National Associaltion of Myofascial Trigger Point Therapists - Symptom Checker

Scalenus Anterior Scalenus Medius
This is the technical name of the muscle being described.  This name may be used to find additional information in any medical resource.

Scalene Muscles:

Scalenus Anterior
Scalenus Medius
Scalenus Posterior

A group of muscles generally denotes muscles of the same function and may share a common attachment point. Cervical (neck) Muscles.
Muscle function, in this definition, is what the muscle could do if it was to contract by itself with the body in anatomical position.  This is a general definition of muscle function.  For more information on how muscles work together on the body please refer to a physiology or functional anatomy text.

The scalenes laterally flex the cervical spine and assist in elevating the rib cage while breathing.

A description of where a Myofascial Trigger Point may produce pain in the body.  This area is generally located away from the trigger point.

The scalene muscles, as a whole, can refer pain into the chest, into the lateral upper limb, the medial scapular border and interscapular area, as well as pain in the thumb and index finger of the affected side.

A description of the symptoms a person may experience with trigger points in the muscle being described.

A person with TrPs in the scalene muscles may experience pain in any of the areas shown in red, but frequently cause a person to experience shoulder and upper limb syndromes.  Pain in the upper medial border of the scapula.  Numbness in the hand in the ring and pinky fingers may also occur as well as edema and stiffness of the hand that is reportedly worse in the morning.


 A list of possible diseases that fit the information derived from examination of a patient.

  1. Thoracic Outlet Syndrom (TOS).
  2. Carpal Tunnel Syndrome.
  3. C5-C6 radiculopathy.
  4. C4, C5, and C6 articular dysfunctions.
  5. Articular dysfunction that involves elevation of the first rib.

A list of activities or positions that may either CAUSE a trigger point to manifest or PROLONG a pain condition respectively.

  1. Pulling or lifting, as when hauling roes in sailing.
  2. Handling and riding hoarses.
  3. Tug-of-war.
  4. Competitive swimming.
  5. Carrying awkwardly large objects.
  6. Certain musical instruments.
  7. Paradoxical breathing (chest breathing)
  8. Sleeping in a bed where the head of the bed is lower than the foot – may happen with a thick rug under the foot of the bed.
  9. Short upper arms*
  10.  Whiplash accident.
  11.  Severe limping will perpetuate scalene TrPs since the muscles in the neck will contract severely to help movement while walking.

*Short upper arms occur when the elbows of a person are not long enough to reach their iliac crests (the upper aspect of the hip bone) when standing.  Short upper arms are characteristic of Native American body structure, but not limited to that race.  This condition perpetuates TrPs in the shoulder girdle by placing undue stress on shoulder elevator muscles.

A corrective action is usually a modification of daily routine which will reduce stress on the affected muscle(s) in a person with myofascial trigger points.

  1. Paradoxical (chest) breathers should learn diaphragmatic breathing.
  2. Avoid carrying heavy and awkward packages.
  3. Avoid strenuous tugging.
  4. Be aware of stress and stressful situations that will cause a person to unconsciously raise their shoulders.  This is the “stressed out” position.
  5. Use the unaffected arm to talk on the telephone or use a headset for hands free conversing.
  6. The head of the bed may be elevated 3-3.5 inches by placing telephone books under the legs of the head of the bed.  Blocks should be avoided as they allow the bed to slip off.
  7. Keeping the neck and body warm is very effective to reduce muscle irritability.  Use of a scarf helps to avoid cold drafts while outside in cold climates.  A scarf may also be used in drafty bedrooms and is extremely useful during airplane flights.

References : 
Simons DG, Travell JG, Simons LS, Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1, 2nd Ed. Baltimore: Williams and Wilkins, 1999.

Travell JG, Simons DG, Myofascial Pain and Dysfunction, vol 2. Baltimore: Williams & Wilkins, 1992.

This information is not intended to diagnose, treat, or cure any disease.  A proper diagnosis should be sought from a licensed health care provider.