Splenius Capitis Spasm

A splenius capitis spasm is a sudden, involuntary contraction of the splenius capitis muscle in the back of your neck. These spasms can cause sharp pain, stiffness, and restricted head movement. Although often self‑limiting, severe or persistent spasms may affect daily life, work productivity, and sleep quality. A muscle spasm is an involuntary, sustained contraction of muscle fibers. When it affects the splenius capitis—a muscle at the base of the skull—it results in neck pain and tightness. Clinical studies show that muscle spasms arise from electrical hyperexcitability of muscle fibers, often triggered by overuse, strain, or nerve irritation. Gentle stretching, heat, and nonsteroidal anti‑inflammatory drugs (NSAIDs) can relieve acute spasms.

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Anatomy of the Splenius Capitis

Understanding the muscle’s structure helps in diagnosing and treating spasms effectively.

 Structure & Location

• Shape: Broad, flat, strap‑like muscle

• Location: Runs obliquely along the back of the neck, from the upper thoracic spine to the base of the skull

Origin

• Spinous processes of vertebrae C7–T3 (the bony bumps you can feel down your upper back)

Insertion

• Mastoid process of the temporal bone (behind the ear)

• Lateral third of the superior nuchal line of the occipital bone (base of skull)

Blood Supply

• Branches of the occipital artery (a branch of the external carotid artery)

• Deep cervical artery

Nerve Supply

• Dorsal rami of C3–C4 spinal nerves

Functions

1. Head extension: Tilts head backward

2. Lateral flexion: Bends head to same side

3. Ipsilateral rotation: Turns face toward same side

4. Postural support: Maintains upright head posture

5. Dynamic stabilization: Helps control head movements during activity

6. Counterbalance: Works with anterior muscles to stabilize the head

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Types of Splenius Capitis Spasms

1. Acute spasm – sudden onset, brief duration

2. Chronic spasm – persistent tightness over weeks/months

3. Myofascial spasm – involves trigger points (knots) in the muscle

4. Cervical dystonic spasm – involuntary, patterned neck contractions (dystonia)

5. Rebound spasm – occurs after stopping muscle‑relaxant medications

6. Exercise‑induced spasm – follows intense or unaccustomed neck exercise

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Causes of Splenius Capitis Spasms

1. Poor posture (forward head, rounded shoulders)

2. Sudden neck movement (whiplash)

3. Overuse (prolonged computer work)

4. Muscle fatigue (long driving, reading in bed)

5. Trauma (falls, car accidents)

6. Heavy lifting (without support)

7. Cervical spondylosis (age‑related disc wear)

8. Herniated disc (nerve irritation)

9. Arthritis (in neck joints)

10. Myofascial trigger points (“knots” in muscle)

11. Electrolyte imbalance (low potassium, magnesium)

12. Dehydration (muscle dehydration)

13. Cold exposure (drafts, air conditioning)

14. Stress and anxiety (muscle tension)

15. Viral infections (e.g., flu, causing stiff neck)

16. Fibromyalgia (widespread muscle pain)

17. Thyroid disorders (hypothyroidism can cause cramps)

18. Vitamin D deficiency (linked to muscle pain)

19. Medication side effects (statins, diuretics)

20. Caffeine overuse (can increase muscle excitability)

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Symptoms of Splenius Capitis Spasms

1. Sharp neck pain at the base of skull

2. Stiff neck—difficulty turning head

3. Muscle tightness along the back of neck

4. Headache (base‑of‑skull or tension‑type)

5. Tender nodules (trigger points)

6. Pain radiating to shoulder or upper back

7. Reduced range of motion in cervical spine

8. Clicking or grinding sounds with movement

9. Muscle twitching or visible tremor

10. Numbness/tingling in neck or arms (if nerve involved)

11. Earache (referred pain)

12. Dizziness (if posture is severely affected)

13. Uneven shoulder height

14. Head tilt to one side

15. Sleep disturbance (finding a comfortable position)

16. Fatigue (from constant muscle tension)

17. Anxiety about movement

18. Limited ability to look up or down

19. Throbbing pain after activity

20. Warmth or mild swelling over muscle

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Diagnostic Tests

Most spasms are diagnosed clinically. Additional tests rule out other conditions.

1. Medical history & physical exam

2. Palpation (feeling for tight bands/knots)

3. Range‑of‑motion tests (degree of flexion/extension)

4. Neurological exam (reflexes, strength, sensation)

5. X‑ray (bone alignment, arthritis)

6. MRI (disc herniation, soft tissue)

7. CT scan (bone detail)

8. Ultrasound imaging (muscle inflammation)

9. Electromyography (EMG) (muscle electrical activity)

10. Nerve conduction study (nerve function)

11. Blood tests – CBC (infection), metabolic panel (electrolytes)

12. Inflammatory markers (ESR, CRP)

13. Rheumatoid factor (rheumatoid arthritis)

14. Thyroid function tests (TSH)

15. Vitamin D level

16. Creatine kinase (muscle injury)

17. Myositis panel (autoimmune myositis)

18. Bone scan (stress fractures)

19. Thermography (heat patterns)

20. Trigger point injection diagnostic test (pain relief confirms trigger)

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Non‑Pharmacological Treatments

1. Gentle stretches (neck flexion, extension, rotation)

2. Isometric exercises (press head into hand)

3. Physical therapy (supervised rehab)

4. Massage therapy (kneading tight bands)

5. Myofascial release (targeted pressure)

6. Trigger point therapy (deep pressure)

7. Heat therapy (warm compress, heating pad)

8. Cold therapy (ice packs)

9. Contrast therapy (alternating hot/cold)

10. Ultrasound therapy (deep‑tissue heating)

11. Transcutaneous electrical nerve stimulation (TENS)

12. Chiropractic adjustments

13. Osteopathic manipulation

14. Acupuncture

15. Dry needling

16. Acupressure

17. Yoga (neck‑friendly poses)

18. Pilates (core strength for posture)

19. Ergonomic workstation setup

20. Posture correction (reminders, braces)

21. Cervical traction (gentle stretching)

22. Kinesiology taping

23. Foam rolling (upper back)

24. Hydrotherapy (warm baths, aquatic exercises)

25. Stress management (mindfulness, biofeedback)

26. Deep breathing exercises

27. Guided imagery (relaxation)

28. Aromatherapy (lavender for relaxation)

29. Proper pillow selection (cervical support)

30. Sleeping position education (back or side with support)

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Drugs Used in Treatment

Always follow a doctor’s prescription and dosing guidelines.

1. Ibuprofen (NSAID)

2. Naproxen (NSAID)

3. Aspirin (NSAID)

4. Acetaminophen (analgesic)

5. Cyclobenzaprine (muscle relaxant)

6. Tizanidine (muscle relaxant)

7. Baclofen (GABA agonist muscle relaxant)

8. Methocarbamol (muscle relaxant)

9. Diazepam (benzodiazepine muscle relaxant)

10. Tramadol (opioid analgesic)

11. Prednisone (oral corticosteroid)

12. Methylprednisolone (steroid dose pack)

13. Diclofenac gel (topical NSAID)

14. Lidocaine patch (topical anesthetic)

15. Capsaicin cream (topical pain reliever)

16. Gabapentin (neuropathic pain)

17. Amitriptyline (low‑dose tricyclic antidepressant for pain)

18. Botulinum toxin (Botox) injection

19. Ketorolac (short‑term injectable NSAID)

20. Opioid combinations (e.g., hydrocodone/acetaminophen)

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Surgical Options

Reserved for severe, refractory cases or underlying structural problems.

1. Selective peripheral denervation (cuts nerve branches to muscle)

2. Rhizotomy (sectioning dorsal nerve roots)

3. Cervical laminectomy (relieves spinal cord compression)

4. Anterior cervical discectomy and fusion (ACDF)

5. Cervical disc replacement

6. Posterior cervical fusion (stabilizes vertebrae)

7. Foraminotomy (opens nerve exit passage)

8. Muscle release surgery (section of tight muscle fibers)

9. Spinal cord stimulator implant (for chronic pain)

10. Intrathecal pump placement (delivers pain medication)

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Prevention Strategies

1. Maintain good posture (straight back, ears over shoulders)

2. Regular neck stretches (daily routine)

3. Ergonomic workspace (monitor at eye level)

4. Proper lifting mechanics (use legs, not neck)

5. Warm‑up exercises before sports or heavy work

6. Stay hydrated (drink water throughout day)

7. Balanced diet (adequate electrolytes, vitamins)

8. Stress reduction (relaxation techniques)

9. Frequent breaks from static positions

10. Use supportive pillows and mattress

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When to See a Doctor

• Severe pain not improved after 48–72 hours of home care

• Neurological signs (numbness, weakness, tingling in arms)

• Fever or chills (possible infection)

• History of trauma (fall, car accident)

• Unexplained weight loss with pain

• Pain awake at night or waking you

• Headache with neck stiffness and fever (meningitis risk)

• Difficulty swallowing or breathing

• Spasm recurring despite treatment

• New symptoms or sudden change in pain pattern

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Frequently Asked Questions (15)

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Conclusion

Splenius capitis spasms, while painful and disruptive, are often manageable with a combination of home care, lifestyle changes, and targeted treatments. Understanding the muscle’s anatomy, recognizing early symptoms, and practicing prevention strategies can greatly reduce spasm frequency and severity. Always consult a healthcare professional if symptoms are severe, persistent, or accompanied by neurological signs.

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 16, 2025.

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