Upper trapezius and its referral sources

The trapezius commonly contains trigger points, and referred pain from these trigger points bring patients to the office more often than for any other problem. As you can see from the picture, the trapezius is a large kite-shaped muscle, covering much of the back and posterior neck.

There are three main parts to the muscle: the Upper, middle, and lower trapezius, and each part has its own actions and common symptoms.

Common Symptoms

Upper Trapezius

headaches on the temples / "tension" headaches

facial, temple, or jaw pain

pain behind the eye

dizziness or vertigo (in conjunction with the sternocleidomastoid muscle)

severe neck pain

a stiff neck

limited range-of-motion

intolerance to weight on your shoulders

Middle Trapezius

mid-back pain

headaches at the base of your skull

TrP5 refers superficial burning pain close to the spine

TrP6 refers aching pain to the top of the shoulder near the joint

Lower trapezius

mid-back, neck, and/or upper shoulder region pain

possibly referral on the back of the shoulder blade, down the inside of the arm, and into the ring and little fingers (TrP7), very similar to a serratus posterior superior referral pattern

headaches at the base of the skull 5

TrP3 can refer a deep ache and diffuse tenderness over the top of the shoulder 6

Causes and Perpetuation of Trigger Points

one leg shorter than the other

a hemipelvis that is smaller on one side (the part of the pelvis you sit on)

short upper arms (which causes you to lean to one side to use the armrests)

large breasts

fatigue

tensing your shoulders

cradling a phone between your ear and shoulder

a chair without armrests, or the armrests are too high

typing with a keyboard too high

sewing on your lap with your arms unsupported

jogging

sleeping on your front or back with your head rotated to the side for a long period

playing a violin

sports activities with sudden one-sided movements

sitting without a firm back support (sitting slumped)

backpacking

bike-riding

kayaking

any profession or activity that requires you to bend over for extended periods (i.e.. dentists/hygienists, architects/draftsmen, and secretaries/computer users)

bra straps that are too tight (either the shoulder straps or the torso strap)

a purse or daypack that is too heavy

a mis-fitting, heavy coat

carrying a day pack or purse over one shoulder -- even if you think you are not hiking up one shoulder, you are, no matter how light the item

whiplash (a car accident, falling on your head, or any sudden jerk of the head) 10

head-forward posture

walking with a cane that is too long

turning your head to one side for long periods to have a conversation

tight pectoralis major muscles

Often times, we can address these trigger points in 1-2 sessions and by eliminating these, patients see a drastic redution in neck, and headache pain as well as an immediate increase in AROM. Contact us today to set up an evaluation!!! 502-771-1774