Understand the symptoms of shoulder pain in the upper trapezius and discover helpful methods for alleviating the pain.
Chiropractic Care for Upper Trapezius Shoulder Pain: A Comprehensive Guide to Relief
Shoulder pain, particularly from the upper trapezius muscle, is a widespread issue that affects people across various walks of life—office workers, athletes, and those managing daily stresses. This pain can limit mobility, disrupt sleep, and reduce overall quality of life. Chiropractic care offers a non-invasive, holistic approach to managing upper trapezius pain by addressing its root causes and promoting long-term recovery. This in-depth guide explores the anatomy and function of the upper trapezius, the causes of associated shoulder pain, the role of myofascial trigger points, and evidence-based nonsurgical treatments, including chiropractic care. Drawing on clinical insights from Dr. Alexander Jimenez, DC, APRN, FNP-BC, a dual-licensed chiropractor and family nurse practitioner, we’ll highlight how integrative care can transform lives for those dealing with shoulder pain.
Understanding the Upper Trapezius Muscle: Anatomy and Function
Anatomy of the Upper Trapezius
The trapezius muscle is a large, triangular muscle spanning the upper back and neck, divided into upper, middle, and lower regions. The upper trapezius originates from the occipital bone at the skull’s base, the ligamentum nuchae (a fibrous neck structure), and the cervical vertebrae’s spinous processes (C1-C7). It inserts into the lateral clavicle, acromion, and scapular spine (Ziaeifar et al., 2019).
Located close to the skin’s surface, the upper trapezius is easily palpable and susceptible to tension or tenderness. It is innervated by the spinal accessory nerve (cranial nerve XI) and receives blood from the occipital artery’s branches, making it a critical structure for shoulder and neck stability.
Biomechanics and Function
The upper trapezius plays a vital role in upper body movement and stability:
Scapular Elevation: It lifts the shoulder blade, as seen when shrugging shoulders.
Scapular Upward Rotation: It aids in rotating the scapula upward, essential for overhead arm movements like reaching or throwing.
Neck Extension and Lateral Flexion: It supports backward head extension and side tilting.
Stabilization: It stabilizes the shoulder girdle during arm movements, ensuring proper alignment.
These functions make the upper trapezius essential for tasks like carrying heavy bags, typing, or engaging in sports like swimming or CrossFit. However, repetitive or static activities can strain this muscle, leading to pain and dysfunction (Brandt et al., 2014).
References:
Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
Causes of Shoulder Pain in the Upper Trapezius
Upper trapezius-related shoulder pain can arise from multiple factors, often related to lifestyle, injury, or biomechanics. Identifying these causes is key to effective treatment.
1. Repetitive Strain and Overuse
Prolonged activities like typing or overhead sports can overwork the upper trapezius, leading to muscle fatigue and tightness. Office workers, for instance, often maintain static postures, increasing strain, while athletes may experience overuse from repetitive motions (Aydın et al., 2021; Silva et al., 2022).
2. Poor Posture
Forward head posture, common among those using computers or smartphones for extended periods, places excessive stress on the upper trapezius. This posture forces the muscle to overcompensate to stabilize the neck and shoulders, leading to pain (Brandt et al., 2014).
3. Stress and Muscle Tension
Psychological stress triggers involuntary tightening of the upper trapezius, as the body responds by tensing neck and shoulder muscles. Chronic stress can perpetuate this tension, causing persistent discomfort (Cleveland Clinic, 2025).
4. Trauma or Injury
Acute injuries, such as whiplash from car accidents or falls, can strain or tear the upper trapezius, resulting in pain and limited mobility. Whiplash-associated disorders (WAD) are particularly linked to trapezius dysfunction (Voerman et al., 2007).
5. Myofascial Trigger Points
Myofascial trigger points are hyperirritable spots within the muscle that cause localized or referred pain. These points often develop in the upper trapezius due to overuse, poor posture, or injury, contributing to shoulder and neck pain (Ziaeifar et al., 2019).
6. Occupational and Ergonomic Factors
Sedentary jobs and poor workstation ergonomics increase the risk of trapezius pain. Inadequate chair support, improper monitor height, or repetitive tasks can exacerbate muscle strain, particularly in office workers (Brandt et al., 2014).
References:
Aydın, N. S., Çelenay, Ş. T., & Özer Kaya, D. (2021). Muscle activation of the upper trapezius and functional typing performance during computer typing task: A comparison of two different wrist immobilization methods. Journal of Bodywork and Movement Therapies, 27, 472–476. https://doi.org/10.1016/j.jbmt.2021.05.001
Silva, E. R., Maffulli, N., & Santos, G. M. (2022). Function, strength, and muscle activation of the shoulder complex in CrossFit practitioners with and without pain: A cross-sectional observational study. Journal of Orthopaedic Surgery and Research, 17(1), 24. https://doi.org/10.1186/s13018-022-02915-x
Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
Voerman, G. E., Vollenbroek-Hutten, M. M. R., & Hermens, H. J. (2007). Upper trapezius muscle activation patterns in neck-shoulder pain patients and healthy controls. European Journal of Applied Physiology, 102(1), 1–9. https://doi.org/10.1007/s00421-006-0215-8
Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
What is Upper Cross Syndrome- Video
Myofascial Trigger Points and Their Impact on Shoulder Pain
What Are Myofascial Trigger Points?
Myofascial trigger points are tight, sensitive areas in skeletal muscle that form palpable nodules within taut muscle bands. These points can cause localized pain or refer pain to other areas, such as the neck, head, or shoulders. In the upper trapezius, trigger points are common due to the muscle’s constant engagement in stabilizing and moving the shoulder girdle (Ziaeifar et al., 2019).
How Trigger Points Cause Shoulder Pain
Trigger points in the upper trapezius contribute to shoulder pain in several ways:
Localized Pain: Trigger points feel like tender knots, causing sharp or aching pain when pressed.
Referred Pain: Pain can radiate to the neck, head (causing tension headaches), or arm.
Restricted Mobility: Muscle tightness limits neck and shoulder movement, making tasks like turning the head or lifting painful.
Muscle Weakness: Chronic trigger points may weaken the upper trapezius, leading to compensatory overuse of other muscles and worsening pain (Stieven et al., 2021).
These points often arise from repetitive strain, poor posture, or stress, creating a cycle of pain and dysfunction if untreated (Cleveland Clinic, 2025).
Clinical Impact
Research shows a strong link between neck/shoulder pain intensity and trapezius muscle tenderness, with higher pain levels corresponding to greater tenderness severity (Brandt et al., 2014). This underscores the importance of targeting trigger points to alleviate chronic shoulder pain.
References:
Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
Stieven, F. F., Ferreira, G. E., de Araújo, F. X., de Medeiros, F. S., da Rosa, L. H. T., de Oliveira, M. X., & da Silva, M. F. (2021). Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 95–102. https://doi.org/10.1016/j.jmpt.2020.07.003
Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
Chiropractic Care for Upper Trapezius Pain: Clinical Rationale
Chiropractic care is a non-invasive, patient-centered approach to managing upper trapezius pain by addressing musculoskeletal dysfunction and promoting healing. Experts like Dr. Alexander Jimenez, DC, APRN, FNP-BC, leverage advanced diagnostics and integrative therapies to provide effective relief.
Why Chiropractic Care Helps
Spinal and Joint Alignment:
Misalignments in the cervical spine or shoulder girdle can exacerbate upper trapezius tension. Chiropractic adjustments restore proper alignment, reducing muscle stress and improving biomechanics (Jimenez, 2025).
Adjustments enhance nerve function, minimizing irritation that contributes to trigger points.
Myofascial Release and Soft Tissue Therapy:
Chiropractors use myofascial release to target trigger points, relieving tension and improving muscle elasticity (Stieven et al., 2021).
These techniques enhance blood flow and reduce stiffness, supporting recovery.
Postural Correction:
Poor posture significantly contributes to upper trapezius pain. Chiropractors assess and correct posture through exercises and ergonomic guidance, reducing muscle strain (Brandt et al., 2014).
Pain Reduction and Mobility:
Chiropractic interventions reduce pain intensity and restore range of motion by addressing muscle and joint dysfunction, enabling patients to resume daily activities (Crookes et al., 2023).
Holistic Approach:
Chiropractors consider lifestyle factors like stress or repetitive activities, offering strategies like stretching or strengthening to prevent pain recurrence (Jimenez, 2025).
Dr. Alexander Jimenez’s Clinical Approach
Dr. Alexander Jimenez, a dual-licensed chiropractor and family nurse practitioner, is renowned for his integrative approach to musculoskeletal health. His practice emphasizes:
Advanced Imaging and Diagnostics: Using X-rays, MRIs, and ultrasound to identify structural issues in the spine and shoulder, such as misalignments or soft tissue damage (Jimenez, 2025).
Dual-Scope Procedures: Combining chiropractic adjustments with diagnostic tools like electromyography (EMG) to assess muscle activation and pinpoint trapezius dysfunction.
Personalized Treatment Plans: Tailoring interventions based on diagnostic findings, incorporating adjustments, myofascial release, and rehabilitative exercises.
Patient Education: Empowering patients with ergonomic advice, posture correction, and lifestyle modifications to prevent pain recurrence.
Dr. Jimenez’s approach aligns with research supporting chiropractic care and soft tissue therapies for reducing shoulder pain and improving function (Jimenez, 2025; Crookes et al., 2023).
References:
Stieven, F. F., Ferreira, G. E., de Araújo, F. X., de Medeiros, F. S., da Rosa, L. H. T., de Oliveira, M. X., & da Silva, M. F. (2021). Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 95–102. https://doi.org/10.1016/j.jmpt.2020.07.003
Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
Crookes, T., Ewald, A., & Jennings, M. (2023). Chronic shoulder pain. Australian Journal of General Practice, 52(11), 753–758. https://doi.org/10.31128/AJGP-04-23-6790
Nonsurgical Treatments for Myofascial Trigger Points in the Upper Trapezius
Several nonsurgical treatments effectively reduce myofascial trigger point pain in the upper trapezius, supported by research evidence. These can complement chiropractic care for optimal outcomes.
1. Dry Needling
Dry needling involves inserting a thin needle into a trigger point to elicit a twitch response, which releases muscle tension and reduces pain. It significantly decreases pain intensity and improves neck and arm function, with effects lasting up to three months (Ziaeifar et al., 2019). It also produces local and distant pain relief (Stieven et al., 2021).
2. Trigger Point Compression
Trigger point compression applies sustained pressure to a trigger point until the muscle relaxes. This technique reduces pain and disability in the upper trapezius, with benefits persisting for months (Ziaeifar et al., 2019). It’s a non-invasive option often used by chiropractors.
3. Myofascial Release
Myofascial release uses gentle, sustained pressure to release fascial restrictions. A single session can increase pressure pain thresholds, reducing pain sensitivity in the upper trapezius (Stieven et al., 2021). It’s commonly integrated into chiropractic treatments.
4. Thermal Ultrasound
Thermal ultrasound uses sound waves to heat and soften trigger points, reducing tissue stiffness. It significantly increases tissue depth (indicating less stiffness) compared to sham treatments, offering a comfortable intervention (Draper et al., 2010).
5. Stretching Relaxation
Daily stretching exercises targeting the upper trapezius reduce tension and stiffness while improving elasticity. A two-week regimen showed significant improvements in muscle properties (Li et al., 2024).
6. Mechanical Vibration Massage
Mechanical vibration massage uses oscillatory devices to decrease tension and stiffness. Applied daily for two weeks, it enhances trapezius muscle elasticity and reduces pain (Li et al., 2024).
7. Pulse Massage
Pulse massage, involving rhythmic pressure, similarly reduces tension and stiffness in the upper trapezius, offering benefits when used consistently (Li et al., 2024).
8. Trigger Point Massage
Trigger point massage applies direct pressure to relieve tension and pain, improving circulation, mobility, and sleep quality. It can be performed at home or by a licensed therapist (Cleveland Clinic, 2025).
9. Rigid Taping
Rigid taping limits wrist movement to reduce upper trapezius strain during tasks like typing. It improves typing performance compared to splinting, making it a practical option for office workers (Aydın et al., 2021).
References:
Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
Stieven, F. F., Ferreira, G. E., de Araújo, F. X., de Medeiros, F. S., da Rosa, L. H. T., de Oliveira, M. X., & da Silva, M. F. (2021). Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 95–102. https://doi.org/10.1016/j.jmpt.2020.07.003
Draper, D. O., Mahaffey, C., Kaiser, D., Eggett, D., & Jarmin, J. (2010). Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles. Physiotherapy Theory and Practice, 26(3), 167–172. https://doi.org/10.3109/09593980903423079
Li, G., Liu, D., Yang, D., & He, L. (2024). The impact of different muscle relaxation techniques on the upper trapezius and its relationship with the middle trapezius. Journal of Physiological Investigation, 67(4), 225–232. https://doi.org/10.4103/ejpi.EJPI-D-24-00041
Aydın, N. S., Çelenay, Ş. T., & Özer Kaya, D. (2021). Muscle activation of the upper trapezius and functional typing performance during computer typing task: A comparison of two different wrist immobilization methods. Journal of Bodywork and Movement Therapies, 27, 472–476. https://doi.org/10.1016/j.jbmt.2021.05.001
Ergonomic Adjustments: Use a supportive chair and position monitors at eye level to maintain neutral posture (Brandt et al., 2014).
Regular Stretching: Perform daily upper trapezius stretches to enhance flexibility (Li et al., 2024).
Stress Management: Practice relaxation techniques like deep breathing or yoga to reduce muscle tension (Cleveland Clinic, 2025).
Strengthening Exercises: Strengthen scapular stabilizers, such as the lower trapezius, to reduce upper trapezius strain (Silva et al., 2022).
Routine Chiropractic Care: Regular adjustments prevent misalignments and maintain muscle function (Jimenez, 2025).
References:
Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
Li, G., Liu, D., Yang, D., & He, L. (2024). The impact of different muscle relaxation techniques on the upper trapezius and its relationship with the middle trapezius. Journal of Physiological Investigation, 67(4), 225–232. https://doi.org/10.4103/ejpi.EJPI-D-24-00041
Silva, E. R., Maffulli, N., & Santos, G. M. (2022). Function, strength, and muscle activation of the shoulder complex in CrossFit practitioners with and without pain: A cross-sectional observational study. Journal of Orthopaedic Surgery and Research, 17(1), 24. https://doi.org/10.1186/s13018-022-02915-x
Upper trapezius shoulder pain, often driven by repetitive strain, poor posture, stress, or myofascial trigger points, can significantly impact daily life. Chiropractic care, combined with nonsurgical treatments like dry needling, myofascial release, and thermal ultrasound, offers a powerful solution to alleviate pain and restore function. Experts like Dr. Alexander Jimenez emphasize integrative, evidence-based approaches to address both symptoms and underlying causes, empowering patients for long-term wellness.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Shoulder pain may have various causes, and persistent or severe symptoms require evaluation by a qualified healthcare provider. Consult a chiropractor, physician, or physical therapist for a proper diagnosis and personalized treatment plan. Seek immediate professional care for chronic or worsening symptoms.
References:
Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
Stieven, F. F., Ferreira, G. E., de Araújo, F. X., de Medeiros, F. S., da Rosa, L. H. T., de Oliveira, M. X., & da Silva, M. F. (2021). Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 95–102. https://doi.org/10.1016/j.jmpt.2020.07.003
Aydın, N. S., Çelenay, Ş. T., & Özer Kaya, D. (2021). Muscle activation of the upper trapezius and functional typing performance during computer typing task: A comparison of two different wrist immobilization methods. Journal of Bodywork and Movement Therapies, 27, 472–476. https://doi.org/10.1016/j.jbmt.2021.05.001
Silva, E. R., Maffulli, N., & Santos, G. M. (2022). Function, strength, and muscle activation of the shoulder complex in CrossFit practitioners with and without pain: A cross-sectional observational study. Journal of Orthopaedic Surgery and Research, 17(1), 24. https://doi.org/10.1186/s13018-022-02915-x
Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
Voerman, G. E., Vollenbroek-Hutten, M. M. R., & Hermens, H. J. (2007). Upper trapezius muscle activation patterns in neck-shoulder pain patients and healthy controls. European Journal of Applied Physiology, 102(1), 1–9. https://doi.org/10.1007/s00421-006-0215-8
Crookes, T., Ewald, A., & Jennings, M. (2023). Chronic shoulder pain. Australian Journal of General Practice, 52(11), 753–758. https://doi.org/10.31128/AJGP-04-23-6790
Draper, D. O., Mahaffey, C., Kaiser, D., Eggett, D., & Jarmin, J. (2010). Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles. Physiotherapy Theory and Practice, 26(3), 167–172. https://doi.org/10.3109/09593980903423079
Li, G., Liu, D., Yang, D., & He, L. (2024). The impact of different muscle relaxation techniques on the upper trapezius and its relationship with the middle trapezius. Journal of Physiological Investigation, 67(4), 225–232. https://doi.org/10.4103/ejpi.EJPI-D-24-00041
The cervical spine has a casual relationship with the central nervous system as the brain and spinal cord works together to send neuron signals through the nerve pathways spread throughout the entire body. The cervical spine is part of the neck, where ligaments and muscles encompass the cervical joints to stabilize the head, neck, and shoulders. The neck has various muscles that support the head and can succumb to various injuries that can cause muscle strain and other associated symptoms that can affect the upper extremities of the body. Today’s article looks at the posterior cervical muscles, how trigger points affect the posterior cervical muscles, and how non-invasive treatments can help manage myofascial cervical pain. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with the neck affecting the posterior cervical muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Are The Posterior Cervical Muscles?
Have you been experiencing random headaches that affect your day? Do you feel any tension in your neck? Or do you experience stiffness and limited mobility when turning your neck? Most of these symptoms are associated with trigger pain affecting the posterior cervical muscle on the neck. The posterior cervical muscles function in the neck’s anatomic region while protecting the cervical spine. The muscles in the cervical spine form a triangle on the neck while providing functionality and movement to the neck, the head, shoulder, and upper back. Some of the muscles that work together with the cervical spine include:
Levator scapulae
SCM (Sternocleidomastiod)
Trapezius
Erector spinae
Deep cervical flexors
Suboccipitals
Semispinalis
Splenius
These muscles and soft tissues provide stability to the neck and work together with the tendons and ligaments to rotate, extend, and retract the head, neck, shoulders, and upper back. To that point, if the neck muscles become strained, it can lead to various issues that can cause pain to the neck and cervical spine.
How Trigger Points Affect The Posterior Cervical Muscles
Studies reveal that a musculoskeletal disorder known as cervical myofascial pain causes the surrounding muscles in the neck and shoulder regions to become tender to the touch and evoke pain in different areas of the body. When the posterior cervical muscle has become strained from various issues like poor posture, over-exercising, getting involved in an auto accident, or have suffered from a degenerative condition, it can cause the muscles to be overused, hypersensitive, and stiff while potentially being at risk of developing trigger points along the neck and shoulder muscles. Trigger points are a bit problematic as they are associated with referred pain and can be either latent or active as they create tiny nodules along the taut muscle fibers in the area. Research studies reveal that referred pain from cervical myofascial pain can be elicited by active trigger points on the affected muscle. To that point, the active trigger points can mimic other pain symptoms along the upper extremities, making diagnosing myofascial pain challenging. Thankfully there are ways to manage trigger point pain associated with the posterior cervical muscles along the neck and cervical spine.
Exercises For Neck & Shoulder Pain-Video
Have you been experiencing stiffness along the sides of your neck or on your shoulders? Do headaches make it impossible to get through an entire day? Or have you been feeling tightness along your jawline? Many people with neck pain and its associated symptoms could risk developing myofascial trigger pain along the posterior cervical muscles. Having myofascial trigger pain associated with the posterior cervical muscle and affecting the neck and upper extremities can cause many people to be miserable; however, there are many ways that people can utilize to relieve the pain along the posterior cervical muscles and manage myofascial cervical pain associated with the neck. The video above provides various neck and shoulder pain exercises correlating with myofascial trigger points. To that point, finding non-invasive available treatments to manage myofascial cervical pain can help reduce the effects of pain along the neck and posterior cervical muscles.
Non-Invasive Treatments To Manage Myofascial Cervical Pain
Many people suffer from neck pain associated with myofascial cervical pain; many factors can contribute to developing tiny nodules along the posterior muscles. Studies reveal that activities, whether work-related or for entertainment, can yield repetitive stress on the muscle groups that cause chronic tension in the muscle fibers to form trigger points. To that point, myofascial trigger pain causes the taut muscle bands to be hyper-sensitive and affect the muscle area. Many people suffering from myofascial trigger pain can utilize non-invasive treatments to manage myofascial pain associated with the posterior cervical muscle. Some of the treatments that help manage myofascial cervical pain include:
Acupuncture
Trigger point release therapy
Chiropractic care
Heat therapy
Exercise/stretching
Many of these treatments help release the trigger points from the affected muscles and help prevent them from re-occurring on the affected muscles along the upper extremities.
Conclusion
The neck has many muscles, ligaments, and tissues that help support the upper extremities of the body. When issues begin to affect the functionality of the neck muscles, it can lead to the development of myofascial trigger pain in the posterior cervical muscles along the neck to cause painful symptoms. This can lead to overlapping chronic issues like stiffness and tenderness in the upper extremities. Non-invasive treatments can help alleviate the pain and manage the symptoms caused by myofascial cervical pain in the upper extremities of the body. This allows the affected muscle to return to its functionality and prevents future issues from affecting the body.
References
Alghadir, Ahmad H, et al. “Efficacy of Combination Therapies on Neck Pain and Muscle Tenderness in Male Patients with Upper Trapezius Active Myofascial Trigger Points.” BioMed Research International, Hindawi, 10 Mar. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085833/.
Fernández-de-Las-Peñas, César, et al. “The Role of Myofascial Trigger Points in Musculoskeletal Pain Syndromes of the Head and Neck.” Current Pain and Headache Reports, U.S. National Library of Medicine, Oct. 2007, https://pubmed.ncbi.nlm.nih.gov/17894927/.
Stathakios, James, and Michael A Carron. “Anatomy, Head and Neck, Posterior Cervical Region.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 27 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK551521/.
Touma, Jeffrey, et al. “Cervical Myofascial Pain.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, https://www.ncbi.nlm.nih.gov/books/NBK507825/.
The jaw has a primary function in the head as it allows the muscles to move up and down, helps chew food, and allows the host to speak. Each of the muscles and organs inside the jaw has its functions that will enable the head to function correctly. The mouth, part of the gut system, allows air to travel into the lungs so the body can breathe and consume food to be swallowed and digested to be turned into energy for the rest of the body to move around. The mouth, the tongue, and the teeth have a casual relationship as the teeth can grind the food into small pieces to be digested, while the tongue can taste the food. When issues begin to cause an effect on the jaw, it can lead to symptoms that can, over time, be painful to the surrounding muscles, organs, and even nerve endings along the jaw’s skeletal structure. Today’s article looks at the medial pterygoid muscle, how trigger point pain affects this muscle, and ways to manage trigger point pain on the medial pterygoid muscle. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger point pain associated with the medial pterygoid muscle along the inside of the jaw. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Medial Pterygoid Muscle?
Do you have any problems or issues chewing your food? What about throat soreness from swallowing something hard? Or have you noticed stiffness along your jawline? Individuals experiencing these symptoms might be dealing with pain along the medial pterygoid muscle in their jaw. The medial pterygoid muscle is part of the mastication muscles, which includes the temporalis, lateral pterygoid, and masseter muscles of the jaw. The medial pterygoid is a rectangular-shaped muscle that lies inside the lateral pterygoid muscle. The medial pterygoid muscle works together with the masseter muscle as a sling to help stabilize the mandible or the lower jaw. In contrast, the medial pterygoid nerves provide sensory-motor functions to make the lower jaw move and promote chewing action, thus sending nerve signals to travel through the trigeminal nerve and send the information to the brain. Just like any of the different muscles in the body, the medial pterygoid muscle may succumb to injuries that can affect the sensory-motor function of the jaw while triggering various issues to cause more pain to the jaw and the body.
How Does Trigger Point Pain Affect The Medial Pterygoid Muscle?
When various issues begin to affect the muscles of the body, it can be something simple like repetitive motions that causes the muscles to be overused or injuries that can cause the muscles to become inflamed and, if not treated, can become sensitive to the touch. To that point, tiny knots known as trigger points are formed along the taut muscle fibers that can make the muscle become sensitive and overlap various issues that can cause pain in different body locations. Since the medial pterygoid and the masseter muscle work together, studies reveal that muscle hypertrophy may associate with the masseter, medial pterygoid, or both and can potentially be involved with the risk of dental problems or other issues that are affecting the oral-facial region. Trigger points along the medial pterygoid muscle may be challenging to diagnose due to the referred pain that affects different body areas while mimicking various pain symptoms that become the causes. An example would be a person experiencing ear pain associated with jaw pain. Now how would these two correlate when the person is dealing with ear pain? Since trigger points can mimic other symptoms, the jaw muscles (which include the medial pterygoid) become aggravated and overused, causing referred pain to the teeth overlapping with ear pain.
The Anatomy Of The Medial Pterygoid Muscle-Video
Have you been experiencing unexplainable ear pain? What about your jaws feeling stiff when chewing on something? Or have you been dealing with tooth pain in the back of your jaw? Many of these issues are correlated to referred pain symptoms associated with the medial pterygoid. The video above gives an overview look of the anatomy of the medial pterygoid muscle, its functions, and how it helps the body. When the medial pterygoid is affected by trigger point pain, it may potentially cause various conditions to affect the oral facial region or the surrounding areas of the head. Studies reveal that myofascial pain is often characterized by a trigger point in the taut skeletal muscle band or the fascia. When trigger point pain affects the mastication muscles, it may lead to other comorbidities like muscle tension, poor posture, headaches, and jaw disorders like TMJ(temporomandibular joint) pain. Fortunately, there are ways to manage trigger point pain on the medial pterygoid muscle.
Ways To Manage Trigger Point Pain On The Medial Pterygoid Muscle
Trigger point pain often affects the muscles in certain body areas, causing pain that affects the region of the body, thus making the muscle sensitive. Many individuals who suffer from trigger point pain associated with the medial pterygoid muscle would often complain of toothaches or headaches affecting their daily activities to their primary doctors. After an examination, many doctors would refer their patients to musculoskeletal specialists to see what issue is causing the patient pain in their bodies. Since trigger point pain is a bit complex, musculoskeletal specialists like chiropractors or physical therapists will examine trigger points associated with pain. Many musculoskeletal specialists utilize various techniques to release trigger points along the affected muscle to manage the pain and its related symptoms. At the same time, many musculoskeletal specialists incorporate other multiple treatments to help manage trigger point pain on the medial pterygoid muscle. These various treatments allow the muscles to relax and avoid a relapse in future injuries affecting the muscle.
Conclusion
The primary function of the jaw in the head is to allow the muscles to move up and down, enabling the host to speak and help the mouth chew food. The medial pterygoid is one of the four main mastication muscles that help support the jaw, which is rectangular shaped and helps stabilize the lower jaw. This muscle allows the sensory-motor function of the lower jaw and promotes chewing action. When traumatic or ordinary factors cause the medial pterygoid muscles to become overused can developed trigger points along the muscle fibers and initiate pain associated with toothaches and headaches. Trigger points along the medial pterygoid muscle can make the affected area sensitive and challenging to pinpoint. Fortunately, musculoskeletal specialists like chiropractors or physical specialists can help alleviate the pain while managing trigger points on the affected muscle through various techniques. When people begin to incorporate treatments to manage pain in their bodies, it can allow them to be mindful and avoid future injuries.
References
Guruprasad, R, et al. “Masseter and Medial Pterygoid Muscle Hypertrophy.” BMJ Case Reports, BMJ Publishing Group, 26 Sept. 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185404/.
Jain, Prachi, and Manu Rathee. “Anatomy, Head and Neck, Medial (Internal) Pterygoid Nerve.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 June 2022, https://www.ncbi.nlm.nih.gov/books/NBK547712/.
Jain, Prachi, and Manu Rathee. “Anatomy, Head and Neck, Medial Pterygoid Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 June 2022, https://www.ncbi.nlm.nih.gov/books/NBK546588/.
Sabeh, Abrar Majed, et al. “Myofascial Pain Syndrome and Its Relation to Trigger Points, Facial Form, Muscular Hypertrophy, Deflection, Joint Loading, Body Mass Index, Age and Educational Status.” Journal of International Society of Preventive & Community Dentistry, Wolters Kluwer – Medknow, 24 Nov. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791579/.
The head has many functions that provide the body with functionality. The head consists of the skull, which protects the brain, the eyes to make the host see, and the jaw, which has teeth and the tongue to taste and chew food. The neck supports the head to ensure that it is stabilized and functions appropriately. Below the eyes, the jaw has muscles and joints that help stabilize the jaw from hyperextending out while providing motor function. To that point, factors that can affect the jaw could potentially affect the surrounding muscles and joints on the head and neck, causing the individual to be in pain. Today’s article looks at the masseter muscles, how myofascial pain affects the masseter muscles, and ways to relieve myofascial pain associated with the masseter muscles. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial pain associated with masseter muscle pain along the jaw. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Masseter Muscle?
Have you been experiencing headaches located near your temples? Does your jaw feel sore throughout the entire day? Or have tooth pain or ear pain seems to bother you constantly? Some of these symptoms may affect your jaw joints, especially in the masseter muscles. The masseter muscles are powerful quadrangular muscles on each side of the jaw with three divisions: superficial, intermediate, and deep. The masseter muscles are also part of the mastication muscles in the jaw which include:
Temporalis
Medial pterygoid
Lateral pterygoid
Masseter muscles
The masseter muscles also help the jaw function properly, as studies reveal that this quadrangular muscle participates in various activities like mastication (chewing), swallowing, and talking. To that point, the masseter muscles have a relationship with the trigeminal nerve, which provides sensory-motor stimulation for the jaw to move. However, when factors (traumatic or ordinary) begin to affect the masseter muscles and the surrounding muscles associated with the neck and head, pain can either slowly or quickly depending on the severity the muscles have endured.
How Myofascial Pain Affects The Masseter Muscle?
Studies reveal that chronic pain in the orofacial region of the body is common worldwide and can cause disorders affecting jaw motor control. When painful symptoms affect the jaw, many individuals begin to feel pain in the top or bottom of their jaws that cause tooth pain and the brows, causing them cluster-like headaches or experiencing tinnitus (ringing in the ears). These symptoms are associated with myofascial pain affecting the masseter muscles in the jaw. Myofascial pain or trigger points are where the muscle fibers in the body become sensitive after being injured or overused. To that point, the muscle fibers developed tiny knots along the taut muscle bands and caused pain throughout the entire muscle. Myofascial pain can be tricky to diagnose due to mimicking other pain symptoms. For trigger pain to affect the masseter muscles, studies reveal that temporomandibular disorders that involve the oral-facial region may be multifactorial while affecting the masticatory muscles and the temporomandibular joints. To that point, myofascial masseter pain could potentially involve ailments like migraines, toothaches, TMJ (temporomandibular joint) dysfunction, and ear pain.
According to Dr. Janet G. Travell, M.D., complex symptoms and overlapping patterns of facial pain might be referred from multiple trigger points in the head and neck muscles, which can be more easily traced back to the individual’s muscles. By finding the root cause of these symptoms, many doctors can develop a clinical process to assess their patients dealing with myofascial trigger pain and develop a plan that caters to their wants and needs.
Stretching The Masseter Muscles-Video
Do headaches seem to be affecting your daily routine? Have you felt that your jaw feels stiff and has a dull ache when you move your mouth open? Or do you feel pain along the sides of your teeth? Many of these symptoms are referred pain associated with myofascial masseter pain. The video above demonstrates stretching the masseter muscles to reduce trigger pain along the muscle structure. Myofascial pain related to the masseter muscles can make it difficult for doctors to diagnose their patients due to the pain traveling to different areas in the body, known as somato-visceral pain. Somato-visceral pain is pain affecting the muscle connected to an affected organ. An example would be jaw pain associated with a toothache while potentially involving the masseter muscles. Thankfully, treatments are available to relieve myofascial pain along the masseter muscle.
Ways To Relieve Myofascial Pain In The Masseter Muscles
Myofascial pain affecting the masseter muscle could cause pain in the surrounding muscles and organs in the oral-facial region. The symptoms caused by myofascial pain associated with masseter muscles may be complex and challenging to diagnose due to the pain affecting different body regions. Fortunately, many doctors refer musculoskeletal specialists like chiropractors, massage therapists, and physiotherapists to relieve myofascial muscle pain associated with the masseter muscles by providing pain relief techniques. Some of the various methods that help ease trigger pain from the masseter muscles include:
Stretch & Spray: Stretching the jaw slowly to the full extent and spraying coolant along the masseter muscle to relieve pain
Jaw Exercising: Yawning, extending, and retracting the masseter muscle to stretch and strengthen the jaw.
A warm compress on the cheek: Helps relax the aggravating muscle and releases any tension causing myofascial pain.
Studies reveal that soft tissue mobilization is one of the various techniques that can help relieve trigger pain in masseter muscles. What soft tissue mobilization does is that it allows musculoskeletal specialists to use a pincer method to lengthen the masseter muscle to an extent and release trigger points in slow downward traction to alleviate the pain from the masseter muscles. Utilizing these various treatments can help many people with myofascial pain associated with masseter muscles feel relief from jaw pain and its related symptoms.
Conclusion
The masseter is a quadrangular muscle that surrounds each side of the jaw and helps stabilize the jaw’s motor function. When injuries or traumatic factors begin to affect the jaw, over time can lead to the development to trigger point pain associated with masseter muscles. When trigger point pain affects the masseter muscles in the oral-facial region, it can cause somato-visceral pain alongside the jaw affecting the teeth, causing tinnitus symptoms and headaches. Fortunately, various treatments are available to help manage trigger pain and relieve the associated symptoms that affect the masseter muscles. This allows many individuals to get back their health by being pain-free.
References
Al Sayegh, Samaa, et al. “Effects of Chronic and Experimental Acute Masseter Pain on Precision Biting Behavior in Humans.” Frontiers in Physiology, Frontiers Media S.A., 29 Oct. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6828929/.
Corcoran, Nicholas M, and Evan M Goldman. “Anatomy, Head and Neck, Masseter Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 June 2022, https://www.ncbi.nlm.nih.gov/books/NBK539869/.
Kuć, Joanna, et al. “Evaluation of Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral.” International Journal of Environmental Research and Public Health, MDPI, 21 Dec. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767373/.
Maini, Kushagra, and Anterpreet Dua. “Temporomandibular Syndrome.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 28 Apr. 2022, https://www.ncbi.nlm.nih.gov/books/NBK551612/.
Widmer, C G, et al. “Developmental and Functional Considerations of Masseter Muscle Partitioning.” Archives of Oral Biology, U.S. National Library of Medicine, Apr. 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861846/.
The body incorporates different muscles that have specific jobs to help mobilize the skeletal joints while providing function to the arms, neck, legs, and back. Many individuals use their muscles for everyday uses like lifting and carrying objects, moving from one place to another, and protecting vital organs from damage. To that point, issues like traumatic events, injuries, and environmental factors can affect the body and cause damage to the muscles. When the muscles are affected by these factors, tiny knots can form along the taut muscle band that can cause painful symptoms that affect specific areas in the body. One of the muscles affected by pain is the trapezius muscle, known as the “coat hanger” muscle, which can be associated with chronic symptoms of myofascial pain syndrome. Today’s article examines the trapezius muscle, how myofascial pain affects the trapezius muscle, and how to manage myofascial trapezius pain. We refer patients to certified providers specializing in musculoskeletal treatments to aid individuals suffering from trapezius muscle pain associated with myofascial pain. We also guide our patients by referring them to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC provides this information as an educational service only. Disclaimer
What Is The Trapezius Muscle?
Have you experienced pain in your neck, shoulders, or mid-upper back? Do you feel headaches occurring near your temples? What about tenderness in certain areas of your body? Some of these symptoms may appear in your trapezius muscles. The trapezius muscle is located across the back that looks like a simple trapezoid with upper, middle, and lower muscle fibers that have different functions for the upper-middle back, shoulders, and neck. While the entire trapezius muscle helps rotates, elevate, and retract the scapula while extending the head and neck, and turning the chin by itself. At the same time, the entire muscle can help with assisting the extension of the cervical and thoracic spine.
Upper Trapezius muscles: allow the shoulders to rise, bend the head and neck, and help support the weight of the upper extremities of the body, including the arms.
Middle Trapezius muscles: assist with flexion and abduction of the arms around the shoulders at a nearly full range.
Lower Trapezius muscles: Helps retract the scapula while rotating the glenoid fossa upwards by decompressing the vertebral borders of the scapula. These fibers help assist the flexion and abduction of the arms.
When traumatic forces or injuries affect the trapezius muscles, painful symptoms begin to affect the muscles, causing them to be tender to the touch and affecting different areas in the body.
How Does Myofascial Pain Affect The Trapezius Muscle?
When traumatic forces or injuries affect the trapezius muscles, certain parts of the shoulders, neck, and upper-mid back will experience pain-related symptoms. When people experience headaches and shoulder and neck pain in their bodies while feeling tenderness in their trapezius muscles, this is known as referred pain associated with myofascial pain. Myofascial pain is when tiny knots along the taut muscle bands begin to make the muscle area tender to the touch. Individuals who suffer from myofascial pain in their trapezius muscles might experience hyperirritable spots that inflict pain and motor dysfunction. Studies reveal that individuals who work in food services may have symptoms of shoulder pain associated with myofascial pain due to repetitive motions on the upper trapezius muscles affecting their upper bodies. Myofascial trigger pain is a bit challenging to diagnose since the pain can be in different locations and mimic various ailments in the body. To that point, when the trapezius muscles are affected by trigger pain may potentially be involved with cervical myofascial pain. Cervical myofascial pain is a disorder that causes pain from muscle overuse or trauma in the neck. When the pain affects the neck muscles, it can travel down to the trapezius muscles causing tenderness and sensitivity in the affected muscle area. Stress, postural mechanics, or repetitive movements can develop myofascial pain syndrome and affect the surrounding muscles.
Trapezius Trigger Points- Video
Have you felt sore around your shoulders, neck, and upper-mid back? What about muscle tenderness in certain areas of your body? Do you feel tension along your neck or near the temples of your head? If you have been dealing with any of these symptoms, then you might be experiencing myofascial trapezius pain. The video above explains how trigger points from traumatic events can affect the trapezius muscle and cause referred pain that overlaps other conditions that may affect the body. Studies reveal that trigger points in the head and neck muscles of many suffering individuals have tension-type headaches. Tension-type headaches are one of the symptoms associated with myofascial trapezius pain. Some of the other symptoms related to myofascial pain affecting the trapezius muscle include:
Deep aching pain
Stiffness
Muscle spasms
Tightness around the shoulder and neck
Tenderness along the shoulders, neck, and upper back
Occipital headaches
How To Manage Myofascial Trapezius Pain
When many individuals suffer from myofascial trapezius pain, many would go to their primary doctor and explain to them that they are experiencing tension headaches constantly. Since myofascial pain is associated with the trapezius muscle is a bit complex and challenging for doctors to diagnose since every person’s pain is different. Many doctors will refer their patients to associated specialists like physical therapists, massage therapists, or chiropractors to determine where the pain is located along the trapezius muscle. Different treatments can help alleviate stiff muscles, and studies reveal that spinal manipulative therapy can help manage chronic pain from myofascial origins. Spinal subluxations or misalignment could potentially involve the corresponding spinal nerve root causing antinociceptive effects to the tender muscle, thus causing pain to the trapezius muscle. Utilizing various treatments to treat myofascial trapezius pain can provide individuals with beneficial relief from their pain along with managing their associated symptoms.
Conclusion
The trapezius muscle is a large superficial trapezoid-shaped muscle located in the back. The upper, middle, and lower muscle fibers have different functions in the head, neck, shoulders, and arms. The trapezius muscle also helps with assisting the extension of the cervical and thoracic spine. When traumatic events or injuries affect the trapezius muscle, it can be developed over time to create trigger points along the taut muscle band of the trapezius muscle and cause referred pain to the upper extremities of the body. Luckily various treatments can help manage the associated pain symptoms from myofascial trapezius pain and can help many individuals get back on their health and wellness journey.
References
Fernández-de-Las-Peñas, César, et al. “Myofascial Trigger Points and Their Relationship to Headache Clinical Parameters in Chronic Tension-Type Headache.” Headache, U.S. National Library of Medicine, Sept. 2006, https://pubmed.ncbi.nlm.nih.gov/16942471/.
Hwang, Ui-Jae, et al. “Predictors of Upper Trapezius Pain with Myofascial Trigger Points in Food Service Workers: The Strobe Study.” Medicine, Wolters Kluwer Health, June 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500039.
Laframboise, Michelle A, et al. “Effect of Two Consecutive Spinal Manipulations in a Single Session on Myofascial Pain Pressure Sensitivity: A Randomized Controlled Trial.” The Journal of the Canadian Chiropractic Association, Canadian Chiropractic Association, June 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915475/.
Ourieff, Jared, et al. “Anatomy, Back, Trapezius – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 26 July 2021, https://www.ncbi.nlm.nih.gov/books/NBK518994/.
Touma, Jeffrey, et al. “Cervical Myofascial Pain – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, https://www.ncbi.nlm.nih.gov/books/NBK507825/.
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