We often encounter patients that suffer from chronic neck pain. Even with the help of chiropractic adjustments, their pain never seems to go away completely. In fact, when we ask these patients to point out the specific area of pain the majority of them indicated the upper back area.
Neck pain is a very common complaint that has a prevalence of 30-50% among the general adult population. Many studies have highlighted the importance of the group of muscles around the shoulder blade (scapular) region. The upper trapezius, middle trapezius, lower trapezius, serratus anterior, pectoralis minor, levator scapulae and rhomboid muscles are included in this group. Visible changes in the scapular motion or position (aka scapular dyskinesis) have become an integral part of the evaluation of patients with neck pain. The underlying thought is that pain producing structures in the neck share muscle attachment sites between the shoulder blade and the neck.
Patients with scapula dyskinesis usually present with alteration in their normal body biomechanics and posture. Changes in biomechanics can be seen in films as loss of the normal cervical spine curvature or the so-called ”military neck”. Often these patients present with forward head posture, a pronounced curvature in the mid-back, rounded shoulders and tight upper back muscles.
A proper assessment of the muscles in the shoulder blade and mid-back region is critical to identify the cause of scapula dyskinesis. Scapular motion such as flexion, abduction, and protraction should be assessed to see the relationship of the scapula and its surrounding muscles. Another area that needs to be taken into consideration is the movement of the glenohumeral joint – the humeral elevation. Both the scapula and shoulder joint plays a big role in how our body reacts to changes in posture.
Scapular dyskinesis is more common than we think. Bad habits such as sitting at the desk for long periods and texting can create significant changes in our posture – resulting in this problem. Treatments for this can comprise of chiropractic adjustments, soft tissue mobilization (trigger point therapy, Graston), and physical rehabilitation.
Kaplan Chiropractic treats patients that suffer from chronic neck pain and other related conditions. We would be happy to help decipher the underlying cause of your neck pain. If you’re interested in getting rid of your neck pain for good – don’t hesitate to call!
Watch “Neck Pain”
- Birgit Castelein, PhD, PT , Ann Cools, PhD, PT, Thierry Parlevliet, MD, Barbara Cagnie, PhD, PT. Are chronic neck pain, scapular dyskinesis and altered scapulothoracic muscle activity interrelated?: A case-control study with surface and fine-wire EMG. Journal of Electromyography and Kinesiology, Volume 31, December 2016, Pages 136–143.