The Scalenes: The Cause of Pain, Tingling, and Weakness in the Upper Back, Shoulders, Arms and Hands

When I wrote my book, Treat Yourself to Pain Free Living: Discover the Secret of Why You Hurt and How to Stop It, it was a challenge to decide where to place this important muscle group. The muscles are called the scalenes, pronounced “skay–leens”. While they are primarily a group of neck muscles, they rarely cause neck pain – with one major exception that was brought to my attention in a testimonial which I will share with you a bit later in this article.

First let me say that the R.I.C.E. method certainly works immediately after having a traumatic injury, but repetitive stress on your muscles requires treatment of the knots that are putting tension onto the tendons and joints. Getting back to basic anatomy will help to unravel the misconceptions that plague both athletes and non–athletes alike. Once you understand the logic of why you are feeling pain, you will know exactly what needs to be done to immediately release a muscle–related pain anywhere in your body.

The scalenes begin at your 1st and 2nd ribs and go up to the front of the 2nd through 6th vertebrae of your neck. When the scalenes contract, they bring your neck forward, and down toward your chest. Think of the millions of times you do this throughout the year, and yet the only way to stretch this muscle is a movement that is never done. Plus, it′s better not to stretch this muscle until after you treat the trigger points. As a muscle tightens, the body actually shortens the muscle to the new length, putting a strain on both ends of the muscle fibers. This is due to a phenomenon called muscle memory which makes the muscle get tighter and tighter. In the case of the scalenes, muscle memory causes the muscle fibers to pull the cervical vertebrae out of alignment and toward the tight muscle. This pulls the vertebrae deeply onto the spinal cord right at the base of your skull. It is a common cause of severe headaches, even those that are related to whiplash. (More information about whiplash is discussed in Chapter 7 of my latest book, Treat Yourself to Pain Free Living: Discover the Secret of Why You Hurt and How to Stop It.)

(note: each of my books, and the Julstro™ System have the charts mentioned in this next paragraph, and you can also see this chart by going to Anatomy Lessons on the website)

If you look at the trigger point chart you will notice that the “X”s pinpointing the trigger points are all in the front of the neck, but the shading that represents the referred pain areas are in:

  • the back of the neck
  • down into the chest
  • down the middle of the back
  • the front and back of the shoulder
  • upper arm, forearm, and finally, into the hand

Most medical practitioners will not examine your scalenes when you go to their offices with wrist/hand pain or numbness. Often surgery will be recommended when it′s really the scalenes that are causing the problem. Releasing the trigger points in the muscle often eliminates the symptoms, and surgery is avoided.

Let′s look at the logic behind the scalenes causing such a wide area of pain. A bundle of nerves called the brachial plexus passes through the anterior and medial scalenes. The brachial plexus divides into three important nerves: the median, ulnar, and radial nerves. These nerves go to the upper body, down your arms, and into your hands. Trigger points in the scalenes will press into the nerves, trapping them between the fibers of the muscle, causing a wide range of burning pain in your chest, upper back, across your shoulders, down your arms, and into your hands – including the symptoms of carpal tunnel syndrome.

One cause of pain in the back of the head is the tight scalenes as they put pressure on the vertebrae. As spasms tie knots in the scalenes, causing them to pull on the front of the cervical vertebrae, the bones move down and forward. This causes the back ends of the vertebrae to push up. This may be very slight, but over time it will change the curve of your neck. This change can often be seen in an x–ray of the neck. The good news is, as long as there hasn′t been damage to the bones, when you release the spasms you can begin to reverse the process and restore the neck to its original curve.

When the scalenes are contracted, they also put strain on a series of small muscles called the suboccipital muscles. These muscles hold the vertebrae and skull together, and when they are strained they cause pain around the back and sides of the skull, causing a headache feeling at the base of the skull.

A true life story:

In 2001 I received a wonderful testimonial about relieving neck pain from a gentleman who purchased the Julstro™ System

In 1992 he was diagnosed with bone spurs on the cervical (neck) vertebrae pressing into the cervical disks. The physicians weren′t able to do surgery because of the location of the spurs. He was in constant pain and was living on pain medications when he received the Julstro™ System in the mail.

The man was experiencing wrist pain and numbness that was preventing him from doing simple movements such as grasping objects or turning doorknobs, and since the Julstro™ System teaches how to self–treat the flexors and extensors of the forearm, he decided to work on those muscles for relief. The Julstro™ System also teaches how to self–treat the scalenes, so he just included that treatment even though he didn′t think it had anything to do with his situation.

He wrote: “The first time I did the Julstro™ System, I was practicing the scalenes treatment, and while pressing on a spasm the pain shot directly into the area of my neck that had been hurting for years. I could feel that this was possibly the cause of my condition, so I focused with the intention of releasing the spasms . . . and it worked! For the first time in nine years the pain was gone from my neck! It only took one treatment, and it was gone!”

He couldn′t believe it was true, so he waited a week to tell me that for the last seven days he had been completely pain free and was no longer taking the pain medications.

This testimonial made me look even closer at the scalenes and their involvement in neck pain and headaches.

Common areas of pain that are caused by a knot in the scalenes muscle are:

  • Pressure in the back of the head and neck:
    When posterior scalenes are pulling down on the vertebrae, they cause a tight feeling that goes around the entire back of the head and down into the neck. People often describe it as a “pressure headache”, as if they had a tight band or cap on the back of their head.
  • Pain and “burning” down into the chest:
    A common referred pain area is down into the chest, giving a burning pain that feels like heartburn. In severe cases it will even mimic a heart attack. Always see your physician when you have chest pain. If you get medical clearance that your heart is healthy, then you can consider the scalenes as a cause of the pain.
  • The feeling of a razor blade cutting into the middle of the back next to the shoulder blade is another common area of referred pain:
    I have found that I must release the pressure on the brachial plexus in order to relieve pain in the area of the shoulder blade.
  • Pain, numbness, burning, and a feeling of “weakness” in the shoulder, upper arm, and forearm.
    These are all common sensations when the anterior scalenes are pressing on the brachial plexus.

When the scalenes press on the median nerve, which is one of the nerves within the brachial plexus, you get numbness and tingling in your thumb and first two fingers. This is often misdiagnosed as carpal tunnel syndrome, but the pressure isn′t in the carpal tunnel at all – it is in the neck. This same situation is the cause of thoracic outlet syndrome, which is the condition that is related to whiplash.

The scalenes are involved in many different painful conditions; however, this treatment is a bit more complicated. The treatment is near a major artery, and doing it incorrectly might be harmful. The full scalenes treatment is taught on the Julstro™ Self–Treatment DVD System. People can easily learn how to do the self–treatment when they watch us demonstrate it “live” on the video.

For more graphic details of the muscles and nerves involved in hand/wrist pain and numbness and to learn how to self–treat the scalenes spasms quickly by releasing trapped nerve fibers, visit


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