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Many times pain in the side of the neck and head is due to injured joints (known as facets) in the upper neck. Sometimes, however, this pain can be due to a little-known neck nerve that supplies these areas. Because the nerve goes to some very specific places, a look at pain distribution makes it relatively easy to determine whether the pain is caused by a problem with this nerve.

The superficial cervical plexus originates from the upper neck spinal nerves. Perhaps the most interesting thing to know for patients with pain in the side of the neck and head is that the nerve exits the body behind the sternocleidomastoid muscle. This is the strap muscle on each side of the neck, and it can become very tight after neck injury. Increased tension in that muscle can irritate these nerves and lead to pain in these areas:

  • back of the head—the plexus gives rise to the lesser occipital nerve
  • side of the neck—the transverse cervical nerve also comes from this spot
  • near the collar bone—the supraclavicular nerves also come from here
  • ear and front of ear near the back of the temple

When this nerve plexus is irritated, a patient would experience pain in the back of the head on that side, pain in the side to front of the neck, and pain that feels like it’s in the collar bone area. If you have pain in these areas, how would you know whether this nerve is causing the problem? A precise injection of a small amount of numbing medicine (a nerve block) under ultrasound guidance can help make the diagnosis by knocking out the pain in these areas for a few hours.

If you have this kind of nerve irritation, what can be done? Since the nerve plexus becomes irritated by an superficial cervical plexus muscle that’s way too tight, finding ways to get rid of that tension is critical. The problem can occur when small stabilizing muscles go off-line, when there’s an injury to the C1-C2 facet joint, or due to injury to the nerves that supply the muscle. Some patients also may need to have scar tissue around the nerve plexis treated with a process called hydrodissection, which isolates growth from your blood platelets and carefully injects them under precise ultrasound guidance to break up the scarring as well as to supply the nerve with healing factors.

This nerve issue is often overlooked by even experienced pain-management physicians and neurologists. It’s usually diagnosed by patients who do their homework on the Internet. If you think you may have this problem, make an appointment to be seen by a doctor who can perform a precisely guided ultrasound nerve block to confirm the diagnosis.


“Pain in Side of the Neck and Head” first appeared as a post on the Regenexx blog.

Like all medical procedures, Regenexx procedures have a success and failure rate.
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