Longus Colli Trigger Points

Introduction

The longus colli is a deep neck flexor muscle responsible for neck stability, forward head posture control, and spinal alignment. When trigger points develop in this muscle, they can cause neck pain, difficulty swallowing, and headaches, often mimicking cervical disc issues, throat infections, or whiplash injuries.

Name and Area

  • Name: Longus Colli

  • Area: Located deep in the front of the cervical spine, running from the upper thoracic vertebrae (T3) to the upper cervical vertebrae (C1–C6).

Indications

Longus colli trigger points may contribute to:

  • Pain in the Front of the Neck and Deep in the Throat (Mistaken for Sore Throat or Swollen Lymph Nodes)

  • Pain That Extends to the Upper Chest or Jaw (Can Mimic TMJ Dysfunction or Esophageal Issues)

  • Difficulty Swallowing or a "Lump in the Throat" Sensation (Common in Anxiety-Related Muscle Tension)

  • Neck Stiffness and Poor Mobility (Difficulty Looking Down or Tilting the Head Forward)

  • Headaches That Originate from the Neck (Can Resemble Tension Headaches or Migraines)

  • Pain That Worsens with Poor Posture, Stress, or Long Periods of Computer Work

Pain from this muscle is often mistaken for throat infections, cervical spine instability, or esophageal disorders.

Muscle Action

  • Flexes the Neck: Moves the chin downward, essential for posture and spinal alignment.

  • Stabilizes the Cervical Spine: Works with other deep neck flexors to support head position and movement.

  • Assists in Neck Rotation and Side Bending: Helps with subtle head movements and balance.

The longus colli is essential for neck posture, core stability, and smooth head control.

Signs and Symptoms

Individuals with longus colli trigger points often report:

  • Pain in the Front of the Neck, Deep in the Throat, or Along the Cervical Spine

  • Sensation of a Lump in the Throat (Common in Stress-Related Neck Tension or GERD-like Symptoms)

  • Pain or Tightness That Radiates to the Jaw or Behind the Eyes (Can Mimic TMJ Dysfunction or Sinus Pressure)

  • Difficulty Swallowing or Feeling Like the Throat Is Constricted (Not Related to an Infection)

  • Neck Stiffness That Worsens with Forward Head Posture or Prolonged Sitting

  • Pain That Worsens with Reading, Computer Work, or Looking Down for Long Periods

Pain worsens with poor posture, forward head positioning, or prolonged static neck positions.

Perpetuating Factors

Common causes of longus colli trigger points include:

  • Forward Head Posture (Common in Desk Workers, Gamers, and Smartphone Users)

  • Whiplash Injuries or Sudden Neck Trauma (Often Seen in Car Accidents or Contact Sports)

  • Chronic Stress or Anxiety (Can Lead to Tightness in the Deep Neck Flexors and Throat Muscles)

  • Frequent Swallowing or Throat Tightening (Can Occur During High-Stress Situations or GERD Episodes)

  • Prolonged Neck Flexion (Common in Reading, Typing, or Looking Down at a Phone)

Trigger Point Referral Pattern

Trigger points in the longus colli refer pain to:

  • The front of the neck and throat (Can Mimic a Sore Throat or Esophageal Dysfunction)

  • The jaw and behind the eyes (Mistaken for TMJ Dysfunction or Sinus Pain)

  • The upper chest and collarbone (Can Resemble Thoracic Outlet Syndrome or Cardiac-Related Pain)

Pain from this muscle is often confused with cervical spine instability, throat infections, or nerve compression.

Differential Diagnosis

Longus colli trigger points may be mistaken for:

  • Cervical Spine Instability (Pain in the Neck and Upper Back, Worsens with Head Movement)

  • TMJ Dysfunction (Jaw Pain and Clicking, Often Exacerbated by Stress or Bruxism)

  • Throat Infections (Sore Throat, Swollen Lymph Nodes, or Difficulty Swallowing, Often Accompanied by Fever)

  • GERD or Esophageal Reflux (Burning or Lump Sensation in the Throat, Worse with Acidic Foods)

  • Tension Headaches (Pain That Starts in the Neck and Radiates to the Temples or Behind the Eyes)

A thorough cervical spine, throat, and TMJ examination is necessary to rule out these conditions.

Associated Trigger Points

Longus colli trigger points often co-exist with:

  • Sternocleidomastoid (SCM) (Neck, Jaw, and Head Pain, Can Contribute to Postural Imbalances)

  • Scalenes (Neck and Shoulder Pain, Affects Breathing and Ribcage Stability)

  • Temporalis (Headaches and Jaw Pain, Often Tied to Forward Head Posture)

Upper Trapezius (Shoulder and Neck Tension, Common in Stress-Related Pain Patterns)

Anatomy and Innervation

Muscle Origin Insertion Innervation
Longus Colli Anterior bodies of C3–T3 vertebrae Anterior bodies of C1–C6 vertebrae Ventral rami of spinal nerves (C2–C6)

The longus colli is innervated by the ventral rami of cervical spinal nerves, which also control neck stability and head movement.

Patient Examination

A comprehensive examination should include:

  • Palpation: Identify tender nodules along the front of the neck and deep cervical spine.

  • Resisted Neck Flexion Testing: Assess pain and weakness when tucking the chin toward the chest against resistance.

  • Postural Assessment: Look for forward head posture, rounded shoulders, or excessive cervical lordosis.

  • Swallowing and Breathing Assessment: Rule out dysphagia (difficulty swallowing) and breathing restrictions due to neck tightness.

Corrective Actions

Dry Needling

  • Dry needling can release trigger points in the longus colli, reducing deep neck tightness and improving head posture.

Manual Therapy

  • Trigger Point Release: Apply gentle pressure to tight spots in the deep anterior neck muscles.

  • Myofascial Release: Helps improve circulation and reduce cervical spine muscle tension.

Stretching

  • Chin Tuck Stretch: Tuck the chin toward the chest while keeping the neck long to stretch the deep neck flexors.

  • Neck Extension Stretch: Gently tilt the head backward to relieve tension in the longus colli.

Strengthening Exercises

  • Deep Neck Flexor Activation (Chin Tucks): Helps strengthen postural neck muscles to reduce forward head posture.

  • Scapular Retraction Drills: Encourages proper posture and reduces excessive strain on the neck.

Postural and Behavioral Adjustments

  • Avoid Prolonged Forward Head Posture (Keep Screens at Eye Level to Reduce Neck Strain)

  • Use Proper Ergonomic Support (Ensure Good Posture While Working at a Desk or Reading)

  • Practice Stress Management and Relaxation Techniques (Reduces Chronic Neck and Throat Tension)

Conclusion

The longus colli plays a crucial role in neck flexion, posture control, and spinal stability, but trigger points in this muscle can cause significant neck pain, throat discomfort, and headaches. By incorporating dry needling, manual therapy, stretching, and strengthening exercises, individuals can reduce pain, improve mobility, and prevent future dysfunction.

➡️ Learn more about Trigger Points

➡️ Explore our Trigger Point Index

Sources:

  • Travell, J. G., & Simons, D. G. (1983). Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.). Williams & Wilkins.

  • Simons, D., & Travell, J. (1999). The Trigger Point Manual, Volume 2: The Lower Extremities. Williams & Wilkins.