The scalenus posterior muscle is one of the small, deep muscles of the neck that plays a vital role in helping with breathing and neck movement. Disorders of this muscle can cause neck pain, stiffness, and may even contribute to conditions such as thoracic outlet syndrome. In this guide, we explain in simple terms what the scalenus posterior muscle is, how it works, the various disorders that can affect it, and the evidence-based causes, symptoms, tests, and treatments available.
Anatomy of the Scalenus Posterior Muscle
A strong grasp of the anatomy is essential when discussing any muscle disorder. Here is what you should know about the scalenus posterior muscle:
1. Structure and Location
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Location in the Neck:
The scalenus posterior is part of a group called the scalene muscles, which are located on the lateral (side) aspects of the neck. Although it is one of the smaller muscles, it lies deep within the neck, behind more superficial muscles. -
Relation to Other Structures:
Because of its location, this muscle lies close to important nerves (such as components of the brachial plexus) and blood vessels. Its proximity to these structures means that any disorder affecting it can sometimes cause radiating symptoms or even affect the flow of blood and nerve signals.
2. Origin and Insertion
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Origin:
The muscle typically originates from the posterior (back) tubercles or transverse processes (side bony projections) of the lower cervical vertebrae. Although the exact vertebral levels can vary between individuals, it often arises from the lateral parts of the cervical vertebrae (commonly from C5–C7). -
Insertion:
The scalenus posterior usually inserts on the upper surface of the second rib. This anatomical pathway allows it to play a role in respiratory movements.
3. Blood Supply
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Arterial Supply:
The muscle receives blood from small branches that come off the subclavian artery—often via the costocervical trunk. Adequate blood flow is essential for muscle health and recovery from injuries.
4. Nerve Supply
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Innervation:
The scalenus posterior is innervated by branches from the cervical spinal nerves (typically C5–C8). These nerves control the muscle’s movements and coordinate its functions within the neck.
5. Functions of the Scalenus Posterior Muscle
Here are six important functions performed by the scalenus posterior muscle:
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Elevation of the Ribs:
It helps lift the second rib during breathing, thus contributing to lung expansion. -
Assistance in Inspiration:
During forced breathing (such as during exercise), the muscle aids in deepening inspiration. -
Neck Stabilization:
It provides support for the cervical spine, contributing to overall neck stability. -
Lateral Flexion:
The muscle assists in bending the neck to the side. -
Neck Rotation:
By working with other neck muscles, it helps rotate the head. -
Postural Support:
It contributes to maintaining good head and neck posture during daily activities.
Types of Scalenus Posterior Muscle Disorders
Scalenus posterior muscle disorders can vary widely in severity and underlying cause. Common types include:
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Muscle Strain or Tear:
Overstretching or injuring the muscle from excessive or improper use. -
Muscle Spasm:
Sudden, involuntary contraction of the muscle that may cause sharp pain. -
Myofascial Trigger Point Syndrome:
The muscle develops small “trigger points” or knots that cause referred pain in the neck, shoulder, or arm. -
Overuse Injury:
Prolonged activities or repetitive motions (for example, poor posture at a computer) can lead to chronic muscle tension. -
Inflammation (Myositis):
Conditions such as polymyositis can inflame the muscle, leading to pain and weakness. -
Thoracic Outlet Syndrome (TOS) Related to Scalene Muscles:
An abnormally tight or shortened scalenus posterior muscle may compress nearby nerves or blood vessels, leading to pain, numbness, and weakness in the arm. -
Fibrosis or Scar Tissue Formation:
After an injury, the muscle may heal with scar tissue that reduces flexibility and causes discomfort. -
Congenital Anomalies:
Some individuals may have anatomical variations in the scalene muscles that predispose them to dysfunction.
Causes of Scalenus Posterior Muscle Disorders
Understanding what causes these disorders can help with prevention and treatment. Here are 20 potential causes:
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Poor Posture:
Slouching or leaning forward for prolonged periods can place extra stress on the neck muscles. -
Repetitive Strain:
Constant repetitive movements (such as during computer work) can lead to overuse injuries. -
Trauma:
Direct blows to the neck or whiplash from a car accident can injure the muscle. -
Overuse in Sports:
Repetitive or strenuous activity in sports (like weightlifting or rowing) can strain the muscle. -
Muscle Imbalance:
An imbalance between neck and shoulder muscles may cause compensatory stress on the scalenus posterior. -
Excessive Tension:
Stress-induced muscle tension can lead to chronic tightness and pain. -
Poor Ergonomics:
Inadequate workstation setup (e.g., improper computer positioning) may force the neck into awkward postures. -
Aging:
Natural age-related muscle degeneration may contribute to reduced strength and flexibility. -
Degenerative Cervical Changes:
Conditions such as cervical spondylosis can lead to altered mechanics of the neck muscles. -
Whiplash Injury:
Sudden acceleration–deceleration events can cause overstretching and strain of the neck muscles. -
Repetitive Overhead Activities:
Repeated reaching above shoulder level may cause chronic strain. -
Inflammatory Conditions:
Disorders like polymyositis can lead to muscle inflammation. -
Fibromyalgia:
A widespread pain syndrome that frequently includes tender areas in the neck muscles. -
Improper Lifting Techniques:
Lifting heavy objects without proper form can place undue stress on the neck muscles. -
Sedentary Lifestyle:
Lack of regular exercise can weaken the muscles, making them more prone to injury. -
Incorrect Sleeping Positions:
Using an unsupportive pillow or sleeping in a poor position may strain the neck. -
Nerve Impingement:
Compression or irritation of the cervical nerves can affect muscle performance. -
Muscle Infections or Inflammatory Myopathies:
Rare infections or autoimmune conditions can target the muscle directly. -
Biomechanical Abnormalities:
Structural anomalies or imbalances in the cervical spine can predispose the muscle to injury. -
Environmental Factors:
Exposure to cold or damp conditions may contribute to muscle stiffness and pain.
Symptoms of Scalenus Posterior Muscle Disorders
The symptoms of scalenus posterior muscle disorders can vary depending on the severity and underlying cause. Here are 20 symptoms to watch for:
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Neck Pain:
Persistent or intermittent pain in the lateral or deep part of the neck. -
Shoulder Pain:
Discomfort that may radiate from the neck to the shoulder. -
Stiffness:
Reduced flexibility and a feeling of tightness in the neck muscles. -
Radiating Arm Pain:
Pain that travels down toward the arm or shoulder blade. -
Limited Range of Motion:
Difficulty turning or tilting the head fully. -
Muscle Tenderness:
Sensitivity when the muscle is pressed or palpated. -
Trigger Points:
Small, painful knots that develop in the muscle tissue. -
Tingling or Numbness:
Sensations in the neck, shoulder, or arm due to nerve irritation. -
Burning Sensation:
A feeling of heat or burning in the affected area. -
Spasms:
Sudden, involuntary contractions that cause sharp pain. -
Headaches:
Tension headaches that originate in the neck muscles. -
Fatigue:
A feeling of tiredness in the neck that can extend to the upper body. -
Difficulty Swallowing:
In some cases, muscle tightness may interfere with swallowing. -
Dizziness:
A sense of lightheadedness, often from tension in the neck affecting blood flow. -
Postural Problems:
Changes in head and neck posture resulting in imbalances. -
Weakness:
Reduced strength in neck and shoulder muscles. -
Increased Pain with Movement:
Symptoms worsen during activities such as turning or lifting the head. -
Sensitivity to Touch:
Overreaction to gentle pressure on the neck. -
Referred Pain:
Pain felt in other areas (such as the upper back or arm) though the issue is in the neck. -
Loss of Coordination:
In severe cases, balance and coordination might be affected due to pain and muscular dysfunction.
VDiagnostic Tests for Scalenus Posterior Muscle Disorders
A variety of tests can help diagnose scalenus posterior muscle disorders. Healthcare providers typically use a combination of these to get a complete picture:
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Physical Examination:
A thorough examination that includes manual palpation to assess muscle tenderness and identify trigger points. -
Posture Analysis:
Evaluating how well you sit, stand, and move can reveal imbalances affecting the neck muscles. -
Range of Motion Testing:
Assessing how far you can move your neck in different directions. -
X-rays:
Imaging studies can rule out bony abnormalities or cervical spine issues. -
Magnetic Resonance Imaging (MRI):
Provides detailed images of soft tissues including muscles and nerves. -
Computed Tomography (CT) Scan:
Useful for visualizing both bones and soft tissues with greater detail. -
Ultrasound Imaging:
A non-invasive way to view muscle structure and any inflammation or tears. -
Electromyography (EMG):
Measures the electrical activity of muscles to detect abnormalities. -
Nerve Conduction Studies:
Evaluates how well the nerves are transmitting signals, which can be affected by muscle disorders. -
Blood Tests:
Tests to check for markers of inflammation or muscle injury (for example, creatine kinase levels). -
Diagnostic Injections:
Local anesthetics or steroids may be injected into the area to confirm the source of pain. -
Trigger Point Examination:
Specific testing to locate trigger points that may be causing referred pain. -
Provocative Tests (Adson’s Test):
Designed to check for thoracic outlet syndrome by evaluating changes in pulses with various neck positions. -
Costoclavicular Maneuver:
A test used to assess vascular compression associated with tight scalene muscles. -
Roos Test:
A maneuver to detect neurovascular compression in cases suspected of thoracic outlet syndrome. -
Cervical Flexion-Extension Views:
Dynamic X-rays that show how the cervical spine moves. -
3D Motion Analysis:
Advanced assessment to quantify neck movement and muscle balance. -
Thermography:
Measures changes in skin temperature that may indicate areas of increased muscle activity or inflammation. -
Surface Electromyography (sEMG):
Noninvasive testing to assess muscle activation patterns. -
Myofascial Pain Evaluation:
A focused examination to study the relationship between muscle tension, trigger points, and pain patterns.
Non-Pharmacological Treatments
For many patients, non-pharmacological treatments play a crucial role in managing scalenus posterior muscle disorders. Here are 30 evidence-based treatments explained in simple terms:
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Physical Therapy:
A trained therapist can design a personalized exercise and stretching program to relieve pain and improve muscle strength. -
Stretching Exercises:
Specific stretches to gently elongate the neck muscles and improve flexibility. -
Strengthening Exercises:
Targeted movements that build muscle endurance and balance in the neck and shoulder area. -
Massage Therapy:
Professional massage can help reduce muscle tension, improve circulation, and ease trigger points. -
Heat Therapy:
Using warm compresses or heating pads can relax tight muscles and increase blood flow. -
Cold Therapy:
Ice packs may reduce inflammation after an acute injury. -
Ultrasound Therapy:
Therapeutic ultrasound delivers sound waves to deep tissues to reduce pain and inflammation. -
Acupuncture:
This traditional therapy may help relieve pain by stimulating nerve pathways. -
Posture Correction:
Learning and practicing good posture habits reduces undue stress on neck muscles. -
Ergonomic Adjustments:
Modifying your workspace (adjusting chair, computer screen, etc.) to support a neutral neck position. -
Trigger Point Therapy:
Techniques focused on releasing muscle knots to alleviate referred pain. -
Chiropractic Manipulation:
Gentle adjustments by a chiropractor may help restore proper neck alignment. -
Myofascial Release:
A specialized form of soft-tissue therapy that aims to release tension in the fascia (connective tissue). -
Yoga:
Gentle yoga practices improve flexibility, balance, and muscle strength while reducing stress. -
Pilates:
Pilates exercises can help strengthen the core and improve overall posture, benefiting neck stability. -
Transcutaneous Electrical Nerve Stimulation (TENS):
A device that sends low-voltage electrical currents to reduce pain signals. -
Relaxation Techniques:
Methods such as progressive muscle relaxation can lower overall muscle tension. -
Biofeedback:
This technique uses electronic monitoring to help you control bodily functions such as muscle tension. -
Stress Management:
Reducing stress through counseling, meditation, or other relaxation strategies can decrease muscle tightness. -
Activity Modification:
Adjusting daily routines to avoid repetitive strain and overuse of the neck. -
Neck Bracing or Support:
Using a supportive collar (short-term) can help stabilize the neck during acute phases of pain. -
Dry Needling:
A technique similar to acupuncture where thin needles are used to release trigger points. -
Kinesio Taping:
Specially designed tape supports muscle and joint function without limiting movement. -
Hydrotherapy:
Exercises in warm water can reduce joint stress and relax muscles. -
Breathing Exercises:
Techniques that encourage proper breathing may improve overall muscular function and decrease tension. -
Balance Training:
Exercises that improve balance can help maintain proper posture and reduce muscle strain. -
Lifestyle Modifications:
Adopting healthier habits like regular exercise and sufficient sleep to support muscle recovery. -
Manual Therapy:
Skilled hands-on techniques that target deep tissue and help to ease muscle tension. -
Cervical Stabilization Exercises:
Specific exercises aimed at strengthening deep neck muscles to provide better support. -
Meditation:
Regular meditation can help manage stress levels, which in turn may reduce chronic muscle tension.
Pharmacological (Drug) Treatments
When non-pharmacological treatments are not enough, medications may be prescribed. Below are 20 drugs commonly used to manage pain and inflammation associated with scalenus posterior muscle disorders:
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Ibuprofen (NSAID):
Reduces pain and inflammation. -
Naproxen (NSAID):
Another nonsteroidal anti-inflammatory option for muscle pain relief. -
Acetaminophen:
Helps reduce pain though it does not reduce inflammation. -
Cyclobenzaprine (Muscle Relaxant):
Eases muscle spasms. -
Tizanidine (Muscle Relaxant):
Works by reducing muscle tone to relieve tension. -
Tramadol (Analgesic):
A pain reliever used for moderate to severe pain on a short-term basis. -
Codeine/Acetaminophen Combination:
Used when stronger pain relief is needed. -
Celecoxib (COX-2 Inhibitor):
Offers anti-inflammatory benefits with less risk to the stomach. -
Prednisone (Corticosteroid):
May be prescribed for short-term control of inflammation. -
Gabapentin (Anticonvulsant):
Often used to treat nerve-related pain. -
Pregabalin (Anticonvulsant):
Another option for neuropathic pain management. -
Amitriptyline (Antidepressant):
Can be useful for chronic pain management. -
Duloxetine (SNRI):
Helps in managing chronic pain and associated mood issues. -
Lidocaine Patch (Topical Analgesic):
Provides localized pain relief when applied to the skin. -
Diclofenac Gel (Topical NSAID):
Directly applied for reducing inflammation and pain. -
Capsaicin Cream:
Helps relieve pain by reducing substance P, a chemical involved in pain transmission. -
Baclofen (Muscle Relaxant):
May be used as an alternative to reduce muscle spasm. -
Meloxicam (NSAID):
An anti-inflammatory option for managing pain. -
Etodolac (NSAID):
Often used for short-term relief of inflammation and pain. -
Local Anesthetic Injections (e.g., Bupivacaine):
When applied as nerve blocks, they can provide temporary relief from severe pain.
Note: Many of these medications are available in different formulations and may be used in combination with one another based on your healthcare provider’s assessment.
Surgical Options for Severe Cases
Surgery is rarely the first treatment choice but may be considered when conservative measures fail, or if there is significant nerve or vascular compression. Here are 10 possible surgical interventions:
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Scalenectomy:
Partial removal or release of the scalene muscle to relieve compression. -
First Rib Resection:
Removal of the first rib to open up space in the thoracic outlet—often done in conjunction with a scalenectomy. -
Thoracic Outlet Decompression:
A procedure to relieve pressure on nerves and blood vessels in the upper chest and neck. -
Neurolysis:
Surgical freeing of a nerve from adhesions or compressive tissue. -
Cervical Decompression Surgery:
Removing bone or tissue that compresses nerves in the cervical spine. -
Endoscopic Decompression:
A minimally invasive technique to relieve muscle and soft tissue tension. -
Selective Muscle Release:
Targeted release of contracted portions of the scalene muscle. -
Adhesion Release:
Surgical removal of scar tissue that may be restricting muscle movement. -
Microscopic Nerve Decompression:
A delicate procedure to relieve nerve compression at the level of the cervical spine. -
Laser-Assisted Release:
Using laser technology to release tight muscle fibers or scar tissue.
Prevention Strategies
Prevention is a key part of managing scalenus posterior muscle issues. Here are 10 practical prevention tips:
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Maintain Good Posture:
Keep your head aligned with your spine. Avoid slouching. -
Ergonomic Workstations:
Arrange your desk, chair, and computer screen to minimize neck strain. -
Regular Stretching:
Daily neck stretches help keep muscles flexible and reduce tension. -
Strengthening Exercises:
Engage in neck and upper body exercises to support muscle balance. -
Stress Management:
Practice relaxation techniques to reduce overall muscle tension. -
Proper Lifting Techniques:
Use your legs, not your back or neck, when lifting heavy objects. -
Correct Sleeping Positions:
Use a supportive pillow and sleep on your back or side to keep your neck aligned. -
Scheduled Breaks:
Take regular breaks if you work at a computer or in a static position. -
Regular Exercise:
Maintain overall physical fitness to support muscle health and circulation. -
Early Intervention:
Address neck pain early with self-care or professional help to prevent chronic issues.
When to See a Doctor
It is important to seek medical advice if you experience any of the following:
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Persistent or Worsening Neck Pain:
Pain that does not improve with rest and self-care measures. -
Radiating Pain or Numbness:
Symptoms that extend into the shoulder, arm, or hand. -
Limited Range of Motion:
Difficulty turning or bending your neck. -
Muscle Weakness:
A noticeable decrease in strength in the neck or upper limbs. -
Severe Headaches or Dizziness:
Accompanied by neck pain, these could indicate nerve involvement. -
Symptoms of Thoracic Outlet Syndrome:
Such as numbness, tingling, or coldness in the hands. -
Unexplained Muscle Spasms:
Frequent and painful involuntary contractions. -
Failure of Conservative Treatments:
When non-pharmacological therapies and medications do not relieve symptoms.
If you notice any of these signs, a healthcare provider can evaluate your condition, perform necessary diagnostic tests, and recommend an appropriate treatment plan.
Frequently Asked Questions (FAQs)
Below are 15 common questions and their straightforward answers related to scalenus posterior muscle disorders:
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What is the scalenus posterior muscle?
It’s one of the deep neck muscles located on the side of the cervical spine, playing a role in breathing and neck movement. -
What causes disorders of this muscle?
They are often caused by poor posture, repetitive strain, trauma, overuse, muscle imbalances, or inflammatory conditions. -
How do I know if I have a scalenus posterior muscle disorder?
Look out for neck pain, stiffness, trigger points, and sometimes radiating pain to your shoulder or arm. -
What are trigger points?
Trigger points are small, tight knots in the muscle that can cause pain in the area or refer pain to other parts of the body. -
Can these disorders contribute to thoracic outlet syndrome?
Yes. A tight or overactive scalenus posterior muscle can compress nearby nerves or blood vessels, potentially leading to thoracic outlet syndrome symptoms. -
How are these disorders diagnosed?
Through a combination of physical exams, imaging tests (X-rays, MRI, CT), and specialized tests such as EMG and nerve conduction studies. -
Is physical therapy useful?
Absolutely—physical therapy with stretching, strengthening, and postural correction is a key part of managing these disorders. -
What non-drug treatments are available?
Options include massage, acupuncture, trigger point therapy, ergonomic adjustments, and various forms of physical therapy. -
Do I always need medication?
Not necessarily. Many patients can manage symptoms with non-pharmacological treatments, using medications only when necessary for pain relief. -
When is surgery recommended?
Surgery is usually a last resort for severe cases, especially when there is significant nerve or vascular compression or if conservative treatments fail. -
Are there lifestyle changes that can help?
Yes—maintaining proper posture, ensuring ergonomic work setups, regular stretching, and stress management can greatly reduce symptoms. -
How long does recovery take?
Recovery varies depending on the severity of the disorder, ranging from a few weeks with mild cases to several months for more severe conditions. -
Can exercise worsen my condition?
If exercises are not performed correctly or if you overexert yourself, they can exacerbate symptoms. It’s essential to follow a guided program from a professional. -
Is this condition common?
While not as widely discussed as other neck issues, scalenus posterior muscle disorders are not uncommon—especially in individuals with poor posture or repetitive neck strain. -
What should I do if my pain doesn’t improve?
It’s important to follow up with your healthcare provider for further evaluation and treatment adjustments if your symptoms persist or worsen.
Conclusion
Scalenus posterior muscle disorders can be a source of significant discomfort and functional limitation if not properly addressed. By understanding the anatomy, causes, symptoms, and available treatments—from non-pharmacological strategies such as physical therapy and ergonomic adjustments to drug therapies and surgical options—you can take proactive steps to manage your condition.
With early intervention, guided therapy, and lifestyle adjustments, many patients experience marked improvement in their symptoms and quality of life. Always remember that the most effective treatment is the one that is tailored to your individual needs in consultation with a trusted healthcare provider.
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.
