How Really Small Muscles Can Be A Real Pain In The Neck – A NYC Chiropractor/Applied Kinesiologist/NKT Practitioner Explains

When a patient complains of neck pain or headaches, I first muscle test both the cervical flexor and extension muscles and muscles which when they test bilaterally weak such as the psoas or gluteus maximus suggest a fixation of the cervical vertebrae.

I ask questions: are the muscles weak and therefore affecting the alignment, movement of the cervical vertebrae?

Are one set of muscles weak or inhibited because of compensating (facilitating) muscle.

Or is the opposite true? Is it the hypertonic or facilitated muscle the problem?

Sometimes it’s not the bigger cervical flexor/extensor muscles that are causing pain either directly or by pulling vertebrae out of alignment and putting pressure on the nerves supplying the cervical area.

Sometimes it’s the half inch to inch muscles just below the occipital (base of your skull) that attach it to either the atlas (C1) or the axis (C2) or attach atlas to axis.

These muscles are called the Rectus Capitis Posterior Major, Rectus Capitis Minor, Obliquus Capitis Superior and Obliquus Capitis Inferior.


The Rectus Capitis Posterior Major extends, laterally flexs and rotates the head.  The Rectus Capitis Minor extends and laterally flexes the head. The Obliquus Capitis Superior extends and laterally rotates the head. The Obliquus Capitis Inferior  rotates C1 and cranium.

Problems with these muscles can pull vertebrae out of alignment and put pressure on the cervical spinal roots and cause neck stiffness, pain and headaches. See dermatome map below for areas of innervation.

head dermatome

Note there is no C1 dermatome. The C1 root innervates the meninges of the posterior fossa of the skull and has no cutaneous branch; the posterior fossa also contains the meningeal branches of vagus and hypoglossal nerve. Neck stiffness may be a test of the C1 root that innervates the meninges.

For more information, please see the following blogs:

For discussion about meninges:

© 2016-Dr. Vittoria Repetto

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Medical Articles of Interest For July 2016

 The following are from a site summarizing medical research:

Association of Vitamin D Level With Clinical Status in Inflammatory Bowel Disease

Mediterranean Diet Cuts Risk for CV Events, Cancer, Diabetes

Exercise as Effective as Surgery for Meniscal Tears

Avoiding Meds That Worsen, Cause HF: AHA Presents Action Plan

Getting providers and patients with heart failure (HF) to consider a medication’s sodium load is just one of the steps highlighted in the American Heart Association’s (AHA) first-ever scientific statement on medications that may worsen or cause HF. The 35-page document features a comprehensive list of medications that can promote HF through direct myocardial toxicity, increases in blood pressure, high sodium loads, or drug–drug interactions.

Cardiac MRI Shows Post-MI Remodeling Gains From High-Dose Omega-3 Fatty Acids

The trial randomized 358 patients who had had a recent heart attack to receive placebo or 4 mg/day of Lovaza plus standard care for 6 months. Patients who received the study drug had a lower adverse left ventricular end systolic volume index (LVESVI; an indication of the heart’s pumping ability), less myocardial scarring (fibrosis) in the undamaged areas of the heart, and better levels of some serum biomarkers.

The following are from

Bridges Between Whole-Body Dysfunctions and the Feet: A Close Examination

Lateral Femoral Cutaneous Nerve Entrapments

Medical Articles of Interest for June 2016

The following are from a site summarizing medical research:

Click here: Hypovitaminosis D in Elderly Women and Mortality

Click here: Nutritional Strategies for Skeletal and Cardiovascular Health – Mg, Vitamin K, right amt of  protein, Potassium/Sodium, and right type of Calcium supplement and Ca from cheese, fermented dairy , leafy green veggies, almonds rather than drinking cow’s milk.
 The sugar in milk, lactose, is broken down in the gastrointestinal tract to d-galactose and d-glucose. d-Galactose has been found to increase inflammation and oxidation in adult humans, and in adult animals this sugar triggers accelerated ageing, neurodegeneration, and a shortened life span.Thus, cow’s milk, though rich in many nutrients, including calcium, has issues that render it less than ideal as a dietary staple for many adults. On the contrary, fermented dairy foods, such as yogurt and cheese, appear to be safer than milk, possibly because the most or all of d-galactose has been metabolized by bacteria.
Are you aware of these 10 important drug-drug interactions?
And from Integrative Practitioner:
Inflammation and Brain Health

Research has shown links between our modern high-carbohydrate, low-fat diet, and increasing rates of certain diseases, particularly those relating to neurological dysfunction and overall brain health. As neurodegenerative disorders rise, so too has sugar consumption in the Western world. Yet, new research has shown that healthy, fat-rich diets have a myriad of benefits to the brain on the macro-scale in brain function, and benefits on the micro-scale in terms of inflammation. Recent studies have documented blood sugar’s effect on a wide collection of troubles from the size of the hippocampus, to diabetes, stroke and dementia risk.