Cervicothoracic and dorsal thoracic pain. A review of the main anatomic syndromes

The cervical spine may be the source of many pain syndromes, including : neck pain, headaches of cervical origin, cervical radiculopathies, upper thoracic pain and even shoulder and elbow pain. This paper deals with the referral of cervical pain to the upper part of the thorax. The major point is that in this case, the pain is felt at the thoracic level and not in the neck (or at a lesser extent). The clinical experience leads to the description of two different syndromes (in fact, very closed one from the other): the Splenius Cervicis syndrome, also known as interscapular pain of cervical origin and the Levator Scapula syndrome. The unexpected referral pattern is due to the distribution of the nerves and to the presence of two particular muscles the Splenius Cervicis and the Levator Scapula), which seem to transmit the pain to their lower attachment.