They presented with constant dull left anterior-lateral neck pain of 3 weeks duration and they pinpoint the pain to be just inferior to the SCM muscle closest to the anterior border. Along w the pain they present w “itching and burning” inside their left ear.They previously saw an ENT and also had an MRI to rule out pathology. All tests were negative.
I had seen similar presentations in the past and so thinking of the anatomy the first thing that I thought of was the cervical plexus. The cervical plexus runs from C1-C4 and is motor to some of the deep cervical muscles as well as the spinal accessory nerve. However, it plays an even bigger sensory role as the supraclavicular, transverse cervical, lesser occipital, and greater AURICULAR nerves branch off of it.
Typically you can find the root of the plexus can be found just posterior to the SCM at the level of C3. To begin the assessment I began “pre-treating” by manually treating the root of the cervical plexus by entering anteriorly behind the SCM by entering posterior to the SCM. All I did was created tension by manually sliding my fingers distinctly but gently under the SCM muscle and then I began “cleaning” the area in and around the cervical plexus working the fascia in a tension-rich fashion. I did this for 20 mins. I gave him a 5 minute break and to his amazement he did not have pain anymore. He touched the area and applied pressure but could not elicit pain. The sensation in his ear was also completely gone.
I’ve seen this before if the nature of the pain is primarily neurogenic inflammation. By “cleaning” the adhesed area we change the chemical environment of the area often causing spontaneous resolution of the problem. In a problem like this one the sensitivity will return in a couple of days but with much less intensity. In a couple of more treatments the problem was resolved.
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