Splenius Capitis: Pain Pattern and Treatment
The splenius capitis is the strap muscle on the side of the back of the neck, running from the upper spine to the bone behind the ear. It turns the head to its own side and holds it up. Its documented pattern is a single one: pain at the top of the head, on the same side. A headache "on top of my head" with a stiff, turned neck is this muscle until proven otherwise.
Attachments and action
Origin: The lower half of the nuchal ligament and the spinous processes of the seventh cervical and upper three or four thoracic vertebrae.
Insertion: The mastoid process and the outer third of the superior nuchal line of the occiput.
Action: Extension of the head and neck; with one side working, rotation and side-bending of the head to the same side.
Where the pain is felt: The top of the head, on one side. Patients put a hand on the crown.
Common causes: A screen or a passenger held off to one side for hours; forward-head posture; a cold draft on the neck; whiplash; craning to watch a game, a bird, or a ceiling.
Patients say: “The headache is right on top of my head.” “It started after a week of turning to look at a second monitor.” A stiff neck that will not turn all the way to one side.
When to get evaluated: A headache that is the worst of your life, that arrives with fever and a stiff neck, or with weakness, confusion, or vision change needs emergency evaluation. A new headache after a head injury needs medical assessment before anything else.
How this muscle is examined and treated
Examination tests rotation to each side, compares the two strap muscles behind the neck, and presses the muscle below the mastoid for the point that sends pain to the crown. Needling here addresses the muscle on the side of the neck below the skull. Assessment and treatment happen in the same visit.
Related conditions
Headaches & MigrainesNeck & Cervical PainChronic Pain Patterns
This page is educational. It describes muscle referral patterns commonly associated with pain; it does not diagnose your condition. Individual patterns vary. For evaluation of your specific pain, see a licensed clinician. Seek immediate medical care for emergencies. Eugene Baek, L.Ac. · New Jersey License 25MZ00080600