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