SCALENUS SYNDROME

-Hitesh Rohit
(3rd year BPT)
Content:-

 Introduction
 Causes
 Clinical features
 Test
 Management
 Complications
Introduction:-

 Scalene myofascial pain syndrome is a regional pain

syndrome wherein pain originates over the neck area and
radiates down to the arm.

 It is usually caused by compression of brachial plexus and

subclavian artery against the first rib by hypertonic
anterior scalene muscle.
Causes:-

 Whiplash injuries
 Excessive coughing
 Gasping of air(people who suffer from asthma, emphysema,or have
bronchitis or pneumonia are especially susceptible to problematic
scalene muscles)
 Pulling or lifting with arms level With the waist
 Working for long-periods with head turned to one side
 Sleeping on the stomach with head turned to one side
 Carrying a heavy backpack or purse
 Wearing a tight collar or tie
Clinical features:

 Pain in the shoulder and neck

 Numbness
 Pins and tingling sensation
 Reduced sensation of touch
 Breathing difficulty
 Chest pain
Test for scalene:-

Individuals position :-The individual is lying supine with head

elevated and rotated to the contralateral side to be
assessed;with hand raised above the head.

Examiner’s position:- Standing on the head of the table with the

fingers of his hand on the forehead of the individual.

Description of muscle test:- The individual is requested to flex

his/her head to the chest against the examiner’s mild resistance.
Management:-

 Pain relievers such as NSAIDs.

 Stretching of the scalene muscles.

 Strentghening of the scalene muscles.

Complications:-

 Permanent paralysis due to T1 root compression

 Pneumothorax
 Hemothorax with pneumothorax
 Recurrence of symptoms
 Subclavian artery and vein injuries
 Causalgia
 Chylothorax
Thank you