Pain in the trapezius muscle

Pain in the trapezius muscle is one of the most common pain syndromes, it is in this zone that most often there are overvoltage points. Trapezius muscle is not accidentally called one of the most vulnerable, according to statistics, myalgia in this zone ranks second, giving priority to pain in the lumbosacral spine.

The muscle consists of different in structure fibers and layers, from which the upper forms the shoulder, controls its movements, the middle layer is responsible for the mobility of the scapula as well as the lower muscle fibers. Overexertion, spasm or vice versa, weakness in these structures provoke a pain sensation in the trapezius muscle.

[1], [2], [3]

Causes of pain in the trapezius muscle

Most often, the causes of the pain symptom in the collar zone are associated with overstrain of the muscles, less often with their stretching as a result of intensive training. It's no secret that many representatives of the stronger sex seek to pump the trapezius muscle and create an impressive cervical-shoulder relief. Sometimes, without calculating its resources, the muscle is subjected to excessive stress, its fibers are injured, and pain arises.

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

Factor, the cause that causes pain	Explanation
Overstretch of the trapezius muscle	Insufficient warm-up before training, sharp movements of a head, a neck, lifting of gravity in snatch, including in sports (a bar). The pain symptom is clearly associated with a provoking factor
Muscular contusion (injury)	Typical injury to athletes. Pain in the muscles occurs after the formed hematoma, which activates the myofascial trigger point
Tendonitis of the tendon, migelosis (painful compaction)	Degenerative process in the tendon, cartilage tissues at the point of attachment of the trapezius, rhomboid muscles to the spinous processes of the vertebrae (cervical section). The disease is most often provoked by sports overloads
Permanent traumatization of the trapezius muscle	Performing monotonous movements - head turns, movement of the neck, shoulder girdle, shoulder blades. Stereotyped chronic overstrain is inherent in certain occupations, art forms (dancers, gymnasts). Also, traumatization is possible with the constant wearing of heavy bags, backpacks (tourists, travelers)
Static voltage, overvoltage	Permanent position of the body in the antiphysiological posture, more often sitting, stretching forward (drivers, office workers) or tilting the head (telephonists). Also, the cause may be an anomaly of the anatomical structure of the skeleton, a violation of posture, scoliosis
The influence of the temperature factor, more often the supercooling	Subcooling not only provokes the spastic tension of the trapezius muscle, but it can also provoke myositis - inflammation of the muscle tissue
Psychoemotional factor	Anxious, depressive condition, stress cause a general overstrain of the muscles, more often the muscles of the neck and are accompanied by GBN - a tension headache. Pain in the muscle can persist even after eliminating the provoking anxiety factor

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

[4], [5], [6], [7], [8], [9]

Symptoms of pain in the trapezius muscle

Signs and symptoms of pain in the trapezius muscle is a description of typical myofascial pain.

Pain characteristics: 

• Painful, it causes a feeling of pressure on the shoulders.
• The pain is permanent, subsides only after adequate treatment, muscle relaxation.
• Pain in the trapezius muscle is often reflected in the shoulders, upwards - in the neck, the base of the skull, can provoke GBN - tension headache.
• Pain in the trapezius muscle can limit the amount of movement of the head, turns of the neck, less often the movement of the hands.
• When palpation of the muscle tension the pain increases, but then quickly subsides.

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

How are the symptoms of pain in the trapezius muscle? 

1. TT - trigger points in the upper layer of the muscle manifest painful sensations in the neck, near the base of the skull. Pain can be felt as a headache, often it is reflected in the temples, in the ear zone. The patient has a characteristic posture - raised shoulders with the neck tilted toward the strain. Man unwittingly tries to relax the muscles, constantly rubs them with his hand, makes typical rotational movements of the head.
2. TT in the middle layer of muscle fibers as the pain manifests less often, it provokes a aching, burning pain in the area between the scapula. The pain increases with the movement of the hands forward, especially when necessary to hold objects on extended arms (waiters, drivers). A man acquires a stooping posture characteristic of a trapezoidal muscle injury.
3. Trigger points in the lower layer of the trapezius muscle are manifested by a constrictive, pressing pain at the bottom of the neck, closer to the shoulders, often one shoulder above the other.

In addition, the symptomatology of muscle pain in the trapezius muscle can be masked for signs of facial neuralgia, especially when the MFBS - myofascial pain syndrome - is localized in the upper fascicles of the muscle.

Diagnosis of pain in the trapezius muscle

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

The main method, which involves the diagnosis of pain in the trapezius muscle, is palpation, the technique of which the doctor should have. With the help of palpation of muscle tissue, it is possible to identify diagnostic trigger points, spasms and clarify the nature of the pain. The muscle with this examination stretches along the length to the limits of pain sensation within reasonable limits. Against the background of more relaxed, undamaged muscles, spastic tissue is felt as a tight cord (cord). Along the strand are painful points, with palpation, they are as painful as possible. The method of palpation can be performed both in a deep, "tick" way, and superficial. Deep technique involves capturing the muscle across the fibers, tick-like - grasping the muscle and rolling it between the fingers to determine the characteristic strands. The surface method can be used in the initial stage of overtraining of the trapezius muscle. For a doctor, the following criteria for muscle pain may be important: 

• The relationship of the symptom with physical overstrain, static posture or hypothermia, that is, with typical provoking factors.
• Definition by means of palpation of characteristic cords in the absence of signs of atrophy, atony of muscles.
• Pain during palpation should be reflected in other, more relaxed muscles.
• When palpation, a symptom of a "jump" should appear, when the pain sensation is significantly increased by pressing on the TT.
• The pain symptom is well supervised by the local action on the TT - trigger point (massage, rubbing, warming, injection puncture).

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

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

• Test to identify the resistance, the strength of the upper tufts of the trapezius muscle. The patient is asked to raise his shoulders up, while the doctor presses down on them, while palpating the strained muscle tissue.
• A test that reveals the level of strength of medium muscle beams. The patient moves his shoulders back, the doctor exerts resisting pressure, palpating the muscle.
• A test for detecting the level of tone in the lower part of the muscle. The patient raises his hand and carries it backward. The doctor palpates the muscles, giving a test resistance to the movement of the hand.

The diagnosis of painful muscle syndromes is directly related to a thorough clinical analysis of the data obtained during the tests and palpation.

[10], [11], [12], [13], [14]

Treatment of pain in the trapezius muscle

As a rule, the treatment of muscle pain is manual techniques, which are often used by orthopedists, vertebrologists. In recent studies on myogenic pain, it has been noted that manual techniques affect, to a greater extent, only shortened, contracted muscles. It does stop the symptom, but does not eliminate the etiologic factor. Thus, the anomalies of the biomechanics of the humeral section persist and eventually cause a relapse of pain due to a new compensatory overstrain of the muscles. Especially it concerns the impact on the deltoid muscle, the relaxation of which provokes the functional overload of the trapezius muscle. It is for this reason that doctors are trying to find new, more effective algorithms that presume a lasting result in the treatment of pain in the trapezius muscle.

We offer one of the variants of the complex therapy of the pain symptom taking into account the interrelation of the shoulder girdle with other parts of the body through reflexes (tendon, respiratory, reflex gait and others), and also taking into account the inevitable psychoemotional factor. Treatment of pain in the trapezius muscle does not accidentally begin with the restoration of the emotional sphere, since according to statistics in 85% of cases, myalgia is accompanied by an oppressed, depressed state. 

• Psychoemotional correction. A wonderful relaxing result is provided by aromatherapy provided that the patient is not allergic. Effective breathing techniques, the method of autogenic training.
• Correction of respiratory function, respiratory diaphragm. It is established that simultaneous forced diaphragmatic breathing and shoulder girdle massage relieve pain much faster and much more effectively than warming up, compresses, rubbing with external anti-inflammatory drugs.
• Correction of vascular disorders of the brain. The most commonly prescribed are nootropic preparations of plant origin, a complex of amino acids.
• Conducting gentle visceral manual therapy.
• Manual therapy of functional blocks of the spinal column.
• Manual therapy of the lumbosacral zone, as an interconnected site (gait reflex).
• Correction of acupuncture imbalance, acupuncture.
• Training the patient to perform independent exercises for relaxation, stretching of muscles (post-isometric relaxation).

In myofascial syndrome treatment should be aimed at breaking the pathological stress zone at the trigger point. Exclude all provoking static overload poses, correction of posture is carried out, it is recommended the use of special straightening corsets. With a strong pain symptom, mechanical destruction of TT with the help of injections (lidocaine, novocaine) is prescribed.

Drug treatment is prescribed only by indications, mielorelaxants are used, which destroy the pathological connection of spasm with pain.

The effectiveness of therapy depends on the timely treatment of a sick person to a doctor, as well as from his responsible performance of all appointments.

How to prevent pain in the trapezius muscle?

Prevention of pain in the trapezius muscle according to the apt expression of one experienced and famous physician is the disposal of the Atlanta and Caryatid complex. These images are associated with us with strength and power, because according to the myths they support in the form of columns not only the ancient temples, but the whole heavenly vault. The life of modern man, of course, assumes an increased workload, but to take on the functions of ancient Greek fairy-tale creatures is inexpedient and unreasonable. It is impossible to bear all the burdens of the world on our shoulders and be responsible for everything that happens in the sphere of professional activity, in the country and in the world. It is not by chance that many practitioners associate pains in the muscles of the shoulder girdle with psychoemotional stress, most often this syndrome affects hyperopearic people, perfectionists, and also very impressionable persons. Therefore, the primary prevention of pain in the trapezius muscle is a competent distribution of the load, not only physical, but also mental, emotional.

In addition, preventive measures that prevent myalgia in the shoulder girdle may include such actions: 

• Systematic support of physical activity, exercise, fitness.
• Regular workouts during work associated with a monotonous position of the body.
• Massage of the collar zone, including self-massage.
• Periodical dispensary examinations, the passage of complex surveys at least once a year.
• Correction of posture and gait, getting rid of stoop either independently, or with the help of a masseur, a special corset.
• Selection of ergonomic, comfortable furniture - a table, a chair.
• Watch TV, work at a computer at a distance that does not strain neither the eyes, nor the muscles of the shoulder girdle.

In general, the pain in the trapezius muscle, despite its prevalence, is not life-threatening syndrome. However, a constant, chronic overstrain of the muscle tissue can lead to headache, a depressed state, a decrease in the productivity of labor. Therefore, the earlier strained muscles of the collar zone receive adequate help, the faster the normal rhythm and quality of life will be restored.