Understanding Trigger Points – Pain In The Base Of The Head With Earache

Clinical experience reveals that pain at the base of the head with ear ache is usually caused by two other trigger points. By lifting our chin out to, for instance, study a computer screen, the atlas is wedged forward that creates trigger points in semispinalis capitis and either the medial pterygoid or masseter. This is a problem particularly when we jut our chin with a slight twist to activate sternocleidomastoid as well. Check out these links to see if this is really the pattern you’re looking for.

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This is one of the trigger points that refers a pattern of parasympathetic phenomena. That means that instead of pain, we get an irritated organ. In this case, an earache.

Client’s Description

People with this headache come in and complain of the ache in the back of their head. They often tell me that they’ve had an earache. This seldom occurs by itself and usually involves working with a number of joints and muscles at the top of the neck.

There are a few headaches that create pain at the base of the head but they all seem to be connected to an atlas that is stuck. As part of connecting the problem to the muscle with NMT assessment, I ask to be specific about where the real target is located and to understand the consistency of trigger point patterns.

Because the atlas is heavily involved in tilting the head in a “yes” nod, you’d think this was mostly caused by the strain or repetition while tilting your head. Usually, that tilting happens with a twist, which bumps that atlas more to one side. The gal in this picture that is talking on her cell while applying make-up and driving might just create this problem.

More commonly, this comes from muscles that tighten to protect swallowing with an irritated throat. That’s right, trigger points protect more than just joints. A headache and ear problem from a “stuck” trigger point may continue for a while after a sore throat is gone. Relieving the trigger point and getting the atlas back in place while the throat is still sore consistently speeds the recovery when the throat and ear are still irritated. Your NMT may not see you, however, while you are contagious.

Self Care

The next time you have an earache and headache, try rubbing an ice cube on the front of your neck for a few seconds followed by some light stretching.  It may just be some trigger point referral. Watch this video, if you’d like a few tips on how to do that.

Your NMT can help you with this headache and earache. Some of them can also release the palatini muscles in the throat that help the ears tubes to drain. I help a lot of children with earaches by working that area in the back of the neck to clear their Eustachian tubes.

Similar Patterns

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

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Therapy Notes

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Actual treatment of the rectus capitis anterior can be done more easily by mobilizing the atlas from the transverse process and following up with ice and stretch. If the trigger point is more chronic and requires direct work on the muscle, more advanced intra-oral or anterior throat techniques are needed.


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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