Alec Titan
The neck is an essential part of the human body, and its muscles play a crucial role in our daily movements and overall health. While the symmetry of neck muscles may not be something we often think about, it is a topic of growing interest in the field of medical research. This is especially true when it comes to understanding and treating neck pain and other related issues. So, are our neck muscles symmetrical? The answer lies in understanding the complex interplay of muscles, bones, and nerves in this region.
| Characteristics | Values |
|---|---|
| Motion patterns | Right arc, left arc, bottom arc, upper arc, rotation, extension-flexion |
| Muscles | Sternocleidomastoid, upper trapezius, cervical multifidus, longus colli |
| Muscle activity | Higher in simple movements such as extension-flexion and rotation |
| Asymmetry | SI was 86% higher during right arc motion, the lowest asymmetry was for upper arc motion (62.36 ± 46.92) |
| Gender differences | CSAs were significantly larger in males, male vertebrae are wider and longer than female vertebrae, cervical muscle torque is smaller in females |
| Pain | Chronic neck pain is associated with impairment of deep cervical muscle function, neck pain is more common in females |
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What You'll Learn
The impact of neck muscle asymmetry on migraine
The neck is made up of several muscle groups, including the upper trapezius and sternocleidomastoid, which are responsible for neck rotation and flexion/extension movements. While the activity of these muscles should ideally be symmetrical, imbalances and asymmetries are common and can lead to various issues, including neck pain and, in some cases, migraines.
Neck muscle asymmetry can have a significant impact on individuals who experience migraines. Studies have shown that women with episodic or chronic migraines tend to present with reduced cervical muscle force and altered electromyographic activity during maximal cervical muscle contractions. This suggests that there may be a link between migraine frequency, migraine-associated neck pain, and impaired muscle function.
The exact mechanism behind this link is not yet fully understood, but it is theorized that the abnormal secretion or release of neurotransmitters in the brain, which is known to cause migraines, may also contribute to muscle impairment and pain. Additionally, it is possible that neck muscle asymmetry and impaired muscle function could be a result of frequent migraine attacks, creating a cycle of pain and impairment that reinforces itself over time.
Furthermore, trigger points or muscle knots in the neck can also be a factor in migraine attacks. These trigger points are caused by muscle fibers tensing or tightening, and they can lead to referred pain and discomfort, potentially triggering a migraine episode. In some cases, these trigger points may be associated with more serious disorders, particularly if other symptoms such as nausea, vomiting, weakness, or numbness are present.
To effectively manage migraines associated with neck muscle asymmetry, it is crucial to obtain an accurate diagnosis and understand the underlying causes. This may involve ruling out serious conditions, assessing muscle activation patterns, and considering the frequency and severity of both the migraines and any accompanying neck pain. Treatment options can then be tailored to the specific needs of the patient, potentially including combined-modality treatments, tension-reducing techniques, and targeted interventions to address any identified issues with neck muscle asymmetry.
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Neck muscle symmetry in women with neck pain
Neck pain is a common issue, affecting 10-20% of adults, with a higher prevalence in women. It can be caused by various factors, including physical changes, injuries, stress, and age-related degeneration. To diagnose and treat neck pain effectively, a comprehensive approach is necessary, considering both the patient's medical history and a physical examination.
The symmetry of neck muscle activation has been a topic of interest in recent studies. Research has shown that the activity of neck muscles during motion in one direction should ideally be symmetrical when compared to the activity of the contralateral muscles in the opposite direction. This means that symmetrical movements should result in symmetrical muscle activation. However, the literature on neck muscle symmetry is scarce, and more studies are needed to fully understand this area.
In a study by Błaszczyk and Ogurkowska, it was found that the extension-flexion movement was the most symmetrical for both the upper trapezius (UT) and sternocleidomastoid (SCM) muscles. This movement can be useful for assessing the symmetry of neck muscle activation. Additionally, low SI values were observed for the upper arc movement for the SCM muscle, but it should be noted that this movement does not activate the left and right muscles simultaneously. Asymmetrical movements, such as right and left arcs, can be challenging to interpret due to variations in movement speed, resulting in different muscle activity outcomes.
The study by Błaszczyk and Ogurkowska included 18 participants, 9 of whom were women, and focused on analyzing the activity of the UT and SCM muscles at rest and during basic neck motions. The results indicated that the muscle activity at rest was higher on the left side than on the right for both the UT and SCM muscles. This finding suggests that further research is needed to understand the implications of muscle asymmetry and how it relates to neck pain in women.
In conclusion, while the available studies provide valuable insights into neck muscle symmetry and its potential relevance to neck pain, more comprehensive research is required to establish definitive conclusions. Further studies should aim to include larger and more diverse participant groups, particularly focusing on women, to enhance our understanding of neck muscle symmetry and its impact on neck pain in this specific demographic.
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The role of deep neck muscles in neck motion
The neck muscles are a complex musculoskeletal system, comprising about 30 muscles that support and stabilise the head, neck, and upper spine. They enable head movement in different directions and assist with chewing, swallowing, and breathing. The neck muscles can be categorised into three groups: anterior (front), lateral (side), and posterior (back).
The deep neck muscles, as the name suggests, are found in the deeper layers of the neck. They include the transversospinalis group, which is a group of deep spinal muscles that lay underneath the erector spinae group. The transversospinalis group includes the semispinalis cervicis, semispinalis capitis, and a cervical section of the multifidus and the rotatores. The semispinalis cervicis and semispinalis capitis attach to most of the cervical and upper thoracic vertebrae. The cervical multifidus spans two to four vertebrae, while the rotatores are smaller and span one or two vertebrae.
The first of the deep neck muscles on the front of the neck is the longus colli, which can be described as having three sections: superior, inferior, and intermediate or vertical. The sections attach at various points to the cervical and first few thoracic vertebrae. The longus capitis attaches to the base of the occipital bone and the cervical vertebrae. Other deep neck muscles in this flexor group include the rectus capitis lateralis and rectus capitis anterior, which attach to the occipital bone and C1. The suboccipital muscles are also deep neck muscles found along the base of the skull.
The deep neck muscles have important functions in neck motion. For example, the semispinalis cervicis and semispinalis capitis help extend and rotate the head, while the cervical multifidus and rotatores contribute to neck stability. The longus colli and longus capitis are involved in neck flexion, and the rectus capitis lateralis and rectus capitis anterior assist in neck extension. The suboccipital muscles help extend the head in different directions, with unilateral contraction resulting in lateral flexion and rotation of the head to the same side.
In terms of symmetry, studies have shown asymmetrical activity in neck muscles during basic motion patterns. For instance, the upper trapezius and sternocleidomastoid muscles exhibited higher activity on the left side of the neck compared to the right side. However, the extension-flexion movement was found to be the most symmetrical for these muscles. Asymmetrical movements, such as right and left arcs, can be challenging to interpret due to variations in speed and muscle activity. Nevertheless, understanding the symmetry and asymmetry of neck muscle activation can help define reference values for patients experiencing neck pain.
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Gender differences in neck muscle symmetry
While the literature lacks data on the symmetry of neck muscle activation, some studies have analysed the activity of the upper trapezius and sternocleidomastoid muscles during basic motion patterns. These studies found that the resting activity of both muscles located on the left side of the neck was higher than on the right side. However, no statistically significant differences were obtained between the mean baseline activities of these muscles.
In terms of gender differences, one study investigated the influence of gender on neck muscle activity and neck flexion when using smartphones across different postures. The study found that women displayed higher muscle activity in the cervical erector spinae and UTZ and exhibited lesser neck flexion, while using smartphones in both standing and unsupported sitting positions compared to men. These findings provide a potential rationale for gender-related disparities in injury outcomes, as they suggest that women experience higher neck and shoulder discomfort levels, despite their smaller neck flexion during smartphone use.
Another study found that the single physical measure that consistently differed between genders was neck girth, which was larger for men. Additionally, neck characteristics, both physical and visual, were significantly associated with the perception of gender. Larger necks were typically perceived as more masculine, while neck length was not associated with gender or speaker voice characteristics.
Furthermore, the size of the thyroid prominence (i.e. Adam's apple) was not associated with gender differences in voice. However, thyroid protrusion was the single visual-appearance measure that consistently differed between genders. Chondrolaryngoplasty, a procedure to reduce the thyroid prominence, has become common for transgender women, but only 60% of patients report high satisfaction, and some complain that their neck still appears masculine.
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Asymmetry in patients with chronic neck pain
The neck muscles are responsible for neck rotation, flexion, and extension. The activity of these muscles during motion in one direction should be symmetrical when compared to the activity of the contralateral muscles during motion in the opposite direction. However, studies have shown that individuals with chronic idiopathic neck pain (CINP) exhibit altered spatiotemporal gait parameters and slower and asymmetric gait.
A case study published in August 2024 reported a patient who experienced constant neck pain, especially when working in a seated position. Upon examination, it was discovered that her shoulders were at different heights, indicating an asymmetric posture. Further assessment revealed that the asymmetry originated from a restriction in her upper thoracic spine. The treatment plan targeted the upper ribs and upper thoracic spine to address these restrictions. The patient also received education on maintaining proper sitting posture while working to support long-term benefits. After the treatment, the patient reported a significant reduction in discomfort and an overall improvement.
Another study involving 95 participants, 50 with unilateral chronic radicular neck pain (CRNP) and 45 without pain, found that impairment of deep cervical muscle function was associated with CRNP. Weakness and atrophy of the deep cervical muscles may be a risk factor for the presence and recurrence of neck pain. The cervical multifidus (MF) and longus colli (LC) muscles, which are the deepest tonic and postural paraspinal muscles located in the spine, were found to have asymmetric sizes in patients with unilateral CRNP.
A different study investigated the symmetry of neck muscle activation during basic motion patterns. It was found that the extension-flexion movement was the most symmetrical for the upper trapezius and sternocleidomastoid muscles. The lowest asymmetry was noted for the upper arc motion. The results of this study can be used to define reference values for patients with neck pain.
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Frequently asked questions
The activity of muscles during motion in one direction should be symmetrical when compared to the activity of the contralateral muscles moving in the opposite direction. However, there is a lack of data on the symmetry of neck muscles.
Asymmetrical neck movements include right and left arcs. These movements can be difficult to interpret as they can be performed at different speeds, resulting in different muscle activity.
The extension-flexion movement is the most symmetrical movement for the neck. The upper arc movement is also relatively symmetrical, although it does not activate the left and right muscles simultaneously.
Asymmetry in neck muscle activation can be associated with neck pain. Impairment of deep cervical muscle function and atrophy of deep cervical muscles have been linked to chronic radicular neck pain.
