Causes of Sternocleidomastoid Pain & Treatment Options

What is Sternocleidomastoid Pain?

The sternocleidomastoid (SCM) is a large muscle that extends from the collarbone to behind the ears on both sides of the neck. SCM pain is caused by a variety of factors, including poor posture, which often results in headaches and neck tenderness.[1]

What are the symptoms of Sternocleidomastoid Pain?

Sternocleidomastoid pain is not often felt in the muscle itself. Sternocleidomastoid pain often radiates to other sites of the body, including the ear, behind the eyes, the face, or the front of the head. Symptoms of SCM pain include headaches or migraines, dizziness, throat pain, neck stiffness, and tingling in the face, head, and neck.

Causes of Sternocleidomastoid Pain

Sternocleidomastoid pain has many causes, mostly related to lifestyle factors that result in muscle tension. For example, poor posture, sitting in an awkward position while typing on a computer, or looking down at your phone for extended periods can cause SCM pain. Sudden head movements, traumatic neck injuries, or other trauma can also damage the SCM.

Other causes of Sternocleidomastoid Pain include:

• Neck injuries such as whiplash

• Tension in the muscles of the neck or upper back

• Carrying heavy objects, such as a backpack or a child on the hip

• Overhead activities such as painting or hanging curtains etc.

• Prone (tummy) sleeping with the neck turned to the side.

• Arthritis in the neck vertebrae (spine) which leads to holding the head in a different position

• Chronic health conditions such as asthma or chronic obstructive pulmonary disease

How is SCM Pain Diagnosed?

In order to diagnose SCM injury, your doctor or physiotherapist will ask you questions about your medical history and what symptoms you are experiencing. The following symptoms are indicative of SCM injury:

• Pain behind the eyes

• Headaches or migraines

• Pain in or behind the ears

• Neck stiffness or difficulty rotating the neck

• Facial or forehead pain

• Pins and needles or tingling in the face, neck, or head.

The examiner will then perform a detailed physical examination. The physical examination generally consists of the assessment of your posture, neck movements, and any tightness in the SCM.

Sometimes your doctor or physiotherapist may find it necessary to perform further investigation. These may include X-Rays to check for bone fractures in the case of a traumatic injury, or an ultrasound scan to determine if the muscle is injured.

Treatment of Sternocleidomastoid Pain

The treatment of SCM pain depends on the cause of the injury.[2] Treatment usually consists of the following approaches:

• Pain management - Resting from aggravating activities is important for reducing SCM pain. Ice and non-steroidal anti-inflammatories also help reduce the pain and inflammation.

• Posture correction - Poor posture is a common cause of SCM pain. Improving your posture can greatly reduce the strain placed upon the structures of the neck and SCM.

• Physiotherapy - Physiotherapy management for SCM pain is aimed at relieving pain, reducing inflammation, and restoring full SCM function. Physiotherapy includes manual therapy to mobilise the joints in the neck and upper thorax. It also involves reducing the tension in the SCM and surrounding muscles through massage, trigger point therapy, and dry needling.[3]

• Strengthening exercises - Strengthening the neck muscles is also important for preventing further injury and ensuring that the head balances correctly on the neck.

• Stretching - Stretching exercises improve the flexibility of the SCM, reducing tightness and pain.

• Surgery - In severe cases, where the SCM is ruptured or torn, which can occur with a collarbone fracture or other traumatic injury, surgery may be necessary.

Outlook

SCM pain occurs for a number of reasons, mostly related to lifestyle factors such as poor posture. SCM injury usually radiates to other areas of the body, including the ears, jaw, behind the eyes, and head. There are many treatment options available for SCM pain, depending on the nature of the injury. These include posture correction, pain management strategies, physiotherapy, stretching, and strengthening exercises.

Anatomy of the Sternocleidomastoid

The SCM is located on both sides of the neck and runs from behind the jaw just underneath the ear to the clavicle (collarbone) near the sternum (breastbone). The functions of the SCM are:

• To flex the neck forwards towards your chest

• To tilt the head to both sides

• To rotate the head both left and right.

• To help with breathing

• It also plays an important role in the balance of the head.