Suboccipital Muscles Pain: Causes, Symptoms, and Treatments

thumb and index fingers pressing on a man's nape

Today let’s learn more about the suboccipital muscles pains, causes, symptoms and treatments?

Do you have clients and patients that come in to see you that have recurring tightness in those upper cervical muscles, especially the ones attached to the skull? We call them our suboccipital muscles and they’re the ones that our patients will say; these are the muscles that are really, really tight.

What are the suboccipital muscles?

The suboccipital muscles are a set of four paired muscles in the back of the neck.

The suboccipital muscles attach to the atlas (C1), axis (C2) and occipital bone, connecting the atlas to the axis and the two vertebrae to the base of the skull.

They are deep to the trapezius, splenius and semispinalis muscles and superficial to the atlanto-occipital and atlanto-axial joints.

The suboccipital muscles commonly become tense and tender due to factors such as eye strain, wearing new eyeglasses, poor ergonomics at your home office computer setup, grinding the teeth, slouching posture, and trauma (such as a whiplash injury).

Suboccipital muscle pains symptoms

However, when the suboccipital muscles become tight, any of these symptoms may occur. These could include:

  1. Stiff neck
  2. Neck pain
  3. Headaches with a band of pain on the side of the head that extends from the back of the head to the eye. This type of pain feels deeper in the head.

Messages sent to the brain may be affected; reason why some people who have headaches may also experience sensory symptoms, including dizziness and visual instabilities.

Suboccipital pains treatments

Most treat them with one or a combination of things like neuromuscular techniques, muscle energy techniques, glides, joint capsule mobilizing, but here’s something that’s a little bit more global, and something that I’ve found in the clinic that has got a little bit more lasting results with my clients’ and patients’.

In this video, I started with assessing my patients upper cervical range of motion.

  1. Pushing the chin forward to see the quality and quantity of range she had (this is the extension of the upper cervical spine)
  2. As she pulls the head back we are testing her flexion
  3. Neck we looked at the quality and range of seated forward flexion of the spine, we need to look at the bigger picture when we are treating focused on the large myofascial lines (this assesses your thoracic spine)
  4. Observing any stiffness within her lumbar region
  5. Next, we assess passive ranges of upper cervical flexion and extension. We rule out any joint or inert tissue with this. If the head moves further through range, I know it is mostly muscular/soft tissue, if it is still heavily restricted I am erring towards the joints of the cervical spine. Active assisted would be getting them to try to get a double chin into the head back maneuver.
  6. Then, bending her knees and putting her feet flat, we get her to do some bridging actions. Get those big power driver buttocks muscles to bring her hips and pelvis off the ground. Always ask to move up into the bridge slowly so that the gluteal muscles are the primary target, quick moves can push the pelvis into an anterior tilt and cause the hamstrings to contract. We want the glutes to be the driver in this technique.
  7. Applying the traction to the suboccipital ridge when she’s elevating and relaxing off your pressure to the skull as she lowers herself. We increase the drag along the whole paravertebral erector spinae group with every move. Getting up into that position requires squeezing those glutes.
  8. Rolling down bone by bone, starting with a thoracic and then going down to lumbar vertebra is great because it forces the buttocks to stay in control of the move.
  9. As you do this technique take the pressure off the skull traction but try to find more of a chin flexed position between each hold. We are focused on lengthening the full paravertebral muscles.
  10. Each hold is for the count of 5.

The video shows us retesting Kristen to see what her neck and lumbar ranges were like. The movements on upper cervical flexion and extension looked quite a bit better glide. The seated flexion was probably the greatest of postural changes but the subjective pain had reduced dramatically along the right lumbar erector spinae and the suboccipital ridge on the same side.

Use this for any clients that present with suboccipital pain, chronic tightness up through those erector spinae, and those who have got low back problems that you might be able to do this to assist with low back by acknowledging that we can work on the skull as well.

NB* The erector spinae is not just one muscle, but a group of muscles and tendons which run more or less the length of the spine on the left and the right, from the sacrum, or sacral region, and hips to the base of the skull. They are also known as the sacrospinalis group of muscles.

Watch the full video instruction below:

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