Understanding neck pain: What are the main muscles in the neck?

Welcome to an exciting journey of self-discovery as we explore the main muscles residing in your neck. This intricate network of muscles plays a vital role in supporting your head, facilitating movement, and maintaining proper posture. Understanding these muscles can empower you to take better care of your neck health. While there are 26 muscles in your neck, we are only going to focus on the six main muscles today.

Trapezius Muscle

The trapezius muscle is named after its trapezoidal appearance. It is located at the back of your body and it is a large piece of muscle that starts from the base of your skull to the top of your low back. The trapezius can be divided into three distinct regions:

• Upper trapezius: The upper portion originates from the back of the skull and attaches to the outer third of the collarbone (clavicle) and the shoulder blade (scapula). It plays a key role in elevating the shoulder girdle, shrugging the shoulders, and assisting with neck extension and lateral flexion. The trapezius muscle often becomes tender and sensitive for people with chronic neck and shoulder pain.
• Middle trapezius: The muscle fibres originates from the spine’s spinous processes in the upper back and attaches to the shoulder blade. The middle trapezius helps retract or squeeze the shoulder blades together, aiding in good posture and stabilising the scapula. If you have upper back pain, most of your pain will be felt around the middle trapezius. The middle trapezius sits over another huge muscle of your upper back called rhomboids.
• Lower Trapezius: The lower portion originates from the lower thoracic spine and attaches to the inner surface of the shoulder blade. It contributes to shoulder depression, scapular upward rotation, and assists in retracting and stabilising the shoulder blades.

Among the three portions of the trapezius muscle, only the upper trapezius is primarily considered a neck muscle. This portion of the trapezius muscle plays a significant role in neck-related movements, such as neck extension, lateral flexion, and shrugging the shoulders.

Exercises that target the upper trapezius include shoulder shrugs, upright row and face pulls.

Levator Scapulae Muscle

A small but mighty muscle, the levator scapulae muscle runs from your neck vertebrae down to your shoulder blade. As the name suggests, its function is to lift your scapula (shoulder blade). On top of that, it also plays a significant role in neck extension, lateral flexion, and rotation.

The levator scapulae muscle can become sensitised in individuals experiencing neck pain. Factors such as prolonged sitting, muscle strain, muscle imbalances, repetitive movements, and emotional stress can contribute to its sensitivity.

Exercises that strengthen the upper trapezius can also strengthen the levator scapulae. On top of that, scapular retraction can be a good addition to improve your shoulder blade function.

Precaution when using exercises to help upper trapezius and levator scapulae pain

If you are experiencing a lot of pain in your neck, exercises can be painful and difficult to perform. It can aggravate your pain and may even cause injury to your neck. Adult torticollis is one of the conditions that can result from doing the wrong neck exercises. The condition is characterised by involuntary muscle contractions that cause the neck to twist or turn to one side. This results in an abnormal head position or posture. Torticollis is extremely painful and does impact quality of life.

Here are some precautions that may be helpful:

• Consult with a chiropractor: Before starting any exercise program for neck pain, it is recommended to consult with a chiropractor. We can provide you with a proper evaluation, diagnose the underlying cause of your neck pain, and prescribe exercises that are appropriate for you.
• Start Slowly and Progress Gradually: Begin with gentle exercises and gradually increase intensity and range of motion over time. Avoid pushing through sharp or increased pain during exercises.
• Practice Mindful Movements: Pay attention to the sensations and movements of your neck and shoulders during each exercise. Be fully present in the moment. Focus on engaging the appropriate muscles without unnecessary tension. Mindful movements can help enhance body awareness, promote relaxation, and prevent overexertion.
• Focus on Proper Technique: Pay attention to your technique. Perform the exercises slowly and with control. Avoiding sudden or jerky movements. Proper alignment and execution of the exercises will maximise their effectiveness and minimise the risk of injury.

Suboccipital Muscles

Even smaller than the levator scapulae muscle are the suboccipital muscles, a group of tiny muscles located at the base of your skull. Despite their small size, they play a crucial role in supporting the head, facilitating movements, and maintaining proper alignment of the neck and upper spine. The suboccipital muscles consist of four individual muscles: the rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, and obliquus capitis inferior. Working together, they contribute to head extension, rotation, and lateral flexion.

The suboccipital muscles have a dense nerve supply. They are more sensitive than other muscles and are susceptible to pain, tension, or dysfunction. When sensitised, they can cause neck pain and even headache.

Because of their small size and the micro movements that they facilitate, there are no exercises that can truly target the suboccipital muscles. However, exercises such as neck retraction and neck extension can be helpful.

Splenius Muscles

The splenius muscle of the neck is a pair of long, strap-like muscles located on either side of the upper back and neck. It consists of two sections: the splenius capitis and the splenius cervicis.

Splenius Capitis

The splenius capitis originates from the lower half of the nuchal ligament, which is a strong ligament at the back of the neck, and the spinous processes of the upper back vertebrae. From there, it ascends to insert onto various parts of the skull. The splenius capitis muscle plays a role in extending and laterally flexing the head and neck.

Splenius Cervicis

The splenius cervicis muscle originates from the spinous processes of the upper back vertebrae and inserts onto the transverse processes of the neck vertebrae. It is located under the splenius capitis. The splenius cervicis muscle contributes to extending and rotating the neck.

Both sections of the splenius muscle work together to facilitate movement and stabilisation of the head and neck. When contracted, they assist in extending the head backward. They also help to tilt the head to the side, and rotate the head and neck.

Sternocleidomastoid (SCM) Muscle

The sternocleidomastoid (SCM) muscle is frequently involved in cases of anterior neck pain. As one of the major muscles in the neck, it runs diagonally from the base of the skull to the collarbone and sternum. The SCM muscle is responsible for movements such as rotating and tilting the head, as well as flexing the neck.

When the SCM muscle becomes tense, strained, it can result in tenderness at the front of your neck. Prolonged sitting or working in a forward head position, repetitive movements, and stress are some factors that can contribute to SCM muscle dysfunction and discomfort. Additionally, injuries or trauma to the neck area may also impact the SCM muscle, leading to pain.

Recognising the involvement of the SCM muscle in anterior neck pain is crucial for effective management and treatment. Exercises that strength the SCM or re-train the movement of the SCM can be helpful for people with anterior neck pain.

Exercises that target the SCM includes chin tucks and lateral flexion of the neck. Lateral flexion of the neck can be done as an isometric contraction (i.e., pushed against the hand) or with a resistance band.

Scalene Muscles

The scalene muscles is a group of muscles located on the sides of your neck. They consist of anterior, middle, and posterior pairs. These muscles actively participate in neck flexion, lateral flexion, and rotation. They help you perform activities like tilting your head to the side or turning your head to look around.

Anterior Scalene

The anterior scalene muscle runs from the first rib to the side of the neck. Its main functions include lifting the first rib during inhalation, flexing the neck forward, and assisting in lateral flexion (bending the neck to the side). It also plays a role in rotating the neck when acting unilaterally.

Middle Scalene

The middle scalene muscle is located between the anterior and posterior scalene muscles. It originates from the upper thoracic vertebrae and inserts on the first rib. Its main functions include assisting in lateral flexion and rotation of the neck. They are  considered accessory respiratory muscles as they elevate the second rib during inhalation.

Posterior Scalene

The posterior scalene muscle is the smallest of the three and runs from the upper thoracic vertebrae to the second rib. Its primary function is to elevate the second rib during inhalation, contribute to lateral flexion of the neck, and assist in neck rotation when acting unilaterally.

Overall, the scalene muscles work together to help control the movement and stability of the neck. They also assist in breathing by aiding rib elevation, and contribute to lateral flexion and rotation of the neck. All of these help to maintain proper alignment and posture of the upper body.

Neck pain is complex and many factors are involved

Neck pain is complex and often involve many muscles in your neck and surrounding areas. While we’ve discussed some specific muscles, it is important to recognise that these are just a few of the many muscles that contribute to your neck function.

Other muscles that may play a role in your neck pain include the deep cervical flexors, longus colli, multifidus, rotator cuff muscles, and even muscles in your chest, back, and shoulder regions. Additionally, the muscles of your jaw, such as the temporalis and masseter muscles, can also contribute to referred pain in your neck.

Various factors can contribute to muscle involvement in your neck pain, including sedentary lifestyle, muscle imbalances, poor fitness, past injuries, stress, and even underlying medical conditions. To get long-term results for your neck pain, you have to address all contributing factors. Seeking guidance from a chiropractor can help identify the specific muscles involved and develop a tailored treatment plan to address your unique situation.

Remember, your neck pain is unique to you. A thorough evaluation by a qualified professional can provide valuable insights and guide you toward appropriate management strategies for your specific condition.