Our last post discussed Splenius Capitis as a neck muscle capable of generating head pain. This post is dedicated to another member of the splenius muscle group, Splenius Cervicis. Just like its relative, this muscle works to anchor and move the head on the neck and can be an overlooked contributor to neck pain and headache, particularly when a whiplash injury from a motor vehicle accident is at play.
No different from Splenius Capitis, Splenius Cervicis can refer pain to areas of the head not immediately related to this muscle's location. Trigger points that create this referral pattern can develop in both the upper and lower portion of this muscle. For this post, a trigger point can be considered a knot or tight ball you might be able to feel in what usually should feel like soft muscle. When pressed, this tight knot will produce a referral pattern that spreads in a pattern commonly associated with that muscle. We discussed the referral pattern concept in our last post. The referral pattern for the upper trigger point of Splenius Cervicis is depicted in the diagram above. Typical referral sensations patients will report from trigger point referral due to an irritated neck muscle can include pain, ache, tingling, pressure, or numb sensations.
The upper Splenius Cervicis trigger point shares the common distribution of a tension-type headache. Such referral can make pinpointing the right target for treatment challenging, particularly if therapy is not using a muscle-based hands-on approach. Unfortunately, not all professionals recognize the difference between a primary form of headache, such as a tension-type headache vs a secondary one, such as a Splenius Cervicis referral. We'll talk more about this when we discuss migraine, cluster-type, and tension-type headaches in future posts. These conditions are distinctly different as they impact a patient's general susceptibility to head and face pain. These diagnoses are key to make (if applicable) as they have a bearing on treatment recommendations and management approaches. When present, these conditions will require very different treatment considerations from that for a simple muscular referral.
Testing for an irritated Splenius Capitis muscle is relatively simple. A trained professional familiar with the anatomy, such as your chiropractor or acupuncturist, will apply pressure to the suspect muscle while possibly positioning your head to add a light stretch. If this procedure increases or reproduces symptoms in the referral distribution, this muscle is likely part of the problem. After identifying this muscle as part of a patient's headache, context activities that provoke it need to be identified. We discussed a few of these in previous posts here and here. As activities are modified to offload this structure and appropriate treatment delivered, relief should quickly follow.
If the depiction of Splenius Cervicis referral looks like how you feel, we'd be happy to assess you. If we determine Splenius Cervicis is a culprit in your headache context, we will provide you with appropriate ergonomic advice, exercises, and focused treatment.
It is not uncommon for patients to have multiple factors contributing to a headache presentation, particularly if they suffer from migraine or tension-type headaches. These underlying headache predispositions can then be increasingly triggered when a patient has suffered neck trauma, such as whiplash from a car accident. We recognize the complexity of headaches at our office. As such, we regularly work collaboratively with other health providers to add our strengths to theirs.
If you feel your headaches are getting the best of you, our chiropractors and collaborative approach will aim to tip the balance in your favour. Book with one of our chiropractors now to see if we can help better manage your headache symptoms.
Anyone suffering from headaches should discuss their symptoms with a trained medical professional to ensure serious medical pathological causes of headaches are excluded before assuming lifestyle-related muscular factors we will discuss might apply to them. None of the information provided is to substitute for appropriate medical evaluation of headaches. The information provided should only be considered after serious medical pathological causes for headaches have been discussed with and excluded by a trained medical provider.