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Pain at the Base of the Head and Under Shoulder Blade

Client Description

With this trigger point, people complain about tension and a focus pain and tension at the base of their head. When I press for more detail, they may tell me about the tension in their neck and under the shoulder. It is easy to feel the tender knot on the backside about halfway down the neck. Occasionally, people complain about the pain under the shoulder as being more of a bother.

People complain more about achy pain than restricted movement. It is This muscle doesn’t create many restrictions in the mobility of the neck like levator scapula does, which creates a similar pattern. If you have a lot of stiffness, refer to these posts on stiff necks.

Often, I have a mild version of this while I’m seated at the therapy table. Gently lifting my head and using stretch #2 and #3 from the Self-Care Post creates a little shift in the mid-neck and immediate relief.



How You Activate and Intensify This Pain Pattern

People are seldom aware of how they aggravated this trigger point, although many complain about doing too much computer work or sleeping in an awkward position. They are bothered by the focus of pain at the base of their head or under the shoulder when they crane their neck like this.

Also, this is one of the patterns that result from whiplash. It usually appears after the therapist has resolved more severe patterns.

It is worth noting that many trigger points have similar patterns of pain. People are usually clear about how those started and when it bothers them. Browse at this collection of posts on Forward-Head Posture and see if there is a trigger point that better matches your pattern.


The Musculoskeletal Anatomy Behind Your Pain

Start by Understanding the Anatomy.
About the coloring of the illustrations…

Multifidi and rotatores are interspinous muscles that manage tension and balance between vertebrae.



Getting Relief on Your Own

Clinically Proven
Self-Care Recommendations.

This post has strategies for getting relief on your own. Explore how to change your activities, stretch and other strategies that relieve the pain associated with this trigger point.


Treatment Notes for Massage and Bodywork

Better Bodywork
Through Shared Expertise.

This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.



This site is undergoing changes. Starting in early 2020, we began improving the format. We are also adding more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We appreciate your input and feedback. You will see us adding posts and updating older posts as time permits.


Weekly Featured Post

This post is about the watershed moment that changed the direction of my bodywork. People would say that it is about treating at the source. I’d say that it is about understanding the governors and accessories in a pattern. This gives the therapist and client choices on how to plan on treating for relief or treating to create a body that is self-correcting.

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.

Question? Comment? Typo?
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*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistency in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.

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