -
Sleeping in a Poor Position:
Using an unsupportive pillow or sleeping in an awkward position. -
Rehabilitation Exercises:
Incorrect form during physical therapy or training. -
Muscle Imbalance:
Weak supporting muscles placing extra strain on the scalenus. -
Sudden Movements:
Quick, unsupported neck twists. -
Heavy Backpack or Bag:
Carrying heavy loads on one shoulder. -
Prolonged Head Tilt:
Looking down or to the side for long periods. -
Occupational Hazards:
Jobs that require static neck postures. -
Degenerative Cervical Changes:
Age-related wear and tear affecting neck muscles. -
Underlying Medical Conditions:
Conditions like cervical spondylosis that predispose muscles to injury. -
Electrolyte Imbalance:
Low levels of potassium or magnesium can make muscles more prone to strain. -
Lack of Warm-Up:
Not preparing the neck muscles before engaging in strenuous activity.
Symptoms of Scalenus Posterior Muscle Strain
Recognizing the symptoms can help with early diagnosis and treatment. The following are 20 common symptoms associated with this strain:
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Neck Pain:
Localized pain in the side or back of the neck. -
Stiffness:
Reduced movement and a feeling of tightness. -
Muscle Spasms:
Sudden, involuntary contractions in the neck. -
Tenderness:
The affected area may be sensitive to touch. -
Limited Range of Motion:
Difficulty turning or tilting the head. -
Radiating Pain:
Pain spreading from the neck to the shoulder or arm. -
Headaches:
Pain often starting in the neck that radiates to the head. -
Numbness:
Reduced sensation in the neck, shoulder, or arm. -
Weakness:
Feeling of reduced strength in the neck or shoulder. -
Burning Sensation:
A sharp or burning pain along the muscle. -
Dull Ache:
Persistent, throbbing discomfort. -
Muscle Fatigue:
Feeling of tiredness in the neck muscles. -
Postural Problems:
Difficulty maintaining proper head alignment. -
Stinging Pain:
A prickling or stinging sensation in the area. -
Swelling:
Mild swelling around the injured muscle. -
Difficulty Breathing Deeply:
If the muscle strain affects breathing mechanics. -
Pain When Chewing:
Sometimes tension in the neck muscles can affect the jaw. -
Discomfort When Sitting or Standing:
Prolonged positions may worsen the pain. -
Irritability or Stress:
Chronic pain can lead to mood changes. -
Sleep Disturbances:
Pain or discomfort disrupting normal sleep patterns.
Diagnostic Tests for Scalenus Posterior Muscle Strain
To properly diagnose this condition, a healthcare provider may recommend several tests, including:
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Physical Examination:
A doctor checks the neck’s range of motion and palpates the area. -
Medical History Review:
Discussion of symptoms, activities, and injury history. -
X-rays:
To rule out bone injuries or cervical spine issues. -
Magnetic Resonance Imaging (MRI):
Provides a detailed view of soft tissues. -
Computed Tomography (CT) Scan:
Offers cross-sectional images of the neck. -
Ultrasound Imaging:
Non-invasive imaging to examine muscle tissue. -
Electromyography (EMG):
Tests muscle electrical activity to detect nerve issues. -
Nerve Conduction Study:
Evaluates the functioning of the nerves. -
Blood Tests:
To check for signs of inflammation or infection. -
Bone Scan:
Can help rule out stress fractures. -
Range-of-Motion Tests:
Measures how far the neck can move. -
Strength Testing:
Assesses if the muscle is weaker on the affected side. -
Palpation:
Manual checking for tenderness and swelling. -
Posture Analysis:
Evaluates ergonomics and alignment. -
Functional Movement Assessment:
Observes how the injury affects daily activities. -
Thermography:
Uses infrared imaging to detect inflammation. -
Pain Mapping:
Identifies areas where pain is most concentrated. -
Provocative Maneuvers:
Specific positions or actions designed to reproduce pain. -
Diagnostic Injections:
Injections of anesthetic may help pinpoint the source of pain. -
Cervical Spine Evaluation:
A comprehensive assessment of the neck’s structures.
Non-Pharmacological Treatments for Scalenus Posterior Muscle Strain
Often, non-drug treatments can play a critical role in recovery. Here are 30 methods to help manage and alleviate the strain:
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Rest:
Give the neck muscle time to heal. -
Ice Therapy:
Apply ice packs to reduce inflammation. -
Heat Therapy:
Use heat packs after the initial 48 hours to relax muscles. -
Physical Therapy:
Professional guided exercises to restore function. -
Massage Therapy:
Helps reduce muscle tension and improve blood flow. -
Stretching Exercises:
Gentle stretches to improve flexibility. -
Strengthening Exercises:
Specific exercises to rebuild muscle strength. -
Posture Correction:
Learn and apply proper posture habits. -
Ergonomic Adjustments:
Improve workstation setup for better neck support. -
TENS (Transcutaneous Electrical Nerve Stimulation):
Reduces pain using mild electrical currents. -
Acupuncture:
Traditional technique to stimulate healing. -
Chiropractic Care:
Manipulative techniques to restore alignment. -
Cervical Collars (short-term):
Provide temporary support to reduce strain. -
Manual Therapy:
Hands-on techniques used by therapists. -
Activity Modification:
Avoid activities that worsen the pain. -
Yoga:
Gentle postures and breathing exercises that enhance flexibility. -
Mindfulness and Relaxation Techniques:
Stress reduction practices to lower muscle tension. -
Hydrotherapy:
Warm water exercises and baths. -
Postural Braces:
Devices to remind you to keep proper posture. -
Kinesiology Taping:
Taping techniques that support and relieve muscle tension. -
Self-Massage Techniques:
Using foam rollers or massage balls. -
Guided Breathing Exercises:
To reduce stress and improve oxygen flow. -
Ergonomic Pillows:
Better neck support during sleep. -
Weighted Neck Harnesses (under professional guidance):
To gradually strengthen neck muscles. -
Biofeedback Therapy:
Learn control over muscle tension. -
Education on Body Mechanics:
Training to use the body in ways that reduce strain. -
Activity Pacing:
Taking frequent breaks during work or exercise. -
Swimming:
Low-impact exercise to strengthen neck and shoulder muscles. -
Pilates:
Exercises focused on core stability and body alignment. -
Stress Management Counseling:
Professional guidance to handle stress that may affect muscle tension.
Drugs Commonly Used for Managing Scalenus Posterior Muscle Strain
In managing pain and inflammation, doctors may recommend one or a combination of the following drugs. It’s important to note that medication should always be taken under medical supervision:
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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
Ibuprofen, naproxen, etc. -
Acetaminophen:
For pain relief. -
Muscle Relaxants:
Such as cyclobenzaprine or methocarbamol. -
Topical Analgesics:
Creams or gels applied to the neck. -
Corticosteroids (oral):
For reducing significant inflammation. -
Corticosteroid Injections:
Directly into the affected area (if needed). -
COX-2 Inhibitors:
Medications like celecoxib that reduce inflammation. -
Opioids (short-term):
For severe acute pain (rarely used and only under strict supervision). -
Antidepressants (low-dose):
Such as amitriptyline, which can help manage chronic pain. -
Anti-Anxiety Medications:
May be prescribed if pain is accompanied by anxiety. -
Gabapentin:
Sometimes used for nerve-related pain. -
Pregabalin:
Similar to gabapentin, helpful for nerve pain. -
Vitamin D Supplements:
If deficiency is contributing to musculoskeletal pain. -
Calcium Supplements:
To support bone and muscle health. -
Magnesium Supplements:
To help relax muscles and reduce spasms. -
Topical NSAIDs:
Gels that combine NSAIDs with local application. -
Capsaicin Cream:
Derived from chili peppers to relieve nerve pain. -
Transdermal Patches:
Pain relief patches that release medication slowly. -
Botulinum Toxin Injections:
In cases of chronic muscle spasm. -
Anticonvulsants (off-label use):
Sometimes used in refractory cases of chronic pain.
Surgical Options Related to Scalenus Posterior Muscle Strain
Surgery is uncommon for an isolated scalenus posterior strain; however, in severe cases or when other structures become involved (for example, in thoracic outlet syndrome), surgery may be considered. Here are 10 types of surgical interventions that may be proposed for related conditions:
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Scalenectomy:
Surgical removal of part of the scalene muscle to relieve nerve or vascular compression. -
First Rib Resection:
Removal of part of the first rib to reduce compression in thoracic outlet syndrome. -
Neurolysis:
Freeing a nerve from surrounding scar tissue. -
Decompression Surgery:
To relieve pressure on nerves or blood vessels. -
Cervical Spine Fusion:
In cases where instability is causing or contributing to the injury. -
Discectomy:
Removal of a problematic disc segment if nerve compression is linked. -
Foraminotomy:
Widening the nerve exit pathways in the cervical spine. -
Soft Tissue Release:
Releasing tight fascia or scar tissue contributing to strain. -
Arterial Bypass or Repair:
If blood vessels are compromised in the region. -
Arthroscopic Surgery:
Minimally invasive procedure to address joint or soft tissue issues in the neck.
Prevention Strategies for Scalenus Posterior Muscle Strain
Preventing muscle strain is key to avoiding chronic pain and improving quality of life. Consider these 10 strategies:
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Maintain Good Posture:
Keep the head aligned with the spine when sitting or standing. -
Adjust Ergonomics:
Set up workspaces to reduce neck and shoulder strain. -
Regular Stretching:
Incorporate daily neck stretches into your routine. -
Strengthening Exercises:
Strengthen the neck and shoulder muscles to provide support. -
Proper Lifting Techniques:
Learn and use correct body mechanics for heavy lifting. -
Use Supportive Pillows:
Choose pillows that support the neck’s natural curve. -
Take Frequent Breaks:
Avoid sitting in one position for too long. -
Stress Management:
Practice stress reduction techniques like meditation. -
Stay Hydrated and Eat Well:
Good nutrition supports muscle function and recovery. -
Warm-Up Before Exercise:
Always perform a gentle warm-up for the neck and shoulder muscles before physical activities.
When to See a Doctor
It is important to know the warning signs that indicate you should seek professional medical help:
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Severe or worsening pain that does not improve with home care.
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Loss of movement or function in the neck or arm.
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Numbness or weakness that spreads into the arm or hand.
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Persistent muscle spasms that do not respond to non-pharmacological treatments.
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Signs of nerve compression: such as tingling, burning pain, or a “pins and needles” sensation.
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Swelling, redness, or warmth over the affected area, which could indicate an infection.
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Difficulty breathing or swallowing, which may require urgent assessment.
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History of recent injury or trauma affecting the neck.
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New onset of headaches that worsen or change in pattern.
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Unexplained overall weakness or fatigue, which may signal a more serious condition.
Frequently Asked Questions (FAQs)
Below are 15 common questions along with simple and direct answers for those dealing with a scalenus posterior muscle strain.
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What is a scalenus posterior muscle strain?
It is an injury where the muscle fibers of the scalenus posterior in the neck are overstretched or torn, leading to pain and reduced movement. -
What causes this muscle strain?
Causes include poor posture, repetitive strain, trauma from accidents or sports, heavy lifting, and prolonged neck stress. -
What are the main symptoms?
Symptoms typically include neck pain, stiffness, muscle spasms, a limited range of motion, and sometimes radiating pain into the shoulder or arm. -
How is it diagnosed?
A doctor will review your medical history, perform a physical examination, and may order imaging tests like X-rays, MRI, or ultrasound. -
What are the first steps in treatment?
Rest, application of ice or heat, and gentle exercises are often recommended initially. -
Do I need medication?
Often, over-the-counter pain relievers, NSAIDs, and muscle relaxants are used. More advanced cases may require additional medications. -
Are there non-drug treatments available?
Yes. Physical therapy, massage, posture correction, and various alternative methods like acupuncture can help. -
When is surgery necessary?
Surgery is rare for a simple strain. However, in severe cases involving nerve compression or if other structures are affected (as in thoracic outlet syndrome), surgery may be considered. -
How can I prevent future strains?
Maintaining proper posture, regular exercise, ergonomic adjustments, and proper lifting techniques are key prevention measures. -
How long does recovery usually take?
Recovery can vary from a few days for mild strains to several weeks for moderate strains. Severe cases may take longer. -
Can I exercise while healing?
Gentle, guided exercises and stretches are usually encouraged. However, heavy or strenuous activities should be avoided until healing progresses. -
Will I have long-term issues?
Most people recover fully with proper treatment and preventive measures. Persistent pain should be re-evaluated by a healthcare professional. -
What tests can my doctor order?
Common tests include a physical exam, X-ray, MRI, CT scan, ultrasound, and sometimes nerve studies (EMG). -
Is it related to thoracic outlet syndrome?
In some cases, a strained scalenus posterior muscle can contribute to or be part of thoracic outlet syndrome, where nerves or blood vessels are compressed. -
When should I seek immediate care?
If you experience severe pain, neurological symptoms like numbness or weakness, difficulty breathing, or any rapidly worsening signs, seek medical care promptly.
Conclusion
A strain of the scalenus posterior muscle can significantly impact your quality of life, but with proper diagnosis, treatment, and preventive strategies, most people experience good recovery. This guide has covered everything—from the detailed anatomy of the muscle and the many causes and symptoms to a wide range of treatment options and prevention strategies.
Taking care of your neck with proper posture, physical therapy, and appropriate rest and exercise is essential. Always consult with a healthcare provider to design a plan that is tailored to your needs. With careful management and a proactive approach, you can reduce the chances of recurring injury and improve overall neck health.
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.
