It's a question that came up a couple of times this week, always an omen that it's time to blog about it.

The scalenes are a group of 3 muscles, small, but mighty. They are located in the front of the neck, attaching to the anterior lateral aspect of the vertebra and traveling downwards, with one group attaching all the way to the 1st rib just behind and below the clavicle. They are involved in fine motion of the cervical spine such as rotation and lateral bending.

The scalenes are important in many regards:

– as 1 of the primary middle layer of the anterior neck muscles, they are easily injured with rapid extension injuries to the neck which can happen during motor vehicle accidents, falling backwards, and sports. Without involving any additional neurovascular compression, which I'm going to touch on below, the scalenes stem cells can be the source of significant chronic posttraumatic pain, anterior neck posture, and vague radiating pain in the throat and anterior chest

– probably 1 of the most significant contribution of the scalene muscle group is the ability to cause compression over the neurovascular bundle, which is the combination of nerves and arteries and veins that travel between the anterior and middle scalene, just above and then behind the 1st rib, into the arm. This will often result in a sensation of vague pain, tingling, prickly achy sensation in the upper extremity, which does not seem to follow a single nerve root pattern from the cervical spine because the brachial plexus bundle of nerve is comprised of several cervical nerve roots.

https://www.bwclinic.com/blog/2024/11/21/what-are-the-scalene-muscles-and-why-do-they-matter-