Dominic Stone
The trapezius muscle is a large, fan-shaped muscle that extends from the cervical to the thoracic region at the back of the neck and upper back. It is divided into three sections, each with different roles. The upper trapezius, for example, helps lift the arms and turn or tilt the head. A pulled trapezius muscle can cause mild to severe pain in the upper back, shoulders, or neck. This pain can also manifest as a headache. Tension-type headaches, for instance, are associated with trapezius muscle T2. In addition, trigger points in the upper trapezius muscles can refer pain to the temple, causing headaches.
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What You'll Learn
Trapezius myalgia
The trapezius muscle is divided into three sections with different roles: the upper trapezius, middle trapezius, and lower trapezius. The upper trapezius, or superior trapezius, begins at the base of the neck and extends across the top of the shoulders. It helps with lifting the arms and turning or tilting the head. The middle trapezius, located below the upper trapezius, spreads across the shoulders and keeps them steady when the arms are moving. The lower trapezius, or inferior trapezius, extends from the shoulder blades down the back, forming a trapezoid shape. It helps to stabilise the spine during twisting or bending movements and allows for the lowering of the shoulders.
A pulled or strained trapezius muscle can cause mild to severe pain in the upper back, neck, and shoulders, as well as tenderness to the touch. It may restrict the freedom of arm movement, especially overhead. In addition to pain and stiffness, trapezius muscle spasticity may cause tension headaches due to increased pressure on the spinal accessory and occipital nerves that pass through this muscle. These headaches typically manifest as throbbing pain on both sides of the head, from the back of the head to the forehead, and are often exacerbated by stress, poor posture, and lack of stretching.
Treatment for trapezius myalgia includes physiotherapy, exercise therapy, and manual techniques such as ischaemic compression, stretching of the upper trapezius muscle, and transverse friction massage, which can provide instant pain relief. Additionally, addressing biomechanical and psychosocial factors, maintaining good posture, and engaging in stress-relieving activities may help prevent and manage TM.
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Tension-type headaches
Tension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is a common symptom of primary headaches, and the trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons in the brainstem, which explains the link between neck pain and headaches.
Trapezius myalgia (TM) is a complaint of pain, stiffness, and tightness in the upper trapezius muscle, which is characterised by acute or persistent neck and shoulder pain. TM is not a medical disorder but a symptom of an underlying condition. The pain can last from a few days to several weeks and is often associated with spasms, stiffness, and tenderness in the neck region. Trigger points can also cause headaches.
Trapezius trigger points can refer pain to the head and neck, contributing to tension headaches or migraines due to muscle tightness and nerve irritation. The spinal accessory and occipital nerves pass through the trapezius muscle, so spasms or increased tone can put pressure on these nerves, causing a tension headache. This type of headache is exacerbated by stress, bad posture, and a lack of stretching before activity.
Therapeutic interventions such as massage, stretching, and other manual therapies can alleviate headache symptoms associated with trapezius trigger points. Consistent self-care measures, including stretching and posture correction, can help manage pain. Techniques such as ischaemic compression and transverse friction massage can provide instant pain relief, although long-term effects are not well understood.
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Trigger points
A study investigating the involvement of the trapezius muscles in primary headache disorders found that neck pain is commonly associated with primary headaches. The trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons in the brainstem, which is thought to cause headaches in relation to neck pain. The study found that tension-type headache (TTH) is the most prevalent primary headache disorder and that the bilateral trapezius muscles were manually segmented, followed by muscle T2 extraction. The TTH+ group demonstrated the highest muscle T2 values compared to the TTH- group or the healthy control group.
The trapezius muscle is a large, paired, triangular muscle in the back of the neck and upper back, consisting of three sections with different roles. The upper trapezius, or superior trapezius, begins at the bottom of the neck and extends across the top of the shoulders. It helps lift the arms and is involved in turning and tilting the head. The middle trapezius spreads across the shoulders and keeps them steady when the arms are moving. The lower trapezius, or inferior trapezius, extends from the shoulder blades down the back, tapering into a trapezoid shape. It keeps the spine stable when twisting or bending over and allows the lowering of the shoulders.
If you have a strained or pulled trapezius muscle, you may feel mild or severe pain in your upper back, shoulders, or neck. This pain may be accompanied by stiffness and tenderness to the touch. A pulled trapezius muscle may also result in difficulty moving your arms freely, especially over your head.
To treat trigger points in the trapezius muscle, it is recommended to first consult a healthcare professional to rule out more serious issues. Once a muscular diagnosis is confirmed, you may consider self-treating your trigger points at home or in the office. A combination of trigger point self-massage followed by a sustained stretch of the affected muscle can be very effective. Using a trigger point reference book that maps out trigger points and their corresponding referral areas can help you easily target your problem areas.
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Posture and scapula function
Posture and scapular function are closely related to the trapezius muscle and its impact on headaches. The trapezius muscle is a large, fan-shaped muscle that extends from the neck to the upper back, attaching to the clavicle and scapula. It plays a crucial role in maintaining proper posture and shoulder movement.
The trapezius muscle is divided into three sections, each with a specific function: the upper trapezius, middle trapezius, and lower trapezius. The upper trapezius helps elevate the shoulder girdle and is involved in head and neck movements. The middle trapezius keeps the shoulders stable during arm movements, while the lower trapezius maintains spine stability during twisting or bending movements and allows for shoulder lowering.
Poor posture, such as slouching when sitting or standing, can cause the trapezius muscle to tighten and lead to chronic shoulder and neck pain, potentially triggering headaches. This is because the trapezius muscle spasticity can put pressure on the spinal accessory and occipital nerves, resulting in tension headaches. Additionally, protracted scapulae, often associated with poor posture, can contribute to lengthened and weakened lower trapezius fibres.
To improve posture and scapular function, individuals should aim for a straight spine and retracted scapulae. This can be achieved through exercises that strengthen the back and shoulder muscles, such as shoulder shrugs and upright rows. Maintaining good posture not only helps prevent headaches but also promotes overall shoulder and spine health.
In summary, posture and scapular function play a significant role in the impact of the trapezius muscle on headaches. By understanding the anatomy and function of the trapezius muscle and its relationship with posture and scapular positioning, individuals can take preventive measures to alleviate tension and reduce the likelihood of headaches.
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Treatment options
For persistent and recurrent pain, consulting a physiotherapist is advised. They may recommend ischaemic compression, stretching of the upper trapezius muscle, and transverse friction massage, which can provide instant pain improvement.
In more severe cases, a doctor's examination and diagnosis are necessary. They may utilize a range of motion test to assess the patient's range of motion and identify any noticeable rips or tears in the muscle and tissue. X-rays may be required to rule out a fracture, dislocation, or other types of injuries. An MRI scan can also be useful in determining the position and severity of the strain and detecting any hematoma, or collection of blood, resulting from the injury.
If the injury is unresponsive to non-surgical treatments or if muscle rupture occurs, surgery may be recommended to restore muscle strength or reattach any detached tendons, bones, or muscles.
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Frequently asked questions
Yes, a pulled trapezius muscle can cause headaches. The trapezius muscle is a large, fan-shaped muscle that extends from the neck to the middle back and is involved in the movement of the head, neck, shoulders, and arms. A pulled trapezius muscle can cause pain and stiffness in the neck and shoulders, and this pain can lead to tension headaches.
Symptoms of a pulled trapezius muscle include mild or severe pain in the upper back, shoulders, or neck. There may also be tenderness to touch in parts of the upper back and neck. In the case of a grade III strain, there may be a visible gap or dent under the skin where the muscle has ripped apart.
Treatment for a pulled trapezius muscle can include rest, warm compresses, physical therapy, and stretching. It is important to address posture and scapula function, as these can be influenced by trapezius muscle stiffness and increased muscle tone.
