Dominic Stone
The trapezius muscle is a large triangular muscle that extends from the base of the skull to the mid-back and across the shoulder blades. It is responsible for various movements of the shoulders and neck, including stabilization, shrugging, pulling the shoulder blades together, and rotation of the neck. The trapezius muscle is also associated with cervicogenic dizziness, which is caused by abnormal sensory input and structural and functional changes in the suboccipital muscles. Cervicogenic dizziness is characterized by neck pain and dizziness, and it can last for several years with periodic flare-ups. While the exact relationship between the trapezius muscle and cervicogenic dizziness is not fully understood, treating soft tissue dysfunction of the upper trapezius through manual techniques such as ischaemic compression and stretching has shown improvement in managing nonspecific cervical pain.
| Characteristics | Values |
|---|---|
| Trapezius muscle | A large triangular/fan-shaped muscle that extends from the base of the skull to the mid-back and across the shoulder blades |
| Plays a key role in various movements of the shoulders and neck, including stabilization, shrugging, pulling the shoulder blades together, and rotation of the neck | |
| Divided into three parts | |
| The upper trapezius is a high contributor of muscle spindles | |
| The upper trapezius has a significantly smaller surface area compared to other muscles of the cervical spine | |
| Causes of trapezius pain | Repetitive movements or excessive strain on the trapezius muscle, such as carrying heavy loads or prolonged periods of sitting at a desk |
| Muscle strain or overuse can cause trapezius pain by inducing microtrauma, muscle tension, and changes in biomechanics, which can lead to inflammation and pain | |
| Monotonous and repetitive work, forceful exertions, high levels of static contractions, prolonged static loads, constrained work postures, or a combination of these factors are possible causes of neck and shoulder disorders | |
| Trapezius trigger points can be associated with loss of balance and dizziness | |
| Treatment | Ischaemic compression, stretching of the upper trapezius muscle, and transverse friction massage are manual techniques to help patients with trapezius myalgia |
| Treating soft tissue dysfunction of the upper trapezius is effective in managing nonspecific cervical pain | |
| Physical therapy exercises can help keep neck muscles strong and reduce the risk of developing cervical vertigo | |
| Drugs can be used to reduce dizziness |
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What You'll Learn
Trapezius trigger points
The trapezius is a large, triangular-shaped muscle that spans the upper back, extending from the base of the skull down to the mid-back and across to the shoulders. It plays a crucial role in various movements, including shrugging the shoulders, tilting and turning the head, and supporting arm movements. The muscle is divided into three parts: upper, middle, and lower fibres, each contributing to different functions, such as elevating the shoulders and retracting the scapula.
Trigger points in the trapezius muscle are hyperirritable nodules or taut bands within the muscle fibres that can be palpated and are associated with localized pain and tenderness. These points are characterized by a hypersensitive spot in a tight band of muscle that can refer pain to other areas when pressed or stimulated. Trigger points in the trapezius can also contribute to postural abnormalities. The pain patterns associated with trapezius trigger points have been extensively documented, highlighting their impact on musculoskeletal health.
Several factors contribute to the development of trigger points in the trapezius muscle. Common triggers include muscle overuse, poor posture, trauma, and psychological stress. Repetitive activities, such as prolonged periods of sitting, typing, or carrying heavy loads, can lead to muscle imbalances and the formation of trigger points. Emotional stress and tension can also contribute to the development and exacerbation of trigger points in the trapezius.
There are several methods for treating trapezius trigger points (TTP). These include medications, lifestyle changes, and alternative treatments. Massage therapy, such as deep tissue massage, can help release tension and alleviate pain. Ischaemic compression, a type of massage where a therapist applies direct vertical pressure to the trigger points using an instrument, has been found to be effective even in a single session. Cupping is another alternative treatment that may help alleviate TTP pain and discomfort. Stretching the upper trapezius muscle can also help address tightness and trigger points.
In some cases, trapezius trigger points may contribute to cervicogenic dizziness or cervical vertigo, a condition that causes both neck pain and dizziness. It is related to certain neck conditions and can occur following a cervical spine injury. Cervical vertigo can be treated by a neurologist and typically involves physical therapy, vestibular (inner ear) therapy, or medication.
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Cervical vertigo
Symptoms
- Dizziness or a spinning sensation
- Vision issues, such as rapid eye movement or difficulty maintaining a steady gaze
- Nausea and vomiting
- Headaches or neck pain
- Lack of coordination and balance issues
- Difficulty walking or standing
Causes
The exact cause of cervical vertigo is not yet fully understood, and there are several hypotheses under scrutiny. However, it is often associated with neck conditions and injuries, such as:
- Neck trauma or whiplash
- Arthritis (cervical spondylosis)
- Atherosclerosis (hardening of arteries in the neck)
- Cervical degenerative disc disease or herniated discs
- Inflammation
- Poor posture
- Joint issues
- Muscle strain
Treatment
- Physical therapy and inner ear exercises to improve neck strength and range of motion
- Vestibular (inner ear) therapy to address balance issues
- Medication, including muscle relaxants, pain relievers, and anti-dizziness drugs
- Chiropractic manipulation and heat compresses
While cervical vertigo can be a challenging condition to diagnose and manage, proper medical care can help improve symptoms and prevent flare-ups.
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Cervicogenic dizziness
The cervical spine plays a crucial role in maintaining balance, and cervicogenic dizziness is believed to be caused by a disturbance in the cervical spine or the surrounding tissue. The cervical spine is made up of the seven vertebrae closest to the skull, and nerves that run through the spinal cord carry messages between the brain and the body. The muscles surrounding the cervical spine are essential for movement and communication between the body and the brain.
The treatment for cervicogenic dizziness typically involves physical therapy, vestibular (inner ear) therapy, or medication. Manual therapy techniques such as massage and physical therapy are often recommended, along with vestibular therapy tailored to the individual. Episodes of cervicogenic dizziness can last from several minutes to several hours, and the condition can persist for several years with periodic flare-ups.
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Trapezius myalgia
TM is typically diagnosed when neck pain, muscle tightness, and trigger points are present, but tension neck syndrome or cervical syndrome is not. The pain usually occurs in the superior fibres of the trapezius and can last from a few days to several weeks, or even longer. It is often associated with spasms, stiffness, and tenderness in the neck region, and can cause headaches. TM can be caused by a number of factors, including biomechanical, psychosocial, and gender-related factors. Women, for example, are more likely to experience neck pain and persistent pain than men due to the nature of their work tasks, which often involve static load on the neck muscles, high repetitiveness, low control, and high mental demands.
TM can be treated with physiotherapy, exercise therapy, and manual therapy for short-term pain relief. Ischaemic compression, stretching of the upper trapezius muscle, and transverse friction massage are manual techniques that can provide instant pain improvement. However, long-term effects are not yet well understood. Other techniques such as physical therapy exercises can help keep neck muscles strong and reduce the risk of developing cervical vertigo, which is a condition that causes both neck pain and dizziness.
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Trapezius muscle pain causes
The trapezius muscle is a large, fan-shaped muscle that extends from the cervical to the thoracic region, covering the neck, upper back, shoulders, and trunk. It is responsible for providing mobility to the shoulders and arms. The pain in the trapezius muscle, also known as trapezius myalgia (TM), is often a symptom of an underlying problem rather than the problem itself. It is typically caused by overuse or trauma to the trapezius muscles.
TM is commonly associated with neck and shoulder disorders, especially in women. Women are more prone to neck pain and persistent pain due to the nature of their jobs, which often involve static load on the neck muscles, high repetitiveness, low control, and high mental demands. In addition, monotonous and repetitive work, forceful exertions, static contractions, prolonged static loads, and constrained work postures are also risk factors for developing TM.
TM can cause pain and stiffness in the neck and shoulders, especially between the shoulder blades. The pain can be mild or severe, depending on the extent of the injury. It can be accompanied by spasms, stiffness, and tenderness in the neck region. Trigger points can also develop, leading to headaches.
TM can be diagnosed through subjective and objective assessments. The subjective assessment evaluates the patient's condition history, potential cause, and severity, while the objective examination focuses on the neck and upper extremities to confirm TM or exclude other pathologies. Radiography, MRI, electromyography, nerve conduction studies, or blood tests may be performed to rule out other conditions, although they are not standard procedures.
TM can be treated with various techniques, including ischaemic compression, stretching of the upper trapezius muscle, and transverse friction massage, which provide instant pain relief. In addition, strengthening exercises, such as shoulder shrugs, one-arm rows, and upright rows, can help reduce and prevent recurring pain. For severe cases, surgery may be required to restore muscle strength or reattach detached tendons, bones, or muscles.
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Frequently asked questions
The trapezius muscle is a large fan-shaped muscle that extends from the cervical to thoracic region and attaches onto the clavicle and scapula. It is divided into three parts, with the upper fibres elevating the shoulder girdle.
Cervicogenic dizziness, or cervical vertigo, is a condition that causes both neck pain and dizziness. It is related to certain neck conditions and can occur following a cervical spine injury.
Trapezius trigger points can cause tension headaches and pain in the neck and head. Experts believe that these trigger points can be associated with loss of balance and dizziness. The trapezius muscle is also associated with cervicogenic dizziness, which is caused by abnormal sensory input.
Treatment for trapezius muscle issues and related dizziness varies. Manual techniques such as ischaemic compression and stretching of the upper trapezius muscle can provide instant pain relief. For cervicogenic dizziness, physical therapy and inner ear exercises are recommended.
