How To Fix Your Scalene Muscle Pain

What is the scalene muscle?  

The scalenes are a group of muscles found in both sides of your neck. They are made up of three muscles: the anterior scalene, the middle scalene and the posterior scalene.  

The muscles attach to the bones from the transverse processes of the vertebrae (bones of the spine) and on the first two ribs. The graph below provides more detailed information.  

Scalene Anterior Anterior tubercle of transverse process of C3-C6 Tubercle of the first rib 
Scalene Middle Posterior tubercle of transverse process of C2-C7 Upper surface of the first rib (behind the subclavian artery) 
Scalene Posterior Posterior tubercle of transverse process of C5-C7 Lateral surface of the second rib  

The function of the scalene is to flex and rotate the neck. These movements allow you to bend your head forward, bend your head side to side and turn your chin so you can look side to side. They may also function by assisting with breathing by lifting the first two ribs. 

The Cause of Scalene Muscle Pain

There are many conditions that may cause scalene muscle pain. The following are the most common causes: 

  • Whiplash 
  • Excessive coughing 
  • Breathing problems 
  • Sleeping on your stomach 
  • Carrying heavy backpacks or bags 
  • Wearing something tight around the neck 
  • Poor posture  
  • Stress 
  • Torticollis – a condition where your neck may stay contracted (tightened) in certain positions. 

Scalene Muscles and Referred pain: 

The number 1 thing you need to know about the scalene muscle is that pain within the scalene is often felt elsewhere within the body. This is known as referred pain.  

Scalenes - Massage Rx news
Image source: Massage Rx News

As seen in the picture above, the scalene muscles can refer pain to the chest, upper back, shoulder, arms, wrist, hand and thumb. Due to the unusual pain referral patterns occurring from these trigger points, people may mistake their scalene muscle pain as chest pain, arm pain or hand pain. A soft tissue occupational therapist will be able to properly diagnose if you have scalene muscle pain and treat accordingly.  

These scalene pain referrals pathways are caused by trigger points within the scalene muscle. Trigger points are hypersensitive or painful spots found within your muscles – they are essentially the knots within your muscles that are associated with tightness and pain. Pressing on these points may be painful and refer pain to elsewhere in your body. For the scalene muscles, pressing on these trigger points may refer pain to places on the body listed earlier.  

Soft Tissue Occupational Therapy Treatment 

Soft tissue occupational therapy treatment focuses on treating musculoskeletal disorders of the body through diagnosis, treatment, and rehabilitation. A soft tissue occupational therapist will be able to correctly locate the source of your pain and use hands-on treatments such as trigger point therapy and dry needling to provide pain relief.  


You may find using a heat pack on your neck may help to relieve the symptoms of scalene muscle pain. Heat will increase blood flow to your scalene muscle and help with waste exchange. Heat will also allow your muscle to relax to help with painful spasming. Should you not be able to achieve pain relief with the use of heat, consult a soft tissue occupational therapist as it is likely that you will require some hands on treatment.


You may find stretching helpful for your scalene muscle pain. To stretch your scalene you will need to bring your ear to your shoulder and gently hold for 30 seconds. It is important that you stretch mindfully and gently as pushing too far into a stretch or “bouncing” a stretch will cause a spasm reflex and potentially increase your pain.

Scalene stretch
image source: physiowarzish

If you would like treatment for your scalene muscle pain, book in to see a soft tissue occupational therapist at Urban Health HQ. You can make an appointment today or contact us by calling 0411 563 391 or email  

Published by Urban Health HQ

We are a health and fitness centre offering Occupational Therapy, Exercise Physiology, Personal Training and Group Fitness classes.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: