The sternocleidomastoid is a large muscle, close to the neck front. It extends down to collarbone from just below the ear and jaw. Sternocleidomastoid pain can cause tenderness to the neck and headaches.
A person suffering from sternocleidomastoid pain may find trigger points along the neck side or forehead. Nevertheless, pain from this muscle often radiates elsewhere, causing pain in the ear, eye, or sinus.
Keep reading to learn more about the causes of sternocleidomastoid pain, its diagnosis and treatment.
What is the sternocleidomastoid?
The sternocleidomastoid is a superficial muscle, meaning it’s just below the skin and not deep in the arm. It attaches to the mastoid process which is just behind the jaw and under the ear, a portion of the bone. The muscle reaches down the neck length and ends where the collarbone and breastbone link.
The sternocleidomastoid assists with head motion and balance. When a person moves his head from side to side, the muscle becomes noticeable. It also plays a role in rotation, tilt and head and neck extension.
Due to its important role in supporting the head, any issues that affect posture and head position can irritate this muscle. Sudden head movements, blows to the head, and other types of trauma can also cause pain and injuries.
Causes of pain
Many people with sternocleidomastoid pain gradually improve the pain due to a combination of lifestyle issues. This muscle will slowly become irritated and sore when it has to keep the head in an awkward position.
Other causes of pain with the sternocleidomastoid include:
- carrying a heavy object, such as a child or backpack, in an awkward position
- poor posture, for example, when a person spends long days hunched over a computer or straining their neck to reach things in the garden
- an awkward work station layout that makes a person hold their neck in an uncomfortable position
- tension or injury in other muscles of the shoulders, neck, or back
- holding a phone between the ear and shoulder
- sleeping in an awkward position or on an uncomfortable pillow
Less frequently, some other factors may cause sternocleidomastoid pain. They include:
- Trauma: A fall, blow to the side of the neck, or car accident may injure the neck muscles, causing strains, sprains, and other injuries. A person does not have to fall or experience a serious injury to sustain damage to this part of the body, however. A 2014 case report details a ruptured sternocleidomastoid following an epileptic seizure.
- Arthritis: Arthritis in the spine can cause referred pain in the sternocleidomastoid. It may also cause a person to change their posture or move their head in a way that increases the risk of injury.
- Myofascial pain syndrome: Myofascial pain syndrome is a type of muscle pain that causes trigger points in a muscle. A person may feel pain radiating to other areas when they press on these trigger points. Most people with myofascial pain experience symptoms following an injury or due to chronic lifestyle issues, such as bad posture.
Those with an infected sternocleidomastoid usually don’t feel pain at the injury site. The pain seems to radiate to other parts of the body instead. The signs most common include:
- unexplained ear pain, which may present as soreness, aching, or a sense of fullness in the ear
- pain in the face or the front of the head
- pain in or above the eyes
- throat pain when swallowing
- headaches, including migraine-like headaches
- pain in the sinuses or nose
- neck stiffness, including difficulty rotating the head from side to side
- tingling in the face, head, or neck
A doctor will start diagnosing a sternocleidomastoid injury by asking the person about their symptoms and their recent history and experiences in the medical field. It is important to tell the doctor about all the symptoms, even though they may seem unrelated, because injuries to this muscle may cause a wide variety of apparently unrelated symptoms.
The doctor will then perform a physical exam, asking the patient to make voluntary movements. These may display muscle tenderness or stiffness due to bad posture, chronic muscle weakness or heavy objects being lifted.
For the doctor to get a detailed view of the muscles and surrounding structures, mri scans may be needed. The mri may help them identify sternocleidomastoid injuries, whereas an X-ray can rule out broken bones.
Diverse options for sternocleidomastoid pain are available, with the form and cause of the injury determining the best alternative. Possible methods for the diagnosis include:
- Lifestyle changes: When bad posture or carrying heavy objects causes sternocleidomastoid pain, addressing this issue can prevent the pain from getting worse.
- Pain management: Rest, ice, heat, and nonsteroidal anti-inflammatory drugs may help reduce pain. Some people find that alternating heat and ice is helpful.
- Physical therapy: Physical therapy can help a person regain strength in the neck and head. It can also help prevent chronic injuries.
- Surgery: If other treatments fail, a person may need surgery, especially if the sternocleidomastoid ruptures or tears.
- Chiropractic care: Chiropractic care is among the alternative treatments that may help reduce pain for some people.
Smooth stretches and exercises can help restore neck strength and decrease stiffness. Until exercising, it is important to speak with a doctor or physiotherapist. Some exercises will worsen the injury, particularly if a person is not using the correct technique.
With neck pain the following exercises can help:
- Cervical flexion: Sit upright on a chair and slowly tilt the head forward and then back again. Repeat this movement several times, but keep it steady to avoid additional strain.
- Cervical side flexion: Sit upright on a chair and slowly tilt the head to one side and then the other. Repeat this movement in a controlled manner.
- Cervical rotation: Sit upright on a chair and slowly rotate the head to face one side and then the other. Repeat this movement several times, only turning the head as far as is comfortable.
- Chin tucks: Sit upright on a chair and slowly draw the chin inward while keeping the head straight. Keep the repetitions steady to avoid straining the neck further.
A individual may not recognize a sternocleidomastoid injury, as the symptoms usually extend across the head and face.
In many cases they might believe they have an ear infection, an episode of migraine, an eye health issue, or another unrelated issue. Hence, seeing a doctor for any unexplained health symptoms is critical.
Sternocleidomastoid pain usually goes away with appropriate treatment.