Pain in the trapezius muscle.

Trapezius muscle pain is one of the most common pain syndromes, it is in this area that overstrain 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, yielding primacy to pain in the lumbosacral spine.

The muscle consists of fibers and layers of different structure, the upper one forms the shoulder, controls its movements, the middle layer is responsible for the mobility of the shoulder blade, as well as the lower muscle fibers. Overstrain, spasm or, on the contrary, weakness in these structures provoke a painful sensation in the trapezius muscle.

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Causes of Trapezius Muscle Pain

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

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

Factor, cause, causing pain	Explanation
Overstretching of the trapezius muscle	Insufficient warm-up before training, sudden movements of the head, neck, lifting weights in a snatch, including in sports (barbell). The pain symptom is clearly associated with the provoking factor
Muscle contusion (bruise)	A typical injury for athletes. Muscle pain occurs after a hematoma forms, which activates a myofascial trigger point.
Tendonitis, mygealosis (painful lumps)	Degenerative process in tendon, cartilaginous tissues at the attachment point of the trapezius, rhomboid muscles to the spinous processes of the vertebrae (cervical region). The disease is most often provoked by sports overloads
Constant trauma to the trapezius muscle	Performing monotonous movements - turning the head, moving the neck, shoulder girdle, shoulder blades. Stereotypical chronic overstrain is typical for some professions, types of art (dancers, gymnasts). Also, traumatization is possible with constant carrying of heavy bags, backpacks (tourists, travelers)
Static tension, postural strain	Constant position of the body in an antiphysiological pose, often sitting, stretched forward (drivers, office workers) or tilted head (telephone operators). Also, the cause may be an anomaly of the anatomical structure of the skeleton, posture disorder, scoliosis
The impact of temperature factors, most often hypothermia	Hypothermia not only provokes spastic tension of the trapezius muscle, but can also provoke myositis – inflammation of muscle tissue
Psycho-emotional factor	Anxiety, depression, stress cause general muscle tension, more often the neck muscles, and are accompanied by tension headaches. Muscle pain may persist even after the provoking anxiety factor has been eliminated.

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

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Trapezius Muscle Pain Symptoms

Trapezius muscle pain signs and symptoms are a description of typical myofascial pain.

Characteristics of pain:

• The pain is of a nagging nature 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 often radiates to the shoulders, up to the neck, the base of the skull, and can trigger tension headaches.
• Pain in the trapezius muscle can limit the range of head movement, neck rotation, and, less commonly, arm movement.
• When palpating the tense muscle, the pain intensifies, but then quickly subsides.

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

What are the symptoms of trapezius muscle pain?

1. TT - trigger points in the upper layer of the muscle manifest themselves as painful sensations in the neck, at the very base of the skull. The pain can be felt as a headache, often it is reflected in the temples, in the ear area. The patient develops a characteristic pose - raised shoulders with a tilt of the neck towards the tension. The person involuntarily strives to relax the muscles, constantly rubs them with his hand, makes typical rotational movements with his head.
2. TT in the middle layer of muscle fibers manifests itself as pain less often, 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 with outstretched arms (waiters, drivers). A person acquires a stooped posture characteristic of damage to the trapezius muscle.
3. Trigger points in the lower layer of the trapezius muscle manifest as a constricting, pressing pain at the bottom of the neck, closer to the shoulders, often with one shoulder higher than the other.

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

Diagnosis of Trapezius Muscle Pain

Diagnosis of muscle pain syndromes should, first of all, 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 quite 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 used to diagnose pain in the trapezius muscle is palpation, a technique that a doctor should be proficient in. By palpating muscle tissue, diagnostically significant trigger points, spasmodic areas, and the nature of the pain can be identified. During such an examination, the muscle is stretched lengthwise to the limits of pain sensation within reasonable limits. Against the background of more relaxed, undamaged muscles, the spasmodic tissue feels like a dense cord. Pain points are located along the cord, and they are extremely painful upon palpation. The palpation technique can be performed both in a deep, “pincer” manner, and superficially. 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 cords. The superficial method can be used at the initial stage of overstrain of the trapezius muscle. The following criteria of 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 cords in the absence of signs of atrophy or muscle atony.
• Pain on palpation should be reflected to other, more relaxed muscles.
• During palpation, a “jump” symptom should appear, when the pain sensation increases significantly when pressing on the TT.
• The pain symptom is well treated with local action on the TT – trigger point (massage, rubbing, warming up, injection puncture).

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

Specific muscle tests are also used to identify the underlying cause of the pain symptom:

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

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

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Trapezius Muscle Pain Treatment

As a rule, the treatment of muscle pain is manual techniques, which are often used by orthopedists and vertebrologists. In the latest studies on myogenic pain, it is noted that manual techniques affect only shortened, contracted muscles to a greater extent. This really stops the symptom, but does not eliminate the etiological factor. Thus, the anomalies of the biomechanics of the shoulder region remain and over time provoke a relapse of pain due to new compensatory muscle strain. This is especially true for the impact on the deltoid muscle, the relaxation of which provokes a functional overload of the trapezius muscle. It is for this reason that doctors are trying to find new, more effective algorithms that suggest a lasting result in the treatment of pain in the trapezius muscle.

We offer one of the options for complex therapy of the pain symptom, 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 gives a wonderful relaxing result, provided that the patient has no 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 shoulder girdle massage relieve pain much faster and much more effectively than warming, compresses, rubbing with external anti-inflammatory drugs.
• Correction of cerebrovascular disorders. Most often, nootropic drugs of plant origin, a complex of amino acids are prescribed.
• Conducting gentle visceral manual therapy.
• Manual therapy of functional blocks of the spinal column.
• Manual therapy of the lumbosacral region as an interconnected area (gait reflex).
• Correction of acupuncture imbalance, acupuncture.
• Teaching the patient to independently perform exercises to relax and stretch muscles (post-isometric relaxation).

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

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

The effectiveness of therapy depends on the timely referral of the sick person to the doctor, as well as on his responsible fulfillment of all appointments.

How to Prevent Trapezius Muscle Pain?

Prevention of pain in the trapezius muscle, as one experienced and well-known doctor aptly put it, is getting rid of the “Atlanta and Caryatids” complex. These are the images that we associate with strength and power, because according to myths, they support not only ancient temples in the form of columns, but also the entire firmament. The life of a modern person certainly involves increased stress, but taking on the functions of ancient Greek fairy-tale creatures is inappropriate and unreasonable. It is impossible to carry all the weight of the world on your shoulders and be responsible for everything that happens in the professional sphere, in the country and in the world. It is no coincidence that many practicing doctors associate pain in the muscles of the shoulder girdle with psycho-emotional stress; most often, this syndrome affects hyper-responsible people, perfectionists, and very impressionable individuals. Consequently, primary prevention of pain in the trapezius muscle is a competent distribution of the load, not only physical, but also mental and emotional.

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

• Systematic support of physical activity, sports, fitness.
• Regular warm-ups when doing work that involves monotonous body positions.
• Massage of the collar area, including self-massage.
• Periodic medical examinations, undergoing comprehensive examinations at least once a year.
• Correction of posture and gait, elimination of stooping either independently or with the help of a massage therapist or a special corset.
• Selection of ergonomic, comfortable furniture – table, chair.
• Watching TV, working on a 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.