Understanding Trigger Points – Stiffness up the side of the neck

This referral pattern creates pain up the back and side the neck while you turn your head. When it is very active, it also creates soreness and pain under the shoulder-blade. The exact location of trigger point varies with the tilt of the shoulder and such but is somewhere on or just above the superior angle of the scapula.

Client’s Description

referral-levator-scapulaPeople complain about pain while turning their head and usually trace up and down the side of their neck while talking about it. They often complain about turning to look when they change lanes or tend to a child in the back seat. They also wince when lifting the shoulder with their arm beside them as when picking up a purse that is on the floor beside them while seated. This trigger point can make it painful to hang a bag on that shoulder. When it is really stiff, they lean their head to that side and might complain about soreness under the shoulder-blade.

This is activated in a number of ways. People most commonly say that they “slept Asleep on Couchwrong.” I’ve also created this by leaning my head to one side for a long time, especially when I’m leaning it against something like laying on a couch, watching a movie, with my head awkwardly supported by the arm but I don’t want to move as it would wake up Sleeping Beauty.

This pain pattern is very is common, and most people can activate a mild version of this pattern by turning their head to the right until it stops.


Self Care

You can usually get significant relief from this problem with ice and stretch. 70% of the rotation of the neck happens between C1 and C2, so make sure to stretch the upper neck first. After that, stretch the sides of the neck, before rotating the neck.

This problem persists when the joints of the upper neck are displaced and fixated. See your trigger point therapist who may need to get up under the shoulder-blade to release this.

Therapy Notes

oit-levator-scapulaThis trigger point comes from the levator scapula muscle which twists as it lifts the scapula. That twist is increased and increases pain along the length of the muscle as the neck is turned.

It is worth noting that 70% of neck rotation happens between C1 and 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 C1 and C2. Mobilizing the upper cervicals for complete and lasting relief is critical.

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Levator insertionIn my therapy manual The Workbook of Classical Neuromuscular Therapy we found that relief is more effective when the therapist slides the scapula superiorly and gets to the attachment of the levator on the front of the scapula as shown. Upper cervicals were mobilized with static pressure and friction around their transverse processes.


Similar Patterns

When there is a severe restriction in turning, it indicates that more than one of the “Stiff Neck” muscles is involved.

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

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



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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