Why does the trapezius muscle hurt?

Pain in the trapezius muscle is one of the most common pain syndromes; it is in this area that stress points most often occur. It is no coincidence that the trapezius muscle is called one of the most vulnerable; according to statistics, myalgia in this area ranks second, giving way to pain in the lumbosacral spine.

The muscle consists of fibers and layers of different structures, of which the upper one forms the shoulder and controls its movements, the middle layer is responsible for the mobility of the scapula in the same way as the lower muscle fibers. Overstrain, spasm, or, on the contrary, weakness in these structures provoke pain in the trapezius muscle.

Causes of pain in the trapezius muscle

Most often, the causes of pain in the collar area are associated with muscle overstrain, less often with their stretching as a result of intense training. It is no secret that many representatives of the stronger sex strive to pump up the trapezius muscle and create an impressive neck-shoulder relief. Sometimes, without calculating its resources, a muscle is subjected to excessive stress, its fibers are injured, and pain occurs.

In general, the causes of pain in the trapezius muscle are not much different from the typical factors that provoke myalgia, and can be as follows:

• Overextension of the trapezius muscle
• Insufficient warming up before training, sudden movements of the head and neck, lifting weights in the snatch, including in sports (barbell). The pain symptom is clearly related to the provoking factor
• Muscle contusion (bruise)
• Typical injury for athletes. Muscle pain occurs after a hematoma has formed, which activates the myofascial trigger point
• Tendonitis, migelosis (painful lumps)
• Degenerative process in tendon and cartilaginous tissues at the site of attachment of the trapezius and rhomboid muscles to the spinous processes of the vertebrae (cervical spine). The disease is most often provoked by sports overload
• Permanent trauma to the trapezius muscle
• Performing monotonous movements – turning the head, moving the neck, shoulder girdle, shoulder blades. Stereotypical chronic overexertion is characteristic of some professions and types of art (dancers, gymnasts). Injury is also possible when constantly wearing heavy bags, backpacks (tourists, travelers)
• Static tension, postural overvoltage
• Constant position of the body in an anti-physiological position, often sitting, stretched forward (drivers, office workers) or bowing the head (telephone operators). The cause may also be an anomaly in the anatomical structure of the skeleton, poor posture, or scoliosis.
• Exposure to temperature, often hypothermia
• Hypothermia not only provokes spastic tension in the trapezius muscle, but can also provoke myositis – inflammation of muscle tissue
• Psycho-emotional factor

Anxiety, depression, and stress cause general muscle tension, most often the neck muscles, and are accompanied by tension headaches. Muscle pain may persist even after the triggering factor has been eliminated.

In addition, the causes of pain in the trapezius muscle can be associated with vertebral pathologies, injuries – protrusion, herniated intervertebral discs, spinal contusion, facet syndrome.

Symptoms of pain in the trapezius muscle

Signs and symptoms of trapezius muscle pain are a description of typical myofascial pain.

Characteristics of pain:

• The pain is aching and causes a feeling of pressure on the shoulders.
• The pain is constant and subsides only after adequate treatment and muscle relaxation.
• Pain in the trapezius muscle is often reflected in the shoulders, upward – in the neck, base of the skull, and can provoke tension headaches – tension headaches.
• Pain in the trapezius muscle can limit the range of head movements, neck rotations, and, less commonly, arm movements.
• When palpating a tense muscle, the pain intensifies, but then quickly subsides.

It should be noted that the musculus trapezius (trapezius muscle) is the most typical zone of localization of trigger points in myophasic syndrome, and sensations and pain manifestations depend on the type of muscle fibers of the muscle.

What are the symptoms of pain in the trapezius muscle?

• TT – trigger points in the upper layer of the muscle manifest themselves as pain in the neck, at the very base of the skull. The pain can feel like a headache, often reflected in the temples and in the ear area. The patient develops a characteristic posture – shoulders raised up with the neck tilted in the direction of tension. A person involuntarily strives to relax his muscles, constantly rubs them with his hand, and makes typical rotational movements with his head.
• TT in the middle layer of muscle fibers as pain manifests itself less frequently; it provokes aching, burning pain in the area between the shoulder blades. The pain intensifies when moving the arms forward, especially when it is necessary to hold objects on outstretched arms (waiters, drivers). A person acquires a stooped posture characteristic of damage to the trapezius muscle.
• Trigger points in the lower layer of the trapezius muscle manifest themselves as tightening, pressing pain in the lower neck, closer to the shoulders, often one shoulder higher than the other.

In addition, the symptoms of muscle pain in the trapezius muscle can be masked as signs of facial neuralgia, especially when MFPS – myofascial pain syndrome is localized in the upper muscle bundles.

Diagnosis of pain in the trapezius muscle

Diagnosis of muscle pain syndromes, first of all, should exclude inflammatory and life-threatening pathologies, as well as compression radicular syndromes, vertebrogenic factors and spinal pathology. In addition, pain in the trapezius muscle is often similar to the symptoms of migraine, vascular diseases of the head, neuralgia of the facial nerves, which should also be differentiated during examination.

The main method that involves diagnosing pain in the trapezius muscle is palpation, the technique of which must be mastered by the doctor. By palpation of muscle tissue, you can identify diagnostically significant trigger points, spasmodic areas and clarify the nature of the pain. During such an examination, the muscle is stretched in length to the limits of pain within reasonable limits. Against the background of more relaxed, intact muscles, the spasmed tissue feels like a dense cord (cord). Pain points are located along the cord; upon palpation they are most painful. The palpation technique can be performed either in a deep, “pincer” way, or in a superficial way. The deep technique involves grasping the muscle across the fibers, the pincer technique involves grasping the muscle and rolling it between the fingers to determine the characteristic strands. The superficial method can be used at the initial stage of overstrain of the trapezius muscle. The following criteria for muscle pain may be important for a doctor:

• The relationship of the symptom with physical overexertion, static posture or hypothermia, that is, with typical provoking factors.
• Determination by palpation of characteristic strands in the absence of signs of atrophy or muscle atony.
• Pain on palpation should be reflected in other, more relaxed muscles.
• On palpation, a “jump” symptom should appear, when the pain sensation intensifies significantly when pressing on the TT.
• The pain symptom is well controlled with the help of local influence on the TT – trigger point (massage, rubbing, warming, injection puncture).

The most significant criteria are the reproducibility of pain and the identification of trigger points, which in 70% confirm the myofascial nature of the symptom in the trapezius muscle.

Also, to identify the root cause of a pain symptom, specific muscle tests are used:

• Test to identify resistance and strength of the upper trapezius muscles. The patient is asked to raise his shoulders up, while the doctor presses down on them, while palpating the tense muscle tissue.
• A test that reveals the level of strength of the middle fascicles of the muscle. The patient moves his shoulders back, the doctor applies resistive pressure by palpating the muscle.
• A test to determine the level of tone in the lower part of the muscle. The patient raises his hand and moves it backwards. The doctor palpates the muscles, providing test resistance to the movement of the hand.

Diagnosis of muscle pain syndromes is directly related to a thorough clinical analysis of the information obtained from tests and palpation.

Treatment of pain in the trapezius muscle

As a rule, the treatment of muscle pain is through manual techniques, which are often used by orthopedists and vertebrologists. Recent studies regarding myogenic pain indicate that manual techniques only affect shortened, contracted muscles to a greater extent. This really stops the symptom, but does not eliminate the etiological factor. Thus, abnormalities in the biomechanics of the shoulder region persist and over time provoke a relapse of pain due to new compensatory muscle overstrain. This is especially true for the effect on the deltoid muscle, the relaxation of which provokes functional overload of the trapezius muscle. It is for this reason that doctors are trying to find new, more effective algorithms that provide lasting results in the treatment of pain in the trapezius muscle.

We offer one of the options for complex treatment of pain symptoms, taking into account the relationship of the shoulder girdle with other parts of the body through reflexes (tendon, respiratory, gait reflex and others), as well as taking into account the inevitable psycho-emotional factor. It is no coincidence that treatment of pain in the trapezius muscle begins with the restoration of the emotional sphere, since according to statistics, in 85% of cases myalgia is accompanied by a depressed, depressive state.

• Psycho-emotional correction. Aromatherapy provides excellent relaxing results, provided that the patient does not have allergies. Breathing techniques and the autogenic training method are effective.
• Correction of respiratory function, respiratory diaphragm. It has been established that simultaneous forced diaphragmatic breathing and massage of the shoulder girdle relieve pain much faster and much more effectively than heating, compresses, and rubbing with external anti-inflammatory drugs.
• Correction of vascular disorders of the brain. Most often, nootropic drugs of plant origin, a complex of amino acids, are prescribed.
• Carrying out gentle visceral manual therapy.
• Manual therapy of functional blocks of the spinal column.
• Manual therapy of the lumbosacral zone as an interconnected area (gait reflex).
• Correction of acupuncture imbalance, acupuncture.
• Teaching the patient to independently perform relaxation and muscle stretching exercises (post-isometric relaxation).

For myofascial syndrome, treatment should be aimed at destroying the pathological zone of tension at the trigger point. All postures that provoke static overload are excluded, posture is corrected, and the use of special straightening corsets is recommended. In case of severe pain symptoms, mechanical destruction of the TT using injections (lidocaine, novocaine) is prescribed.

Drug treatment is prescribed only according to indications; myelorelaxants are used to destroy the pathological connection between spasm and pain.

The effectiveness of therapy depends on the timely contact of a sick person with a doctor, as well as on his responsible implementation of all prescriptions.

How to Prevent Trapezius Muscle Pain

Prevention of pain in the trapezius muscle, as one experienced and famous doctor aptly put it, is getting rid of the “Atlas and Caryatids” complex. It is these images that we associate with strength and power, because according to myths they support not only ancient temples, but also the entire vault of heaven in the form of columns. The life of a modern person, of course, involves an increased load, but taking on the functions of ancient Greek fairy-tale creatures is impractical and unwise. It is impossible to carry all the burdens of the world on your shoulders and be responsible for everything that happens in the field of professional activity, in the country and in the world. It is no coincidence that many practitioners associate pain in the muscles of the shoulder girdle with psycho-emotional stress; most often, hyper-responsible people, perfectionists, and also very impressionable people suffer from this syndrome. Consequently, the primary prevention of pain in the trapezius muscle is the proper distribution of load, not only physical, but also mental and emotional.

In addition, preventive measures to prevent myalgia in the shoulder girdle may include the following:

• Systematic support of physical activity, sports, fitness.
• Regular warm-ups when working in a monotonous body position.
• Massage of the collar area, including self-massage.
• Periodic medical examinations, comprehensive examinations at least once a year.
• Correction of posture and gait, getting rid of stoop either independently or with the help of a massage therapist or a special corset.
• Selection of ergonomic, comfortable furniture – table, chair.
• Watching TV shows, working at the computer at a distance that does not strain either the eyes or the muscles of the shoulder girdle.

In general, pain in the trapezius muscle, despite its prevalence, is not a life-threatening syndrome. However, constant, chronic overstrain of muscle tissue can lead to headaches, depression, and decreased productivity. Therefore, the sooner the tense muscles of the collar zone receive adequate help, the faster the normal rhythm and quality of life will be restored.