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The trapezius muscle is a large, triangular-shaped muscle that spans the upper back, extending from the base of the skull down to the middle back and across to the shoulders. It is divided into three parts: upper, middle, and lower fibres, each contributing to different functions such as elevating the shoulders, retracting the scapula, and stabilizing the spine. Tension or overuse of the trapezius can lead to discomfort and pain, commonly referred to as trapezius muscle pain. This discomfort often manifests in the upper portion of the trapezius, leading to upper trapezius pain and can be exacerbated by poor posture, stress, or repetitive movements. Trigger points in the trapezius muscle can cause referred pain in the head, resulting in tension-type headaches.
| Characteristics | Values |
|---|---|
| Trapezius muscle pain causes | Overuse, injuries, nerve damage, stress, and tension |
| Trapezius muscle pain symptoms | Pain, stiffness, spasms, tenderness, and restricted range of motion |
| Trapezius muscle pain treatment | Massage, stretching, strengthening exercises, and manual therapies |
| Trapezius muscle pain prevention | Improving posture, avoiding repetitive movements, and reducing stress |
| Trapezius muscle pain duration | Can last from a few days to weeks or become persistent |
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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. 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 may feel like a knot in your upper back, shoulder, or neck. The trigger points may feel especially painful when touched, and the pain may radiate beyond the immediate area.
There are two types of trigger points: active and latent. Active trigger points hurt when you move. Latent trigger points only hurt when someone applies pressure along the raised part of the muscle. Trigger points in the trapezius can be caused by several factors, including 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.
Several treatment options are available to alleviate trapezius trigger points, including massage therapy, trigger point release techniques, and lifestyle changes. Deep tissue massage can help release tension in the trapezius muscle. Ischemic compression, a type of massage performed by a professional therapist, applies direct vertical pressure to the trigger points using an instrument made of wood, plastic, or rubber. Another alternative treatment is cupping, which originated in China and uses suction cups to apply pressure to the body and change blood flow.
In addition to massage and alternative therapies, lifestyle changes can also help address trapezius trigger points. Improving posture by avoiding slouching or hunching, especially while working at a desk, can reduce strain on the trapezius muscle. Specific exercises, such as neck strengthening exercises and stretches, can help improve posture and reduce muscle tension. It is recommended to get up from your desk every 20 to 30 minutes to stretch and walk around.
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Tension-type headaches
Tension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is commonly associated with primary headaches. The trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons of the brainstem, thus conceptualizing the emergence of a headache in relation to neck pain.
Trapezius trigger points can cause headaches, particularly tension-type headaches. The trapezius muscle is a large muscle in the upper back and neck, and when it develops trigger points, it can refer pain to other areas, including the head. The upper part of the trapezius, where it attaches to the base of the skull, is a common area for trigger points that contribute to headache pain.
The pain patterns associated with trapezius trigger points have been extensively documented, highlighting their impact on musculoskeletal health. Identifying trapezius trigger points involves palpation and locating areas of tenderness or tightness. Self-palpation involves gently pressing and exploring the trapezius muscle with your fingers, starting from the base of the skull and moving down towards the shoulder.
To address trapezius trigger points, therapeutic interventions such as massage, stretching, and other manual therapies may help alleviate headaches. Techniques like ischaemic compression, stretching of the upper trapezius muscle, and transverse friction massage can help patients with trapezius myalgia. These techniques can provide instant pain improvement.
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Poor posture
The forward head posture that often results from poor posture puts stress on the nerve that innervates the upper trapezius. This can cause pain in the upper trapezius muscle, which can radiate up into the head. Additionally, poor posture can lead to a vicious cycle where the body curls forward when in pain, causing more muscle spasms and pain, and further exacerbating poor posture.
To improve posture and reduce head pain associated with the trapezius muscle, exercises such as shoulder shrugs, one-arm rows, and upright rows can be performed. These exercises focus on strengthening the upper trapezius muscle and improving posture. Another exercise is the half-kneeling position, which places the pelvis and lumbar spine in an optimal position, influencing the neck and head to be in a proper position, relieving abnormal mechanical stress on nerves that innervate the upper trapezius.
Making postural changes, such as sitting up straight and arching the back, can also reduce stress and tension in the upper trapezius. Using a lumbar cushion or roll while sitting at a desk or driving for long periods can encourage the spine to be upright. Additionally, yoga, Pilates, and other gentle exercises can help keep the trapezius muscles strong and flexible, improving posture and reducing the likelihood of head pain.
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Myofascial involvement
Myofascial pain is pain attributed to muscle and its surrounding fascia. In the cervical spine, the trapezius muscle is one of the muscles most commonly implicated in myofascial pain, along with the levator scapulae, rhomboids, supraspinatus, and infraspinatus. Myofascial pain in any location is characterised by the presence of trigger points located in skeletal muscle. These trigger points are defined as hyperirritable areas located in palpable, taut bands of muscle fibres.
Trapezius myalgia (TM) is a common condition that causes pain in the upper fibres of the trapezius muscle. It is often caused by monotonous, repetitive work, forceful exertions, high levels of static contractions, and constrained work postures. TM can cause pain and stiffness after periods of inactivity, and the pain usually eases after exercise. TM can be diagnosed when neck pain, muscle tightness, and trigger points are present.
Treatment for cervical myofascial pain includes physical therapy, trigger point injection, stretch-and-spray therapy, and ischemic compression. Ischemic compression, stretching of the upper trapezius muscle, and transverse friction massage are manual techniques that can provide instant pain relief for patients with TM. Physiotherapists may also treat cervicogenic headaches, which originate in the neck, with postural training, relaxation techniques, and stretching exercises.
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Therapeutic interventions
Therapeutic ultrasound, laser therapy, and ischemic compression have also been used to treat trapezius muscle pain, with ultrasound being used as a therapeutic modulation but not recommended. Laser therapy has been found to be superior to ultrasound and ischemic compression in one study, due to its ability to stimulate protein synthesis, soft tissue repair, and tissue regeneration. However, ischemic compression may also provide pain relief through reactive hyperaemia, counter-irritant effects, or a spinal reflex mechanism.
Other therapeutic interventions include neck strengthening exercises, such as shoulder shrugs, one-arm rows, and upright rows, which can lead to long-term reduction and prevention of recurring pain. Stretching and posture correction are also important for ongoing pain management, as stress and poor posture are common contributors to trapezius muscle pain. Relaxation techniques, such as diaphragmatic breathing, can be useful for anxious or stressed patients experiencing cervicogenic headaches.
It is important to note that the effectiveness of these interventions may vary among individuals, and consistent self-care measures are crucial for managing trapezius muscle-related head pain.
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Frequently asked questions
Yes, trapezius trigger points can cause headaches, particularly tension-type headaches. The upper part of the trapezius, where it attaches to the base of the skull, is a common area for trigger points that contribute to headache pain.
The symptoms associated with trigger points in the trapezius muscle can manifest as localized pain, tenderness, and stiffness in the upper back and neck region. Individuals may also experience referred pain in the head, causing tension headaches.
Overuse, injuries, nerve damage, and stress are the most common causes of trapezius muscle pain. Poor posture, repetitive movements, and monotonous, highly repetitive work can also contribute to trapezius muscle issues.
Therapeutic interventions like massage, stretching, and other manual therapies may help alleviate trapezius muscle issues and associated headaches. Physiotherapists may also recommend postural training, neck strengthening exercises, and relaxation techniques.
