Symptoms
Neck pain
Stiffness, limited rotation and aching at the base of the neck — most often non-specific and muscular in origin.
Overview
Most acute and chronic neck pain is non-specific. Active trigger points in the upper trapezius, levator scapulae, SCM and scalenes are common contributors. Identifying which muscle reproduces the patient's familiar pain guides treatment.
Clinical notes
Assess rotation, side bend and the upper cervical segments. Reproduction of pain on muscle palpation is more useful than imaging in non-specific presentations.
Red flags — when to refer
Trauma, progressive neurological signs, fever, unexplained weight loss, severe night pain, history of cancer — refer.
Muscles often involved
References
- • Travell & Simons, Vol. 1