Upper Back Pain

Pain at the Base of the Head and Under Shoulder Blade

Trigger point pain post includes

  • how people describe this problem
  • activities that create or aggravate the trigger point
  • links to relief through self-care, anatomy, and massage notes

Want to skip ahead?
Here’s a link to my post about
getting relief on your own.

How People Describe This Pain Pattern

With this trigger point, people complain about tension and a focus on 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. This muscle doesn’t restrict the mobility of the neck as much as others. For Instance, the levator scapula creates a similar pattern but with more severe restrictions. 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 this self-care post shifts in the mid-neck with 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

Musculoskeletal Anatomy

About these Illustrations…

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

Getting Relief on Your Own

Clinically Proven
Self-Care Strategies

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.

Therapy 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.

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This video is a brief overview of the Integrative Bodywork Model. It explores the difference between integrated and integrated approaches. Additionally., it walks through an example.

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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written materials and instructed classes since the mid-90s. This includes anatomy, trigger points, cranial, and neuromuscular.

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*This site is undergoing significant changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and include more patterns with better self-care. Meanwhile, there may be formatting, content presentation, and readability inconsistencies. Until we get older posts updated, please excuse our mess.

Tony Preston

Tony Preston, LMT has been treating adults and children since the early 90s. He has authored a number of texts on neuromuscular and craniosacral techniques. He has taught Neuromuscular Therapy for ASHA School of Massage and craniosacral the National Institute of Craniosacral Studies. He currently teaches seminars in Integrative Craniosacral techniques at The Body Guild.

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