To discuss “levator scapulae syndrome” in an effective manner, let us briefly start by discussing “levator scapulae”.
The levator scapulae muscles span both sides of the back of the neck, and their function is to lift, rotate, and stabilize the shoulders. They also assist in neck movement, rotation, and placement.
They originate from the first four cervical vertebrae and attach to the corner of the shoulder blade.
What is levator scapulae syndrome?
Levator scapulae syndrome also referred to as “pain over the upper medial angle of the scapula”, is a common condition in which the muscles become irritated.
As a result, people often experience neck, shoulder, and even head pain.
What are the levator scapulae syndrome symptoms?
Despite the prevalence of levator scapulae syndrome, it is often overlooked. If you suspect that you may be experiencing this condition, you should watch out for the following symptoms:
- Pain – The most obvious sign is sharp pain around the neck, shoulders, shoulder blades, and upper back areas. It often radiates upwards to the head, causing headaches.
- Restricted movement – Many will also have difficulty moving their neck and shoulders. Attempting everyday activities can worsen the pain.
- Stiffness – This symptom goes hand-in-hand with a reduced range of motion. Healthcare providers have previously described that people who suffer from this condition “walk like Frankenstein”. It can be very limiting and prevent people from functioning normally.
- Inflammation – Pain is a result of inflammation and irritation of the levator scapulae muscles. A noticeable swelling can appear around the neck and shoulders as well.
- Weakness – This can cause the pain experienced in levator scapulae syndrome. As you can imagine, these muscles work overtime to keep our head, neck, and shoulders in line. If the muscles’ dynamic range of motion is limited, then it can cause them to be locked in a certain position and thus, creating weakness.
- Numbness – It is possible to experience numbness if the condition is severe enough to irritate or press a nerve from the neck. Numbness can be isolated to the shoulder and neck or could affect the arms.
- Spasms – After significant use and stress, muscles can retaliate by tightening up, also known as spasms. This can be painful and cause loss of mobility in and of itself.
Why does levator scapulae syndrome occur?
There can be a wide variety of reasons you would develop levator scapulae syndrome.
Finding the root cause will not only help you understand why your body feels this way, but it can also give you a better idea of how to treat it effectively.
Common Causes
Levator scapulae syndrome is the result of overuse or excessive stress on the levator scapulae muscles.
Lately, this has become more common among those of us using devices on a daily basis. Our constant need to be looking down at screens for long periods can lead to bad posture that leads to levator scapulae syndrome.
Other reasons you can develop this condition are physical trauma, emotional or mental stress, repetitive arm motions, etc.
How it can lead to severe pain?
No matter how you develop this condition, it all ends up coming back to you in the form of pain.
It can lead to severe pain if you prolong whatever is causing it or stretch the muscles in a way that puts more stress on them.
If you want to find relief as soon as possible, stop any triggering activities and seek treatment.
When to seek proper treatment?
Depending on your situation, you can choose to seek treatment early on or later down the line.
For more severe cases such as injury, it is strongly recommended to consult a physician as they can provide you with the best course of action.
Otherwise, you can try treating it yourself with various strategies unless you don’t see improvement after some time.
What are the levator scapulae treatments?
With a painful condition such as levator scapulae syndrome, it can be initially confusing as to where to start in terms of treatment.
The easiest and quickest solution to your problem right now is to either stop or manage the culprit of your pain. Then, you can consider your treatment options using our breakdown of treatments below.
Medical treatments
Medication
These can effectively counteract neck, shoulder, and back pain but don’t necessarily address the root of the problem
- Over-the-counter: Taking over-the-counter medications such as acetaminophen (e.g. Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) will help with short-term relief.
However, acetaminophen will not help with the inflammation. NSAIDs, like Advil, will address inflammation but can include side effects such as gastric bleeding, stomach pain, and hypertension. - Opioids: For more severe pain, you can get an opioid prescribed by your doctor. They prevent pain signals from normally processing through the brain and can be used in conjunction with acetaminophen or aspirin. The only downside is that you can become reliant on them over time if you are not careful.
Surgical intervention
If push comes to shove and no other treatments address your problem, you can consider surgery.
However, surgery is not a cure-all. Although it can help with long-term relief, there is no guarantee that it will provide you the best relief possible.
Like any medical procedure, there are risks such as numbness, infection, stiffness, nerve damage, etc.
Alternative treatments
Stretch physical therapy/physiotherapy
Levator scapulae syndrome is often developed due to weakness of the muscles themselves.
Physical therapy/physiotherapy is an excellent way to improve muscle strength and flexibility and even reverse your problems.
Research has shown that physical therapy exercises, especially those for upper back posture, could reduce kyphosis. Treatment with your physical therapist can include the following:
Soft tissue treatment – This encompasses all assessments and treatment procedures that promote healing in your soft tissues. Soft tissues include muscle, tendons, ligaments, nerves, blood vessels, fascia, and skin.
Some examples of treatment are massage, trigger pointing, myofascial release, and electrotherapy.
- Massage – This technique involves the manual application of pressure to different areas of the body. It can reduce muscle tension and stress.
Trigger points – These are the parts of muscles that have been exposed to trauma and stress and have developed into muscular knots. Often used in combination with massage, trigger pointing relieves pain by targeting specific areas through isolated pressure.
- Active release techniques – This is another form of soft tissue method that combines manipulation and movement. It specifically aims at breaking down scar tissue that contributes to pain, weakness, and numbness.
Ergonomic assessment – Your physical therapist may also want to learn more about your workplace environment and provide suggestions on how you can optimize it to better support your condition.
Postural realignment – Because posture is a big driver in levator scapulae syndrome nowadays, learning to have the correct posture is crucial for your health. For this treatment, your posture will be evaluated, and you will be recommended techniques and exercises to help improve it.
Kinesio taping – This utilizes elastic tape that is placed in specific directions and areas of the body to help with mobility. The idea behind this unconventional treatment is that by placing the unstretched tape on injured areas, the skin will form convolutions that promote healing and regeneration.
Chiropractic
Chiropractors have a specific focus on musculoskeletal disorders, particularly the spine.
They can address levator scapulae syndrome by performing myofascial release techniques so that the neck and upper back are aligned with the spine and reduce tension on the muscles.
Additionally, they can improve the curvature of the neck and head posture to further reduce irritation of the muscles.
Dry needling
During this treatment, a licensed practitioner inserts needles into the skin where the affected muscles are. It is supposed to improve muscle tension and spasms. A study from 2013 showed that dry needling of the levator scapulae improved neck rotation in participants.
Scapular orientation
There are exercises that focus specifically on scapular orientation, which work to further optimize shoulder girdle movement and ultimately prevent neck and shoulder pain. Evidence suggests that it also helps with muscle balance ratio.
Do-It-Yourself treatments
Stretches
If you don’t want to commit to any of the above treatments just yet, you can try stretching it out on your own. Cease activity if there is any pain.
- Neck flexion – For this stretch, you want to start out with your chin elevated and shoulders dropped. Begin to slowly look down while tucking in your chin. If you feel tension in the back of your neck, you are doing it correctly.
- Head swings – First, have your chin elevated and shoulders dropped. Gradually tilt your head down toward your chest and turn your head to the right. Repeat on the opposite side.
Exercises
In addition, adding exercises into your regimen will strengthen the muscles and prevent further damage.
- Cervical spine extension – Start by kneeling on your hands and knees, and then arch your back while letting your head drop. Reverse this position by flattening the back and looking up towards the ceiling. Stay in this position for a few seconds and then repeat.
- Shrugs – Just as the name suggests, you want to shrug your shoulders, starting with your chin elevated and shoulders dropped. As you shrug, make sure that your shoulders are not going forward. Stay in the position for a few seconds and then repeat the shrug.
