Headache and Neck Muscles #1 – Splenius Cervicis

Headache is generally considered the #2 chronic pain complaint in the US, but many of them originate in the neck.
There are at least a dozen muscles that refer pain into some portion of the head. A qualified trigger point therapist can help with all of them. Consider this analysis from Drs. Travell and Simons – brilliant MDs that have studied the issue extensively:
The Splenius Cervicis muscle has two trigger points that are quite close the TrP 1 of the trapezius and have similar referral patterns. However, upper trapezius TrPs are quite common, well known to most therapists and covered quite nicely not long ago by the Trigger Point Ninja 😉
These upper and lower splenius cervicis TrPs are located somewhat posterior and slightly above and below the trapezius TrP 1, respectively. The muscle originates on the spinous processes of the T3-T6 vertebrae and attaches to the transverse processes of the upper cervical vertebrae. The splenius cervicis is not easily palpable being covered almost entire by the upper/middle trapezius, rhomboids and levator scapula.
The upper TrP of splenius cervicis typically refers pain THROUGH the inside of the head that focuses strongly behind the eye on the same side. This is a distinguishing factor from pain of the trapezius TrP 1 that radiates along the side of the head from the mastoid across the temple to the eye. Pain in the orbit and blurring of vision are disturbing symptoms that are occassionally referred to the eye from the splenius cervicis upper TrP.
Trigger points in the splenii seldom occur alone and the in the case of the splenius cervicis sometimes become evident only after more obvious TrPs in the levator scapula and other muscles have been released.
Splenius cervicis TrPs can be activated and/or perpetuated several factors including postural stresses such as head forward posture, sleeping with the head/neck in a crooked position or work that involves rotation of the head to one side, stress associated with lifting or pulling excessive weight on exercise equipment and environmental factors such as marked skin cooling, especially when muscles are tired. This can include a draft on the neck in cold weather or cooling in a breeze or the shade, even on a warm day.
Corrective actions following trigger point release include being mindful of head forward posture and learning to keep the head and neck erect and the thoracic spine extended, avoidance of excessive twisting motions (especially for extended periods of time working at a desk or with a computer), care to avoid rotating or projecting the head forward during exercise, and keeping the neck warm. Patients can stretch the splenius cervicis after release by SLOWLY and GENTLY moving the head through the full range of flexion, extension and rotation several times, being careful to avoid swing the head through full ROM (head rolling).
Travell and Simons, Vol 1, pages 432, 436-438, 442-443
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