Scalenus posterior muscle tears refer to injuries of one of the deep neck muscles. These tears can range from mild strains to severe injuries that affect daily activities and even breathing. This guide explains the anatomy of the scalenus posterior muscle, lists many potential causes, describes common symptoms, explains how doctors diagnose the injury, and outlines a variety of treatment options—including non-drug approaches, medications, and even surgical procedures if needed.
Anatomy of the Scalenus Posterior Muscle
Understanding the anatomy of this muscle helps explain how a tear might affect you and why it can cause neck pain and other issues.
Location and Structure
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Location:
The scalenus posterior muscle is found on the lateral (side) aspect of your neck. It is one of three scalene muscles—located deep within the neck, near the cervical spine. -
Structure:
This muscle is a slender, strap-like muscle that works closely with its neighboring muscles to support neck movement and assist in breathing.
Origin and Insertion
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Origin:
The scalenus posterior muscle typically originates from the posterior tubercles of the transverse processes of lower cervical vertebrae (often around C4 to C6). -
Insertion:
The muscle then attaches to one of the upper ribs—most commonly the first rib, although anatomical variations can occur. This insertion helps the muscle play a role in stabilizing the upper rib cage.
Blood Supply
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Blood Vessels:
The muscle receives blood from nearby branches of arteries such as the ascending cervical artery and the costocervical trunk. These vessels ensure that the muscle gets oxygen and nutrients necessary for its function.
Nerve Supply
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Nerves:
Innervation of the scalenus posterior muscle comes from the ventral rami of several cervical spinal nerves (usually C4 through C8). The nerve signals allow the muscle to contract and coordinate its movements.
Functions of the Scalenus Posterior Muscle
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Stabilization of the Cervical Spine:
It helps support the neck during movement and maintains proper alignment. -
Assistance in Respiration:
By affecting the movement of the upper rib, the muscle aids in breathing, especially when you take deep breaths. -
Lateral Flexion:
It allows you to tilt or lean your head from side to side. -
Neck Extension Assistance:
It plays a role in moving the head backward. -
Supporting Posture:
As part of the neck musculature, it contributes to proper upright posture. -
Facilitating Neck Rotation:
Working with other cervical muscles, it helps in turning the head from one side to the other.
Types of Scalenus Posterior Muscle Tears
Muscle tears in the scalenus posterior can vary in severity. Understanding the types can help you and your healthcare provider decide the best treatment plan.
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Grade I (Mild Strain):
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Tiny tears in the muscle fibers
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Minimal pain and stiffness
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No significant loss of muscle strength
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Grade II (Moderate Tear):
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Partial tearing of the muscle fibers
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Noticeable pain, swelling, and reduced range of motion
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May cause difficulty with certain neck movements
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Grade III (Severe Tear):
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Complete rupture of muscle fibers
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Severe pain, significant weakness, and loss of function
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Often requires more intensive treatment and possibly surgery
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Acute Injury:
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Results from a sudden impact or trauma
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Often seen in sports or accidents
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Chronic Overuse Tear:
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Develops over time due to repetitive strain or improper posture
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May gradually worsen if not addressed
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Causes of Scalenus Posterior Muscle Tears
Muscle tears in the neck can be triggered by many factors. Here are 20 common causes:
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Whiplash Injuries:
Sudden jolts during car accidents. -
Sports Injuries:
Trauma during contact sports such as football, rugby, and hockey. -
Repetitive Overuse:
Continuous strain from activities that use the neck muscles repeatedly. -
Heavy Lifting:
Lifting heavy objects without proper form. -
Improper Exercise Technique:
Incorrect movement patterns during workouts. -
Falls:
Slipping on hard surfaces can result in sudden neck strain. -
Sudden Jerking Movements:
Abrupt movements that overstretch the neck. -
Direct Trauma:
A blow to the neck during an accident. -
Occupational Strain:
Jobs involving repetitive neck motions, such as construction or manual labor. -
Weightlifting Mishaps:
Lifting weights incorrectly or too quickly. -
Repetitive Overhead Activities:
Actions such as throwing or reaching up frequently. -
Cycling Accidents:
Falls or collisions while biking. -
Contact Sports Collisions:
Impacts during sports like soccer or basketball. -
Poor Posture:
Long-term slouching or improper sitting habits. -
Accidental Impact:
Sudden blows during daily activities. -
Water Sports Injuries:
Impact injuries from diving or other water activities. -
High-Impact Falls:
Falls experienced during running or walking. -
Martial Arts Injuries:
Strains from rapid movements or blocks. -
Degenerative Changes:
Age-related muscle weakening can predispose tears. -
Sudden Twisting Motions:
Rapid twisting of the neck or head.
Common Symptoms of Scalenus Posterior Muscle Tears
Recognizing the symptoms can help prompt early treatment and prevent further injury.
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Neck Pain:
A deep, sometimes sharp pain in the side or back of the neck. -
Stiffness:
Reduced flexibility and a stiff feeling in the neck muscles. -
Muscle Spasms:
Involuntary contractions or cramping of the neck muscles. -
Limited Range of Motion:
Difficulty turning or tilting the head. -
Radiating Pain:
Pain that spreads from the neck into the shoulder or arm. -
Tingling Sensation:
A prickling feeling, particularly if nearby nerves are affected. -
Headaches:
Tension headaches often accompany muscle strain. -
Muscle Fatigue:
A feeling of tiredness in the neck muscles after use. -
Tenderness:
The muscle may be very sensitive when touched. -
Swelling:
Inflammation around the injury site. -
Bruising:
Visible discoloration from internal bleeding. -
Difficulty Breathing:
In severe cases, neck pain might interfere with normal breathing. -
Numbness:
A loss of sensation in parts of the neck, shoulder, or arm. -
Sharp Pain with Movement:
Pain that increases when moving the head. -
Pain During Physical Exertion:
Activities like lifting or rapid movements may worsen the pain. -
Reduced Neck Stability:
A sensation that the neck isn’t as strong or secure as usual. -
Referred Pain:
Pain felt in surrounding areas, including the upper back. -
Worsening Pain with Sustained Posture:
Pain increases when holding the head in one position for a long time. -
Local Tender Points:
Specific spots on the muscle feel particularly painful. -
Fatigue Around the Jaw or Shoulders:
Secondary muscle groups may feel strained as they compensate.
Diagnostic Tests for Scalenus Posterior Muscle Tears
Diagnosis starts with a detailed physical examination, followed by tests to confirm the muscle tear and its extent. Here are 20 tests doctors may use:
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Physical Examination:
Manual palpation of the neck to locate tender areas. -
Range of Motion Tests:
Assessing how far you can move your neck. -
Neurological Exam:
Checking for nerve involvement by assessing reflexes and sensation. -
X-rays:
To rule out bone damage or misalignment in the cervical spine. -
Computed Tomography (CT) Scan:
Provides detailed images of bones and soft tissues. -
Magnetic Resonance Imaging (MRI):
Offers a closer look at soft tissues including muscles. -
Ultrasound Imaging:
A noninvasive test that uses sound waves to visualize the muscle. -
Electromyography (EMG):
Measures electrical activity in the muscle. -
Nerve Conduction Studies:
Assess how well nerves are sending signals. -
Bone Scan:
Detects inflammation in bones and surrounding tissue. -
Ultrasound-Guided Injection Test:
Helps to pinpoint the source of pain. -
Myelography (in select cases):
An imaging test that may be used when nerve compression is suspected. -
Stress Radiography:
Evaluates stability and pain under movement. -
Positron Emission Tomography (PET) Scan:
Rarely used, but may show areas of increased metabolic activity. -
Cervical Spine Alignment Evaluation:
Checks for abnormal curvature or misalignment. -
Computerized Tomography Angiography (CTA):
Used if there is concern about blood vessel involvement. -
Color Doppler Ultrasound:
Evaluates blood flow in the neck’s vessels. -
Manual Muscle Testing:
Assesses strength and pain response in the neck muscles. -
Palpation-Induced Pain Tests:
Specific maneuvers to replicate pain while pressing on the area. -
Provocative Maneuvers:
Certain neck movements that may reproduce symptoms to help confirm the tear.
Non-Pharmacological Treatments for Scalenus Posterior Muscle Tears
Many therapies do not involve drugs and focus on natural or physical methods to heal the muscle and reduce pain. Here are 30 non-drug treatment options:
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Rest:
Avoiding activities that worsen the pain. -
Ice Therapy:
Applying ice packs to reduce inflammation. -
Heat Therapy:
Using warm compresses to improve blood flow. -
Compression:
Employing bandages to help support the area. -
Physical Therapy:
A guided program of exercises designed to strengthen and stretch neck muscles. -
Stretching Exercises:
Gentle stretches to improve flexibility. -
Massage Therapy:
Targeted massage helps release muscle tension. -
Ultrasound Therapy:
Uses sound waves to promote healing. -
Acupuncture:
Fine needles may be used to relieve pain. -
Chiropractic Care:
Adjustments can help correct neck alignment. -
Kinesiology Taping:
Tape applied to support the injured muscle. -
Manual Therapy:
Hands-on techniques to mobilize tissues. -
Posture Correction:
Training to improve everyday posture. -
Ergonomic Adjustments:
Modifying work and home setups to reduce strain. -
Neck Braces or Collars:
Short-term support can relieve pain. -
Hydrotherapy:
Water-based exercises to ease muscle strain. -
Soft Tissue Mobilization:
Techniques that loosen tight muscles. -
Myofascial Release:
Therapy to ease the tension in the fascia surrounding muscles. -
Transcutaneous Electrical Nerve Stimulation (TENS):
A device sends mild electrical impulses to relieve pain. -
Biofeedback Therapy:
Teaches you to control muscle tension. -
Low-Level Laser Therapy:
Laser treatment to stimulate tissue repair. -
Meditation and Relaxation:
Stress relief techniques can reduce muscle tension. -
Breathing Exercises:
Improve oxygen flow and reduce neck strain. -
Yoga Stretches:
Specific yoga postures to gently stretch the neck. -
Pilates Exercises:
Focus on core strength and overall posture. -
Trigger Point Therapy:
Identifies and relieves points of muscle tension. -
Balance and Proprioception Training:
Improves coordination and reduces injury risk. -
Cold Laser Therapy:
A gentle treatment to speed up healing. -
Supportive Pillows:
Using ergonomic pillows during sleep for neck alignment. -
Gradual Return to Activity:
Slowly resuming exercises to ensure healing without re-injury.
Drugs Commonly Used in the Management of Muscle Tears
While non-pharmacological treatments are usually the first line of defense, several drugs can help control pain and inflammation:
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Ibuprofen:
A non-steroidal anti-inflammatory drug (NSAID). -
Naproxen:
Another NSAID for pain and inflammation. -
Acetaminophen (Paracetamol):
Helps with pain relief. -
Cyclobenzaprine:
A muscle relaxant that eases muscle spasms. -
Tizanidine:
A medication that relaxes tight muscles. -
Oral Corticosteroids (e.g., Prednisone):
Used to reduce severe inflammation. -
Corticosteroid Injections:
Direct injections to reduce localized inflammation. -
Tramadol:
An analgesic for moderate to severe pain. -
Topical Diclofenac Gel:
Applied to the skin over the muscle. -
Topical Capsaicin Cream:
Provides localized pain relief. -
Celecoxib:
A COX-2 inhibitor that reduces pain. -
Low-Dose Codeine Combinations:
In controlled situations for pain management. -
Hydrocodone Combination Products:
For short-term, severe pain relief. -
Gabapentin:
Can help if nerve pain is involved. -
Pregabalin:
Another option for neuropathic pain relief. -
Amitriptyline:
Sometimes prescribed for chronic pain. -
Baclofen:
A muscle relaxant with antispasmodic effects. -
Intravenous Analgesics:
Used in a hospital setting for severe pain episodes. -
Combination Pain Relievers with Caffeine:
Enhance pain relief effects. -
Over-the-Counter Multimodal Pain Formulations:
Often available for mild to moderate discomfort.
Surgical Options for Severe Cases
While most scalenus posterior muscle tears are managed non-surgically, severe cases may require surgical intervention:
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Surgical Repair of the Torn Muscle:
Rejoining the torn fibers. -
Debridement:
Cleaning out damaged tissue. -
Scar Tissue Release (Fasciotomy):
Removing restrictive scar tissue. -
Muscle Grafting:
Transferring tissue to repair significant damage. -
Neck Decompression Surgery:
To relieve pressure on nerves. -
Thoracic Outlet Decompression:
Addressing compression in the upper chest area. -
Cervical Spine Fusion:
Stabilizing the spine if instability is present. -
Endoscopic Muscle Release:
A minimally invasive option. -
Minimally Invasive Muscle Repair:
Using small incisions to repair the tear. -
Reconstruction Surgery:
In cases with extensive structural damage.
Prevention Strategies
The best approach is to prevent injury before it occurs. Here are 10 prevention tips:
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Warm-Up Exercises:
Always prepare your muscles before physical activity. -
Proper Stretching:
Regularly stretch your neck muscles. -
Maintain Correct Posture:
Sit and stand with proper alignment. -
Ergonomic Workplace:
Adjust your work environment to reduce strain. -
Gradual Exercise Intensity:
Increase your workload gradually. -
Use Correct Lifting Techniques:
Lift objects with proper form. -
Strength Training:
Regularly strengthen neck muscles. -
Use Supportive Pillows:
Ensure your pillow supports your neck during sleep. -
Take Regular Breaks:
Avoid long periods of static posture. -
Avoid Repetitive Strain:
Vary your activities to reduce constant stress on one area.
When to See a Doctor
It is important to seek professional medical advice if you experience:
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Severe or persistent neck pain that does not improve with rest.
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Limited range of motion in your neck.
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Radiating pain, numbness, or tingling into your arm or hand.
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Difficulty breathing or swallowing.
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Swelling or bruising that worsens over time.
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Muscle weakness or loss of function.
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Symptoms following an accident or sports injury.
If any of these issues occur, it is best to consult a healthcare provider for a proper diagnosis and treatment plan.
Frequently Asked Questions (FAQs)
Below are common questions about scalenus posterior muscle tears along with simple answers:
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What is a scalenus posterior muscle tear?
It is an injury where the muscle fibers in the deep neck muscle (scalenus posterior) are overstretched or torn. -
Where is the scalenus posterior muscle located?
It is on the side of your neck, originating from the cervical spine and attaching to one of your upper ribs. -
What causes these muscle tears?
They can result from accidents, sports injuries, repetitive strain, poor posture, or sudden heavy lifting. -
How do I know if I have a tear?
Look for neck pain, stiffness, limited movement, and sometimes pain that spreads to your shoulder or arm. -
What symptoms should I watch for?
Common symptoms include muscle spasms, sharp pain when moving, tingling sensations, and swelling. -
How are these tears diagnosed?
Diagnosis is typically through a physical exam and imaging tests like X-rays, CT scans, MRIs, or ultrasounds. -
Can the injury heal without surgery?
Yes; many tears, especially mild strains, are managed with physical therapy, rest, and medication. -
What non-drug treatments work best?
Rest, ice/heat therapy, physical therapy, massage, and posture correction are popular non-pharmacological options. -
When are medications necessary?
Medications such as NSAIDs, muscle relaxants, or corticosteroids are used when pain and inflammation are significant. -
What surgical options exist if the injury is severe?
Surgeries can include muscle repair, debridement, or even neck decompression if nerves are involved. -
How can I prevent a muscle tear?
Warming up, stretching, using ergonomic supports, and proper lifting techniques can reduce risk. -
How long does it typically take to recover?
Recovery depends on the tear’s severity. Mild strains may heal in a few weeks, while severe tears may require months. -
Does physical therapy help?
Yes, physical therapy is often crucial for restoring movement, reducing pain, and strengthening the neck. -
Is it safe to exercise with a muscle tear?
Mild activities may be safe once approved by your doctor, but rest is important during acute phases. -
What are the risks if untreated?
Untreated tears may lead to chronic pain, reduced range of motion, and potential nerve compression issues.
Conclusion
Scalenus posterior muscle tears can be painful and disrupt your daily life, but understanding the condition is the first step toward effective treatment and prevention. This guide has provided an in-depth look at the anatomy of the muscle, the types of tears, what might cause them, and the wide range of symptoms they can produce. From diagnostic tests to both non-pharmacological and drug treatments—and even surgical options when necessary—there are many strategies available to manage this injury. By following prevention tips and knowing when to see a doctor, you can reduce the likelihood of experiencing a tear or minimize its impact if one occurs.
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.
