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Shoulder Tension That Just Won't Go Away

Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood.

The Sternocleidomastoid muscle with Accessory & superficial cervical plexus.

The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The first actions of the muscle are the rotation of the head to the opposite side and flexion of the neck. The accessory nerve innervates the sternocleidomastoid.

The accessory nerve (CN XI) is a motor nerve with cranial and spinal portions and supplies the sternocleidomastoid muscle and the upper two-thirds of the trapezius muscle.

The cervical plexus is formed from the anterior primary rami of C1–C4, deep to the sternocleidomastoid muscle and in front of the scalenus medius and levator scapulae muscles. Sensory branches include the greater and lesser occipital nerves, great auricular nerve, cutaneous cervical nerves, and supraclavicular nerves.

Nerve Entrapment Point in SCM

Poor posture, sleeping incorrectly, long hours on the computer, and texting on your smartphone will cause the SCM muscle to contract, spasm, and build myofascial trigger points (MTrPs). Also, all of these pathological changes in the muscle tissues act as a Nerve Entrapment Point (NEP).

When the NEP has formed in SCM, depending on the nerve branch, it is entrapping to cause hyperexcitability, and it might induce various areas of pain where the nerve is innervating. For example, when the NEP in SCM muscle is entrapping accessory nerve, it can contract trapezius muscle to induce ischemic pain. Also, when the NEP is severely irritating on the superficial cervical plexus, the patient may suffer from hyperalgesia (abnormally heightened pain sensitivity). The person cannot even touch the area nor move the neck.

The Treatment for NEP in SCM

MTrP Acupuncture Treatment – This treatment can resolve the NEP in the muscle tissue by releasing myofascial trigger points.

Electro-Acupuncture (EA) Treatment - EA can upregulate the muscle fibre movement and creating the pumping effect to achieve better blood circulation which helps to nourish muscle tissue with oxygen and energy source.

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