Understanding Trigger Points – Stiffness at the base of the neck

Client’s Description

referral-splenius-cervicis-c7People complain of stiffness in their neck while turning their head. When I ask for more details, they often turn their head slowly until they say, “There. It hurts right there.” When I ask them to touch where it hurts, they lay their hand on the base of their neck and as they turn. They often say that it is interfering with their driving and that they “slept funny.” This muscle is more likely to get aggravated when the muscle gets cold while they sleep in a “funny” position.

When I ask if they have texted or looking straight down at something, they will sometimes realize that they havetexting a new smart phone or was using their phone more than usual.  This is worsened when the hips are pulled forward in the chair and the muscles of the neck are used to pull the shoulders up while breathing.

This muscle can also be strained when something jerks the head forward, like vehicular whiplash.




You can get some relief from this by using the ice-and-stretch routine on this web-site. You will get the best results by icing on the side of the base of the neck and stretching that area before trying to stretch the back of the base of the neck. After ice and stretch, try this routine of breathing to relieve upper back pain. the upper rib heads will often click loose and the trigger point will release.

This can be very tough to resolve yourself and it can take weeks and weeks to resolve on its own. See a trigger point specialist for lasting relief.

Therapy Notes

oit-splenius-cervicisThis trigger point comes from the splenius cervicis muscle. You can see from this illustration how this muscle is disabled by trigger points  so that it does not continue to twist T3 when the rib head is displaced. The trigger point is actually near C7 at the base of the neck but does not release easily or completely when the costovertebral joint of T3 is displaced. The lower cervicals need to be mobilized as well for comfort and mobility.

It is worth noting that 70% of neck rotation happens at C2. When the neck is painful to rotate, even when the pain is not near C2, It is almost always a muscle that attaches to C2.

decompression of 3rd CV joint

In the old manuals on neuromuscular techniques, there is a specific maneuver for pressing into the base of the neck while turning the head to release this muscle. It is a standard taken from the NMT work of St. John and Delaney. It often takes several releases of the soft tissue in this pocket between the spine and trapezius to get into that pocket deep enough to release the rib head.

This trigger point is governed by proprioceptive input from the third costovertebral joint. Specifically, the rib head at T3 has moved posterior and needs to be freed from its displaced position. Reach up under the supine client to find the third costovertebral joint. It will be the obvious, harder and protruding rib head. Lift the rib head until it softens. This often takes 90 seconds or so. When you return to the classic technique in this pic, the trigger point releases more easily and with longer lasting results.

Similar Patterns

Click on these categories to see if there is a referral pattern that better describes your concerns.

tag-stiff-neck tags-base-of-neck tags-neck tags-upper-back tags-top-of-shoulder


Tony Preston has a practice in Atlanta, Georgia where he sees clients.

He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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