Neck and Shoulder Pain: The Levator Scapulae Muscle

The levator scapulae muscle frequently contributes to neck and shoulder pain, yet is often overlooked by acupuncture practitioners. To achieve best results in treating neck and shoulder pain, one should be well‐trained in the diagnosis, assessment and treatment of levator scapulae dysfunction. A jingluo (channel) approach to pain often leads to treatment of the para‐spinal muscles of the Bladder channel and the taut bands of the upper trapezius along the Gall Bladder channel. However, stagnation along a small portion of the Small Intestine meridian – in the region of Jianwaishu SI‐14 and Jianzhongshu SI‐15 – is often missed due to general pain and spasm of the neck and shoulder region. Thus, the site of primary stagnation may remain untreated. Realistically speaking, cervical and scapular pain can be quite complicated to treat. While the levator scapulae muscle may not be the sole cause of a patient’s problems, the simple techniques that follow may benefit many patients whose chief complaint is neck and shoulder pain. Practitioners may need to use other points, treatments and techniques, but should not overlook the levator scapulae. The origin of the levator scapulae is at the transverse processes of C1, C2, C3 and C4. It inserts along a broad portion of the superior angle of the scapula.1 While the Bladder channel follows the para‐spinal muscles lateral to the vertebral column, the pathway of the Small Intestine channel lies along the levator muscle. The points Jianwaishu SI‐14 and Jianzhongshu SI‐15 are in the region of the scapular attachments. Fengchi GB‐20 and Tianzhu BL‐10 are in the region of the attachments at C1 and C2. The extraordinary point M‐HN‐30 Bailao is adjacent to the portion of the muscle in the region of C5. The action of the levator scapulae provides insight into the signs and symptoms frequently reported by patients. When the neck is ‘fixed’, the levator elevates the scapula. With the scapula ‘fixed’, it laterally flexes and rotates the neck.2 Noted as the ‘stiff neck’ muscle by Dr. Janet Travell, the levator is responsible for torticollis when in spasm.3 The patient presents with the neck laterally flexed or inclined to the side of pain and the shoulder elevated. Many practitioners find ashi points and muscle tension in the upper trapezius around Jianjing GB‐21 and Tianliao SJ‐15, concluding that treatment of the Shaoyang channel is indicated. While these points may provide benefit, the primary stagnation in such cases is actually in the levator muscle along the Small Intestine (Taiyang) channel.