Have you ever found yourself trapped in your desk chair, wondering what that nagging pain in your shoulder and neck is? Could you have possibly suffered from an upper back muscle strain, such as a trapezius strain?
Your trapezius is a large muscle that engages each time you shrug, reach, or lift. Understandably, trapezius pain may affect almost every facet of your daily life.
So, what exactly causes it? How can you get rid of it, A.S.A.P.? Let’s dive right into the article and learn how to untrap ourselves from the discomfort.
Can a Tight Trapezius Cause Shoulder and Neck Pain?
Yes, a tight trapezius muscle can show up as shoulder and neck pain. Shoulder and neck pain are common complaints that may appear from a wide range of causes. Trapezius-related pain is just one of them.
Speaking of the trapezius, it’s a large muscle that spans across your upper back. When pain specifically affects this area, it is termed trapezius myalgia, a term that literally translates to muscle pain in the trapezius.
Before we discuss the connection between the trapezius and shoulder and neck pain, let’s briefly go through some anatomy.
Introduction: Around the Trapezius
The trapezius (or simply “the trap/s”) is a trapezoid-shaped muscle. It covers a chunky portion of the upper back, as we discussed previously.
The fibers of the trapezius muscle span from the upper neck to the thoracic region and comprise three groups. Each group plays a different role, as follows:
- Superior or upper fibers
These fibers elevate (lift) the shoulder blades or scapulae. They’re the ones that most commonly become tight or painful.
- Transverse or middle fibers
These retract (“squeeze”) the shoulder blades.
- Inferior or lower fibers
These depress the shoulder blades (pull them downward).
Through these functions, the trapezius also helps with:
- Stabilizing the shoulder blades
- Shrugging and rotating the shoulders
- Tilting and turning the head
- Twisting the upper arm inwards
- Throwing movements of the arm
Now that we’ve got the anatomy out of the way, let’s see how trapezius myalgia may affect the shoulder.
What Causes Extremely Tight Traps?
As we said, a tight, painful, and stiff trapezius may signal the presence of trapezius myalgia. Trapezius myalgia may be associated with one or a few of the following causes:
- Trapezius trigger point activation
Trigger points are specific spots in the fascia (the connective tissue) surrounding the trapezius. These may become overly sensitive and form painful knots. Active trigger points are commonly associated with monotonous jobs that involve repetitive work.
- Muscle spasms and strains
Spasms and strains may result from frequent and long static muscle contractions or tension. This happens after holding your muscles in the same position for a long time.
An example is performing a job that requires maintaining the same poor posture for hours a day. The posture most often associated with a tight trapezius is the forward-head-and-rounded-shoulder posture.
According to a 2014 review, maintaining the same position and posture can cause trap tightness and pain by leading to:- Continuous, low-level activity of trapezius fibers
- Reduced blood flow to the trapezius
- Accumulation of too much calcium (which adds to the contraction activity)
- Excessive physical activity or overuse
Activities like lifting heavy objects or weights, swimming, or rowing for too long can damage your traps.
- Nerve injuries and other traumatic injuries
Accidents that cause whiplash (such as car crashes) could lead to nerve injuries affecting the trapezius muscle.
What Are the Trigger Points for a Tight Trapezius?
As mentioned, trigger points may be crucial for the development of trapezius myalgia.
A vital trigger point is located on the upper trap, halfway between the base of your neck and your shoulder tip. Targeting this trigger point, for example, during massage or acupuncture therapy, may provide quick relief.
What Are the Symptoms of Trapezius Myalgia?
The following symptoms generally characterize trapezius myalgia:
- Severe, sharp shoulder and neck pain that appears suddenly
- Muscle tenderness, stiffness, and spasms
- Tightness of the neck and shoulders
- Headache on the back of the head (occipital region)
- The feeling of having a “heavy head”
- Depressive symptoms, such as low mood
- Sleep-related problems
- Sensation changes and other neurological symptoms
What Aggravates Trapezius Muscle Pain?
Risk factors (other than the ones we listed) that may make trapezius pain worse include:
- Psychosocial work factors, such as:
- Lack of support from colleagues
- Mental stress at work
- High time pressure
- Low job satisfaction
- Boring work tasks
- Physical inactivity and (conversely) extreme workouts
- Prolonged work in front of a computer screen
- White-collar jobs (accountant, financial analyst, call agent, etc.)
Studies also suggest that people with lower incomes get trapezius myalgia more often. In addition, women generally suffer from trap pain more often than men.
So, if you ever feel like your pain is “all in your head,” there’s a clear possibility that it's not. Solid research supports the link between trapezius pain and challenging work environments. You're not alone, and your pain is definitely real.
Why Does My Trap Hurt When I Shrug?
If shrugging triggers sharp shoulder and neck muscle pain, you might have damaged your trapezius. As said, the trapezius is involved in moving your shoulders and shoulder blades up and down. This is the main movement that occurs when shrugging.
If shrugging is overdone during workouts, it can place extreme strain on the trapezius.
Exercises that involve pushing or pressing, such as bench and shoulder presses, are examples of such workouts. The main cause of muscle damage may be a posture with rounded shoulders and a forward-positioned head.
This is also the position that weightlifters usually take when they are tired of trying to get that last rep.
Hence, try to maintain the correct technique and know your limits! Give your trapezius enough rest and stretch before and after a workout.
What Causes Chronic Trapezius Muscle Pain?
Chronic trapezius myalgia is a trapezius muscle ache that persists for more than six months. It can be caused by prolonged exposure to the causes that we mentioned. A 2014 review shows it may affect 10–20% of people with neck and shoulder muscle pain.
The same study shows that chronic trap pain may not only arise from brain signals but also from direct muscle changes. This finding is based on the reported increased levels of certain markers, such as:
- 5-HT (5-hydroxytryptamine or serotonin)
- Glutamic acid
- Lactic acid
- Pyruvic acid
Collectively, these elevated markers suggest altered pain perception, nerve signaling, muscle fatigue, and metabolic stress. This comprehensive view highlights that pain is not merely psychological but has a significant physical component.
Can a Tight Trapezius Cause Nerve Pain?
Yes! A tight and imbalanced trapezius can lead to nerve pain, too.
Tight traps may directly compress nearby nerves, causing shoulder and neck pain. On the bright side, muscle tightness, soreness, or spasm usually goes away by itself after a few days. This means the pain may go away shortly, too.
However, nerve pain may also come in the form of a condition called shoulder impingement syndrome.
Shoulder impingement can happen when the trapezius muscle doesn't work as it should.
As we mentioned earlier, the trapezius has different parts, like the upper and lower muscle fibers.
The lower parts help keep your shoulder blade steady and help your shoulder move correctly. If these lower parts don't tighten or work enough, or if the upper parts work too much, it can affect how your shoulder joint moves. This imbalance can lead to shoulder impingement.
Shoulder impingement from a tight or imbalanced trap may manifest primarily as shoulder pain. The pain is commonly felt on the top and outer sides of your shoulder. It gets worse when you lift your arm above your head. It can also worsen at night and affect your sleep.
Symptoms may involve your arm and hand as well, causing:
- Numbness
- Weakness
- Tingling sensations
Dysfunction of the trapezius can also result in a “winged scapula.” A winged scapula is an abnormal position of the shoulder blade, which gives it a wing-like appearance. It’s associated with a lack of shoulder blade stabilization.
The other way around can also happen! Damage to the nerves might make the trapezius muscle hurt. Let's look into that.
What Nerve Causes Trapezius Pain?
Trapezius pain is often the result of damage to the nerve that powers it, the spinal accessory nerve. The accessory nerve is the eleventh cranial nerve. It originates from the brainstem and spinal cord.
- Muscle tightness or spasms (for example, during exercise or sudden movements)
- Trauma to the neck
- Surgery to the neck
- A jerking injury of the arm
- A jerking injury of the neck
What Does a Pinched Nerve in the Trapezius Feel Like?
A pinched or damaged accessory nerve (the nerve that powers the trapezius) might give rise to:
- Trapezius muscle pain
The pain may go away on its own in a few days if it originated from temporary muscle tightness.
- Trapezius wasting (atrophy)
- One shoulder being visibly lower than the other
- Muscle weakness (especially when shrugging or raising your arms)
- Decreased range of movement (ROM) at the shoulder joint
How Do I Relieve Chronic Trapezius Pain?
Treating chronic trapezius pain can provide incredible relief and significantly improve life quality.
The first step to getting rid of your pain is addressing your problem. By this, we mean you should consult your doctor to achieve the most effective and quickest relief.
Some of the methods that healthcare providers choose to treat chronic trap pain include:
1. Painkiller Medications
These are medications that can soothe neck pain. Tylenol and NSAIDs (like Ibuprofen) are handy examples.
2. Steroid Injections
Steroid injections may be next in line for chronic pain relief if painkillers don’t work. Steroids ease pain by reducing inflammation.
3. Physical Therapy and Exercise
Exercise is one of the best ways to relieve pain and recover from trapezius myalgia. This theory isn’t something we’re saying out of thin air! Science backs it up, too! Strength training (working out with weights) may be especially helpful.
The key to physical therapy is starting slowly and gradually increasing exercise intensity.
Remember: It’s wise to always consult your doctor before starting a new exercise. This way, you can prevent further damage to your trapezius and other muscles.
The exercises are usually divided into warm-up exercises and strengthening exercises.
3.1. Warm-Up Trapezius Exercises
Let us show you a few useful trap stretches that warm up your trapezius:
- Shoulder Rolls
Sit or stand with good posture. First, roll both shoulders back and down. Then, roll them forward and up in a circular motion. Start with small circles and gradually make the circles larger. Repeat for 30-60 seconds in each direction.
- Neck Flexion Stretch
Sit or stand upright in good posture. Slowly bring your chin in towards your chest without tilting your head. You’ll feel like you’re giving yourself a double chin (don’t get distracted by laughing). Hold for three seconds and relax. Repeat 10-15 times.
- Upper Trap Side Bends
Sit upright in a chair (always keeping your posture in check). Tilt your head to one side, with your ear toward your shoulder. Keep your eyes and nose pointed forward. Hold the tilted head position for three seconds and return to the starting position. Perform 10-15 on each side.
- Upper Trap Head Tilts
Sit upright in a chair that allows for good posture. Hold the bottom of the chair with one hand and tilt your head to the opposite side. You can use your hand to help tilt your head further. Repeat ten times on both sides.
- Middle Trapezius Stretch
While sitting or standing, place your hands and forearms together in front of your face. Pull your shoulders and shoulder blades forward until you feel a stretch along your back. Hold the position for 15–30 seconds and repeat 3-5 times.
- Sideways Child’s Pose
This yoga pose requires standing on all fours (hands under shoulders, knees under feet). Gently lower your hips to your heels, letting your chest come down to the floor. Hold this position and bring both of your hands to one side. Hold for 30 seconds. Repeat 2-3 times on each side.
- Massage Ball Stretches
Stand with your back against a wall and place the ball behind your back over the trapezius area. Lean back to apply pressure and stretch the trapezius. Hold for 30-60 seconds first, then progress to 1-2 minutes.
3.2. Strength Trapezius Exercises
After getting familiar with trap stretches, you may continue with strength exercises, such as:
- Shoulder blade (scapular) strengthening exercises
These exercises help trapezius function and recovery by stabilizing the shoulder blades. They can be performed with or without the help of a wall and resistance bands.
- Shoulder shrugs
While standing, slowly elevate the shoulders, then bring them back to the starting position. Focus on contracting the upper trapezius muscle. After gaining some strength, repeat the exercise with dumbbells in your hands.
- One-arm row
Stand upright, holding a dumbbell in your right hand. Bend your upper body forward about 30° and put your left knee on a bench (or couch) while keeping your right foot on the floor. Slowly pull the dumbbell towards your chest while keeping your left arm extended on the bench for support. Repeat on the other side.
- Upright row
Standing upright, hold a dumbbell in each hand. Keep your arms hanging and relaxed. Lift the dumbbells toward the chest in a vertical line close to the body while flexing the elbows and abducting the shoulders. Your elbows should be pointing forward and upward.
- Reverse flies
Start by lying prone on a bench at a 45° angle from horizontal. Take a dumbbell in each hand. Your arms should be pointing towards the floor. Raise the dumbbells until the upper arms are horizontal. Your elbows should be slightly bent.
- Lateral raise
Stand upright and hold dumbbells in each arm. Move your shoulders outward until the upper arms are horizontal. Your elbows should be slightly bent all the time.
4. Biofeedback Training and Ergonomic Advice
The biofeedback approach involves teaching patients how to cope with their pain. Patients with trapezius pain may be advised to be more self-aware and attentive when doing computer work, for example.
According to a 2008 study, the biofeedback approach may benefit pain relief.
5. Radiofrequency ablation (RFA)
This technique uses radiofrequency waves to “numb the pain” by blocking nerve function. It applies a tissue-specific needle.
6. Other methods
Other methods with short-term effects on pain include:
- Heat therapy for shoulder and neck pain
- Manual therapy
- Massage therapy
- Acupuncture therapy and dry needling
- Transcutaneous Electric Nerve Stimulation (TENS)
To effectively ease your pain, though, your doctor will first need to diagnose your trapezius pain.
They’ll start by asking you a few questions regarding your pain. Then, they’ll typically perform a physical examination by testing:
- Shoulder and neck range of motion (active and passive)
- Muscle strength
- Sensitivity of trigger points (knots or painful spots) through palpation
- Neurological function
How Do I Loosen My Tight Trapezius Muscle?
Are you wondering if there’s something you can do yourself to release and relax tight traps? Well, prevention is often the best cure. Here are a few essential tips on how to ease pain and prevent further damage:
- Try to maintain a straight posture at work and even while sleeping
A bad posture can negatively affect joints, muscles, and mental health. You can improve it by tending to the following daily advice:- Think that you’re standing up tall and straight (and proud).
- Tuck your chin inside.
- Keep your shoulder blades back.
- Keep your rib cage relaxed.
- Keep your pelvis area in a neutral, straight position.
- Gently engage your abs.
- Keep your feet shoulder-width apart.
- Spread your weight evenly on your feet.
- When using your phone, hold it up so you aren’t looking down.
- Avoid repetitive work as much as you can.
- Don’t sit for too long.
- Include exercise in your daily regime.
- Apply a warm compress over your neck and shoulders.
- Try to avoid stress (try meditation or yoga).
- Seek medical care if your shoulder and neck pain persists.
Does Massage Help Trapezius Pain?
Yes, a massage may also help with trap-related shoulder and neck pain. Various types of massages may be effective against pain.
You can even perform a shoulder and neck massage on yourself! If you’re wondering how, we’ve got you.
Try kneading down on each side of your neck and shoulders with your opposite hand. Apply gentle pressure with your fingertips in a circular motion. Work your way slowly toward the side of your neck and the back of your shoulders, where your upper trap fibers pass.
For a comprehensive and professional massage session, consult your therapist.
Takeaway
A tight trapezius muscle can show up as shoulder and neck pain. Trapezius pain is known as trapezius myalgia, which means muscle pain.
Trapezius myalgia can happen for a few reasons:
- Trapezius trigger point activation
- Muscle spasms and strains
- Excessive physical activity or overuse
- Nerve injuries and other traumatic injuries
The following symptoms characterize trapezius myalgia:
- Severe, sharp shoulder and neck pain that appears suddenly
- Muscle tenderness, stiffness, and spasms
- Tightness of the neck and shoulders
- Headache on the back of the head (occipital region)
- The feeling of having a “heavy head.”
- Depressive symptoms, such as low mood
- Sleep-related problems
- Sensation changes and other neurological symptoms
Trapezius myalgia is also more common in lower-income groups. In addition, women generally suffer from trap pain more often than men.
Chronic trap pain may affect 10-20% of people with neck and shoulder pain.
A tight and imbalanced trapezius can lead to nerve pain, too. Tight traps may directly compress nearby nerves, causing shoulder and neck pain. Muscle tightness, soreness, or spasm usually goes away by itself after a few days.
Nerve pain may also come in the form of shoulder impingement syndrome.
Shoulder impingement from a tight or imbalanced trap may manifest primarily as shoulder pain.
Trapezius pain is often the result of damage to the nerve that supplies it, the spinal accessory nerve.
Treating chronic trapezius pain can provide incredible relief and significantly improve life quality. The first step to getting rid of your pain is addressing your problem. By this, we mean you should consult a medical professional for a proper diagnosis and the most effective treatment.
Some of the medical therapies for chronic trap pain include:
- Painkiller medications
- Steroid injections
- Physical therapy exercise
- Biofeedback training and ergonomic advice
- Radiofrequency ablation (RFA)
- Heat therapy for shoulder and neck pain
- Manual therapy
- Massage therapy
- Acupuncture therapy and dry needling
- Transcutaneous Electric Nerve Stimulation (TENS)
The key to physical therapy is starting slowly and gradually increasing exercise intensity.
