The sternohyoid muscle, located in the front of the neck, is part of a group known as the infrahyoid muscles. Its primary function involves depressing the hyoid bone and the larynx, structures involved in swallowing and speaking. When this muscle experiences pain or dysfunction, it can lead to sternohyoid muscle syndrome.
The Sternohyoid Muscle’s Role
The sternohyoid muscle originates from the posterior surface of the manubrium, the upper part of the sternum, and the medial end of the clavicle. It extends upwards and inserts into the lower border of the body of the hyoid bone, a U-shaped bone located at the base of the tongue. This anatomical arrangement allows it to exert a downward pull on the hyoid bone.
The muscle’s main action is to depress the hyoid bone, especially after it has been elevated during swallowing. By pulling the hyoid bone down, it also helps to lower the larynx, crucial for vocalization and protecting the airway during deglutition. The sternohyoid muscle also stabilizes the hyoid bone, providing a stable base for the tongue and other suprahyoid muscles.
Recognizing Sternohyoid Muscle Syndrome
Individuals experiencing sternohyoid muscle syndrome often report localized pain in the front of the neck. This pain may worsen with neck movement, swallowing, or speaking. Another common symptom is dysphagia, difficulty or discomfort when swallowing food or liquids.
Changes in voice quality, known as dysphonia, can also manifest, leading to hoarseness, a strained voice, or a reduced vocal range. Many people describe a feeling of tightness or a “lump in the throat,” medically termed globus sensation, even when no physical obstruction is present. Pain may also radiate from the sternohyoid muscle to other areas, such as the jaw, ear, or temple, creating referred pain patterns.
What Leads to the Syndrome
Several factors can contribute to sternohyoid muscle syndrome. Overuse or repetitive strain is a common culprit, often seen in individuals with prolonged vocal use or chronic coughing. Poor posture, particularly a forward head posture, places increased strain on the anterior neck muscles, leading to muscle tightness and dysfunction.
Physical trauma or injury to the neck, such as whiplash from an accident or direct impact, can directly damage the muscle or surrounding tissues. Chronic muscle tension can cause the sternohyoid muscle to remain in a contracted state, developing taut bands or myofascial trigger points. These factors can lead to muscle tightness, inflammation (myositis), or painful trigger points that perpetuate discomfort and dysfunction.
Getting a Diagnosis and Treatment
Diagnosing sternohyoid muscle syndrome begins with a physical examination and medical history. A healthcare professional will palpate the sternohyoid muscle, feeling for tenderness, taut bands, or trigger points that reproduce symptoms. The assessment also includes evaluating neck movement and observing for pain or limitations during swallowing or speaking. Imaging studies like ultrasound or MRI may be used to rule out other causes of neck pain or swallowing difficulties, such as thyroid nodules or cervical spine issues.
Treatment for sternohyoid muscle syndrome often involves a multidisciplinary approach to reduce pain, restore muscle function, and prevent recurrence. Physical therapy is a primary component, incorporating stretching exercises for the sternohyoid muscle, alongside strengthening exercises for surrounding neck and core muscles to improve posture and stability. Manual therapy techniques, such as myofascial release and trigger point therapy, can directly address muscle tightness and deactivate trigger points.
Pain management strategies may include non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation or muscle relaxants for acute spasms. For persistent trigger points, injections of a local anesthetic, sometimes combined with corticosteroids, directly into the affected muscle can provide significant relief. Lifestyle modifications are also beneficial, encompassing posture correction, stress reduction techniques, and voice rest for individuals whose symptoms are exacerbated by vocal strain. A comprehensive treatment plan involves collaboration among physical therapists, speech-language pathologists, and pain specialists to achieve the best outcomes.