The semispinalis capitis is the largest and most superficial posterior cervical muscle, forming the bulk of the posterior neck. The greater occipital nerve (C2 dorsal ramus) pierces through the semispinalis capitis near the occipital attachment — compression of the GON as it pierces this muscle contributes to occipital neuralgia and cervicogenic headache.
| Origin | Transverse processes of C4-T6 and articular processes of C4-C6 |
|---|---|
| Insertion | Between the superior and inferior nuchal lines of the occipital bone — the largest suboccipital muscle mass |
| Nerve Supply | Dorsal rami of C1-C6 |
| Blood Supply | Occipital artery |
| Actions | Bilateral: head and cervical extension; Unilateral: ipsilateral lateral flexion and contralateral rotation |
|---|
Semispinalis capitis trigger points are a primary source of posterior cervical and suboccipital pain with headache referral over the vertex and behind the eye. Dry needling of semispinalis trigger points and GON decompression/steroid injection are effective for cervicogenic headache.
The semispinalis capitis forms the prominent posterior neck muscle mass medial to the trapezius, palpable from the suboccipital region to the upper thorax.
Posterior neck trigger points referring headache to the vertex managed with dry needling and cervical stabilisation exercises.
