Scalene muscles are a prime contributor to thoracic outlet syndrome as well as neck, shoulder, chest, upper back and arm pain.

Scalene Muscles Muscle Pain: Signs and Symptoms

  • Muscle twitching, jerking and restlessness similar to the sensations of restless leg syndrome felt in the neck and shoulder is a classic sign of scalene dysfunction
  • Pain in the shoulder that travels down the middle of the upper back and toward the shoulder blade
  • Pain in the upper chest muscles
  • Pain down the arm and into the hand and thumb and forefinger occasionally with swelling
  • Occasionally pain in the back of the neck

The Scalene Muscles Are A Major Contributor To Thoracic Outlet Syndrome 

Thoracic Outlet Syndrome (TOS) happens when the nerves and/or blood vessels running from the neck down into the arm are compressed in an area between the base of the neck and armpit. The most notable symptoms of TOS are pain in the shoulder extending into the arm and many times going down into the hand. Numbness, tingling and occasionally swelling in the affected arm and hand are common as well as loss of strength and grip on the affected side.

Where are the Scalene muscles?

The Scalene muscles are a group of muscles consisting of the scalenus anterior, scalenus medius, and scalenus posterior. These muscles are located toward the side of the neck and attach the neck vertebrae to the 1st and 2nd ribs.

What movements do the Scalene muscles control?

  • Raises 1st and 2nd ribs during inhalation
  • Side bends the neck, ear to shoulder motion
  • Turns the head side to side

Activities that cause scalene pain and symptoms:

  • Whiplash injuries
  • Excessive coughing
  • Gasping for air (people who suffer from asthma, emphysema, or have bronchitis or pneumonia are especially susceptible to problematic scalene muscles
  • Pulling or lifting with arms level with the waist
  • Upper Limb amputation
  • Working for long periods with head turned to one side (word-processor headache)
  • Sleeping on your stomach with your head turned  to one side
  • Carrying a heavy backpack or purse
  • Wearing a tight collar or tie.

TWD Recommends: Learn To Breathe And Improve Your Health

Do you know that very few of us breath correctly? Most of us breathe shallowly, using our neck, upper chest and back muscles, instead of deeper belly breathing which better distributes the work of the breathing muscles. Shallow breathing is not only detrimental for the muscles mentioned, but also negatively affects overall health. Max Storm's Learn to Breathe DVD teaches 5 breathing exercises that will make you aware of your breathing patterns. You will be surprised at how quickly after following his instruction you will become aware of your shallow breathing and begin to build the deep breathing habit. This is an excellent resource for those who have scalene muscle dysfunction as well as anyone with asthma, COPD, and other breathing problems.

Interesting facts about the scalenes:

  • In about 30% of the population, another scalene muscle, the scalenus minimus is found. The scalenus minimus is often only found on one side of those who have this ‘extra’ muscle.
  • The scalene muscles are seldom painful, yet refer pain throughout the chest, upper back, shoulders, arms and neck.
  • Symptoms caused by scalene muscle dysfunction is sometimes misdiagnosed as thoracic outlet syndrome and carpal tunnel syndrome
The Scalene Muscles

You use the scalene muscles to side bend your head, turn your head side to side, and breathe. It also assists with breathing.

Scalene Muscles Pain and Symptoms Can Be Similar To, Contribute To, and Be Affected By These Medical Diagnosis:

  • Thoracic outlet syndrome
  • C4 C5 C6 C7 or C8 radiculopathy
  • Subacromial tendinitis
  • Bicipital tendinitis
  • Subacromial tendinitis
  • Lateral epicondylitis
  • Tennis Elbow
  • Spasmodic torticollis (Wryneck syndrome)
  • Carpal tunnel syndrome
  • Costoclavicular syndrome (Cervical rib syndrome)

Other muscles that should be considered and examined in conjunction with the scalenes:

Satellite trigger points associated with the scalene muscles:

  • Sternocleidomastoid
  • Pectoralis major
  • Pectoralis minor
  • Levator scapulae
  • Trapezius
  • Splenius capitis
  • Triceps Brachii

For detailed anatomy information see:  Scalene Muscles Anatomy

TWD Recommendations Fore Scalene Muscle Pain and Symptoms

Cold Therapy Gel For Recent Neck Injury

Biofreeze Pain Relieving Gel is an excellent pain relieving gel and I recommend it for those who have sudden onset muscle pain or recent injuries.  It is better than warm therapy gels and creams for recent injury muscle pain as it cools the area much like ice and does not promote swelling. A recent study showed that Biofreeze decreased pain 2 times more than ice and the pain relief lasts 9 – 10 longer.  Biofreeze  is recommended for those who have had a recent neck injury or sudden onset pain. Rub Biofreeze into the upper back and shoulders, into the neck going up to the base of the skull to treat scalene muscle pain. Highly recommended for early treatment of whiplash.

Hot Cold Wrap for Neck and Shoulders

Elasto-Gel Cervical Collar can be used for heat or cold therapy to the neck, upper shoulder area. This is a great wrap to use with the scalene muscles as it covers all the muscles. Use cold therapy for new and recent injury or sudden onset pain. Use heat therapy for injuries over a week old and chronic pain from old injury and tight muscles. I recommend this because it conforms to the contours of your body and is well made so it will last for years.

Warm Therapy Gel for Scalene Muscles Neck and Shoulder Pain

Sombra Warm Therapy Pain Relieving Gel is a pain relieving gel that is highly recommended. It provides warmth without burning heat and is great for relieving pain.  It can help reduce tightness and pain in the back of the neck, shoulder and arm that are caused by the scalene muscles. Apply Sombra to the area around the shoulder blades, up the neck to the area behind the ears and along the base of the skull to help scalene pain.

Stretch and Relax The Scalene Muscles

Soothe-a-ciser: Relief for neck and shoulder pain helps relieve pressure and pain in the neck and shoulders.  10 - 15 minutes laying on the pillow allows muscles in the neck, chest, shoulders and upper back to relax and can relieve or even stop some headaches. It can work very well for those with tight painful scalene muscles, sternocleidomastoid muscles, tight pectoral (chest)  muscles, people who have slumping upper posture or rounded shoulders and for some who suffer from wry neck syndrome.

Self Treatment For Neck, Shoulder, Chest, Back and Arm Pain Caused By The Scalene Muscles

If you are suffering from unresolved thoracic outlet syndrome and stinging burning pain and numbness down the arm, consider Claire Davies  The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. Mr. Davies explain the trigger point phenomenon and muscle pain in everyday language.  But what makes this book worth its weight in gold are the individual muscle trigger point treatments that Davies has compiled. His diagrams and step by step instructions help you locate which muscles are contributing to your pain,  how to find the trigger point and treat it. It takes time and practice to master finding trigger points, but once you learn you have a tool and method to help relieve muscle pain throughout the body. If you suffer from TOS and shoulder, arm and hand pain I highly recommend this book. Relieving trigger points in the three scalene muscles have helped many people resolve TOS and their pain issues. This book is a must-have for anyone interested in finding the cause and treating muscle pain.

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