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Neck pain can be debilitating eroding one’s quality of life.  What is the Levator Scapulae?  What causes Levator Scapulae pain?  How to relieve Levator Scapulae pain?  What is Levator Scapulae massage? Are there new treatment options available?  Let’s dig in.

What is the Levator Scapulae?Levator Scapulae - ligament and bone

The Levator Scapulae is an important neck muscle that lifts and rotates the scapulae (wing blade).  It is located in the backside of the neck near the center.  It starts near the base of the skull and extends down to the inside aspect of the wing blade.  Nerve information that powers the levator scapulae muscle comes from the 4th, 5th cranial nerves, and the dorsal scapular nerve. The levator scapulae is one of the muscles in the posterior triangle of the neck.  It lies beneath the trapezius and the sternocleidomastoid muscles.

Causes of Levator Scapulae Muscle Pain

There are multiple causes of levator scapulae pain. The four most common are:

Poor PostureLevator Scapulae - curve in the back from modern life

Long hours in front of a computer screen and our compulsive use of cell phones have compromised our posture placing stress on neck muscles including the levator scapulae. Muscle stress due to poor posture can result in pain, muscle tightness and dysfunction (2).

Repetitive Arm Motions

Athletes who have repetitive overhead motions such as swimmers, throwers, and racket sports enthusiasts are prone to pain in the levator scapulae. Construction workers working on ceilings or those looking upward for prolonged periods of time are also susceptible.

Shoulder Injuries

The scapulae oftentimes called the wing blade is an integral part of shoulder activity and function. Multiple factors impact scapulae position and function which in turn can result in pain and tightness in the levator scapulae (3).

Neck Injurieslevator scapulae massage

There are multiple structures in the neck that when injured can cause levator scapulae pain and dysfunction.  The two most common are the cervical disc and cervical facet joint.  The disc is the shock absorber between each of the seven building blocks in the neck called vertebrae bodies.  The facet is a small joint on the backside of the neck that is susceptible to injury with resultant pain.  Each facet has a very specific referral pattern as shown below.  The C4/C5 facet referral pattern illustrated in red involves the same area as the levator scapulae muscle. Injury to the C4/C5 facet produces a pain pattern that oftentimes is mistaken for levator scapulae muscle tightness.

Are There Ways to Relieve Levator Scapulae Pain?

There are many different causes of levator scapulae pain as discussed above.  Identifying the underlying cause is always the best option.

Muscle Tightness and Dysfunction

Levator Scapulae massage is effective in treating painful, tight muscles.  Levator Scapulae massage can involve manual massage as well as the use of a massage ball.  Other options include active and passive stretching, accupressure, and trigger point injections.

Poor Posture & Shoulder Injuries

Physical therapy is the first line of treatment.  Focused PT on thoracic extension is effective in improving scapular pain and function (4).

Neck Injuries

Injuries to the cervical discs and cervical facets can cause significant Levator Scapulae pain.  When conservative treatments including physical therapy fail to provide benefit, patients are often referred for steroid injections.   While steroids are powerful anti-inflammatory agents they have significant side effects and therefore should be avoided.  Side effects include an increased risk of spinal fracture, hormonal changes, and injury to joint cartilage (5).

Is There a Better Option?  Absolutely

At the Centeno-Schultz Clinic, we are experts in the management and treatment of neck pain.  We use PRP and bone marrow concentrate in the treatment of neck injuries.  PRP is rich in growth factors that can increase the amount of blood flow to an injured area and decrease inflammation.  The injections require extensive training and expertise.  These injections can not be performed by your PCP or orthopedic surgeon.  To better understand PRP injections into the neck please watch the video below.

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In Conclusion: What to do when levator scapulae massage doesn’t help anymore

The Levator Scapulae is an important neck muscle that lifts and rotates the scapulae.  There are multiple causes of Levator Scapulae pain which include poor posture, repetitive arm motions, shoulder injuries, and neck injuries.  Identifying the underlying cause of the pain is best.  Levator Scapulae massage can be effective in the treatment of mild, intermittent Levator Scapulae tightness and pain. If Levator Scapulae pain is persistent and does not respond to conservative care it is most likely arising from a shoulder or neck injury.  Cervical disc and facet injuries can produce Levator Scapulae tightness and pain and can be effectively treated with precise PRP and bone marrow concentrate injections.


1.Menachem A, Kaplan O, Dekel S. Levator scapulae syndrome: an anatomic-clinical study. Bull Hosp Jt Dis. 1993;53(1):21-4.

2.Ludewig, P.M., Cook, T.M. The effect of head position on scapular orientation and muscle activity during shoulder elevation. J Occup Rehab 6, 147–158 (1996). https://doi.org/10.1007/BF02110752

3.Paine R, Voight ML. The role of the scapula. Int J Sports Phys Ther. 2013;8(5):617–629.

4.Yoo WG. Effects of thoracic posture correction exercises on scapular position. J Phys Ther Sci. 2018;30(3):411–412. doi:10.1589/jpts.30.411

5.Wernecke C, Braun HJ, Dragoo JL. The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review. Orthop J Sports Med. 2015;3(5):2325967115581163. Published 2015 Apr 27. doi:10.1177/2325967115581163

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