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Physio Energy

Muscles

Scalenes

Three deep neck muscles that refer pain into the chest, upper back, shoulder and down the arm — frequent mimics of cervical radiculopathy.

Referred pain map

Scalenes
Scalenes — anterior/middle/posterior scalene trigger points along the lateral neck refer a wide, dramatic pattern: down the front of the chest, along the medial scapular border and upper back, over the deltoid, down the arm and forearm to the thumb and index finger; a classic mimic of C6/C7 cervical radiculopathy and thoracic outlet syndrome.

Overview

Anterior, middle and posterior scalenes connect cervical transverse processes to the first two ribs. They are accessory respiratory muscles and side-bend the neck. Tight scalenes can contribute to thoracic outlet symptoms.

Trigger point locations

Multiple trigger points along all three scalenes, palpable between the SCM and the upper trapezius.

Referred pain pattern

Anterior chest, upper back between the scapulae, lateral shoulder, posterior arm and forearm, sometimes into the thumb and index finger.

Palpation & testing

Locate the lateral border of the SCM, slide posteriorly. Palpate gently — avoid sustained pressure over neurovascular structures.

Common causes

Chronic upper-chest breathing, anxiety, persistent cough, sustained head rotation, carrying heavy loads.

Self-care & clinical treatment

Diaphragmatic breathing retraining is the highest-yield intervention. Gentle stretching, postural work. Clinically: careful manual release, avoid aggressive needling due to brachial plexus proximity.

Symptoms commonly linked

References

  • • Travell & Simons, Vol. 1
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