Most people today lead a predominantly sedentary lifestyle and have a sedentary job. The state of stiffness in the neck is well known for them, since the spine does not receive the proper level of stress when it is in the wrong position. As a result, the vertebrae become displaced, muscles become pinched, and nerves become inflamed. However, the feeling when movements in the neck are limited can also appear for other reasons and be a sign of certain diseases. In any case, this condition gives a person obvious discomfort and pain, and he cannot live and work fully.
Trapezius syndrome
Pain in the trapezius muscle is not always limited to just the muscle area.
For example, this muscle can cause pain in the ear, eye or lower teeth, and it is also a common cause of headaches. Moreover, all these pains are felt not as radiating from the back to the head or teeth, but as completely independent toothaches or headaches. And, in general, the trapezius muscle is perhaps the most common source of pain in our body. This is due to the fact that the muscle performs many different functions and is often overloaded. Overwork and overload open the door to illness. It has been established that pain in the trapezius muscle is caused by trigger points. According to Travell and Simons, authors of a book on myofascial syndrome, trigger points in the trapezius muscle are much more common than in other muscles [J. Travell and D. Simons, Myofascial Pain and Dysfunction. Volume I. P. 353].
But the cause of trapezius muscle pain does not always lie only in the physical plane. This muscle, like no other, is influenced by emotional factors. However, we will talk about the psychosomatics of the trapezius muscle and myofascial syndrome a little lower, in the “Symptoms...” section, and now - anatomy.
Differential diagnosis
MTM can be diagnosed when neck pain, muscle tension, and trigger points are present.
Other pathologies that can cause similar symptoms:
- Cervical spondylosis.
- Cervical osteoarthritis.
- Cervical radiculopathy.
- Superior outlet syndrome.
- Pathology of the glenohumeral complex, including pathology of the rotator cuff and osteoarthritis of the shoulder joint.
- Polymyalgia rheumatica.
Diagnostic methods
The basis for diagnostic criteria for trapezius myalgia is not entirely clear, and diagnostic terminology and assessment methods vary.
- Subjective examination.
- An objective examination includes a neurological examination and assessment of the condition of the cervical and shoulder joints.
- Instrumental diagnostics may be useful to exclude other pathologies, especially if there is no improvement in well-being, and neurological symptoms or signs of serious pathologies (“red flags”) have appeared.
- Carrying out diagnostic injections.
- Referral to an orthopedist if there is no improvement with conservative treatment.
In general, there are no objective diagnostic methods developed specifically for trapezius myalgia. Diagnosis is made based on medical history, interpretation of presenting symptoms, and objective examination.
Rating scales
Visual Analog Scale (VAS)
This scale visualizes the degree to which the patient is experiencing pain. It is a 100 mm line on which the patient must indicate a point that corresponds to his level of pain. On the left is the minimum score (0), meaning “no pain,” and on the right is the maximum score (10), meaning “unbearable pain.”
Anatomy of the trapezius muscle
The anatomy of the trapezius muscle indicates that the muscle is indeed shaped like a trapezoid. To be precise, we have two trapezius muscles - left and right. Each individually has the shape of a triangle, with its apex facing the shoulder joint and its base facing the spine. Connecting together at the spine, they form a trapezoid. Recall that a trapezoid is a quadrilateral in which two sides are parallel and the other two are not. By the way, due to the fact that there are not one, but two muscles, situations are possible when the trapezius muscle hurts on the left, on the right, or on both sides.
The anatomy of the trapezius muscle involves dividing the muscle into three parts: upper, middle and lower. The upper part is usually called the trapezius muscle of the neck, and the middle and lower part are called the trapezius muscle of the back. But let us immediately clarify that this division is not official - for documents, but colloquial - for ease of use in speech. In general, the trapezius muscle is one of the largest muscles. Starting from the back of the head, it extends to the lower thoracic vertebra, while, covering the top of the shoulder girdle, it reaches the collarbone.
Functions of the trapezius muscle
The functions of the trapezius muscle provide movement and static movement of the shoulder, scapula and neck. For example, we use this muscle if we want to straighten our shoulders and straighten our neck, or when we bring our shoulder blades together and throw our head back, or when we move our shoulders up and down and back and forth. While walking, we swing our arms, and the muscle works dynamically, and if we are sitting at a computer, it works statically. And even when we just stand with our arms down, the muscle also works to provide an anti-gravity effect. By the way, precisely in order to relieve tension and relieve the trapezius muscle, we automatically fold our arms on our chests or put them in our pockets.
Speaking about the anti-gravity function of the trapezius muscle, it becomes clear why, when working at a desk, you need to make sure that your elbows are not suspended - otherwise the weight of your arms will cause overload. And, if this is repeated day after day and continues for many hours, then the appearance of pain cannot be avoided. This is about the cause of pain in the trapezius muscle. The same can be said for driving – your elbows should not be hanging.
The “cervical” function of the trapezius muscle provides turns and tilts of the head. Therefore, the monitor and TV screen should be located directly in front of us. This will also prevent the development of pain and pathology. And, by the way, the habit of holding the phone with your ear also causes pain in the trapezius muscle.
NECK PAIN: TREATMENT
If a muscle in the neck is cramped, first of all you need to immobilize the affected area and ensure a state of rest. You can apply ice or a painkiller and then go to the doctor for advice, because sometimes the problem is more serious than a sprain. What to do if your neck is cramped? Treatment may be as follows16:
- Taking medications. Painkillers, anti-inflammatory drugs, anticonvulsants, or muscle relaxants may be used to relieve discomfort. These may be gels, patches, tablets or injections.
- Use of special medical devices. Wearing a hard or soft collar may be recommended to provide rest to the injured area.
- Massotherapy. Impact on active points helps relieve tension, remove vertebral displacement and dislocations.
- Physiotherapy. Performing certain exercises will improve the condition of the muscles, remove tension and stagnation.
You can learn about massage techniques, treatment, and first aid from a physiotherapist or orthopedist, who will draw up an individual treatment plan.
Symptoms of trapezius muscle syndrome
Symptoms of the trapezius muscle are mainly painful in nature, this is due to the fact that trapezius muscle syndrome is myofascial in nature.
Myofascial syndrome of the trapezius muscle is a pathology in which small painful areas - trigger points - form in the muscle tissue. For a long time they may not manifest themselves in any way, remaining in a latent state. But as soon as they are activated, pain immediately arises. An activation factor can be an uncomfortable posture, sudden movement, overload, hunger, hypothermia or stress. By the way, pain associated with stress and emotions is the psychosomatics of the trapezius muscle.
The mechanism of psychosomatic reactions is easier to understand using the example of animals. When in danger, a turtle pulls its head into its shell, while most others simply press their heads into their shoulders. Thus, animals protect their most vulnerable place - the neck. For us too, evolution has preserved this biological reflex. It is he who, in response to stress, causes tension in many muscles, but, first of all, the trapezius. It is not difficult to guess that for those people who experience constant emotional stress, the psychosomatics of the trapezius muscle will only increase. But let's return to trigger points.
We have already said that trigger points occur more often in the trapezius muscle than in others. At the same time, there is an amazing pattern. In 95% of cases, trigger points are localized exclusively in the upper part - in the trapezius muscle of the neck and only 5% - in the trapezius muscle of the back.
In addition, for the vast majority of people, the points appear in the same places; and there are seven such places. These are the seven classic trigger points of the trapezius muscle. Moreover, some of them can cause pain only in the back and neck, while others, in addition to the back and neck, can also cause headaches. But, let's list all the symptoms of trapezius muscle syndrome.
Let's start listing the symptoms of the trapezius muscle with the neck. After all, trapezius muscle syndrome is the main source of neck pain. Most often, the pain goes along the posterolateral surface and reaches the skull. From the neck, pain can move to the temple and side of the head, and can also be felt behind the eye socket or spread to the back of the head. Myofascial syndrome of the trapezius muscle can also cause referred pain in the auricle (but not in the depths of the ear), as well as reflex dizziness and vegetative-vascular crises.
The next symptom of the trapezius muscle is facial pain. It is usually localized in the angle of the lower jaw, the area of the masticatory muscles and lower teeth. This syndrome is well known to dentists.
Often, pain from the trapezius neck muscle activates satellite trigger points located in other neck muscles. This causes tension headaches. In general, activation of satellite points is very characteristic of the trapezius muscle. This most often occurs with the scalene muscles. And if points in the levator scapulae and splenius muscles are activated, then the symptom of a “fixed neck” occurs, in which it is impossible to turn the head.
When talking about trigger points of the trapezius muscle, you need to pay special attention to a very insidious point located below, between the spine and the scapula. Its insidiousness lies in the fact that it can cause the re-formation of trigger points at the top - in the trapezius muscle of the neck. Inexperienced doctors often stumble over this problem. Having eliminated all the triggers in the neck and upper back, such a doctor cannot understand why the pain does not go away. And the reason, most often, is precisely at this point.
Also, trapezius muscle syndrome is characterized by pain in the area of the shoulder girdle and the top of the shoulder joint. And then, everything that puts pressure on the shoulders causes particular pain and inconvenience. These include bra straps, heavy outerwear, a shoulder bag, etc. It should also be noted that in this area there is a point that causes unpleasant sensations like “goose bumps”. Another symptom of the trapezius muscle is a burning pain in the interscapular area or along the vertebral edge of the scapula.
In general, it must be said that many people sincerely do not understand why their trapezius muscle hurts. After all, in their opinion, there is no reason for this. To clarify this issue, it must be said that pain in the trapezius muscle is often a consequence of our habits. After all, what we consider an ordinary habit turns out to be a chronic microtrauma. For example, with trapezius muscle syndrome, symptoms may appear due to the habit of holding the phone with your ear or sleeping on your stomach with your head turned to the same side. Habitually placing our hands on the top of the steering wheel or accompanying our speech with active gestures, we also cause muscle overload. The same unnoticeable overload forms symptoms of the trapezius muscle due to the habit of constantly throwing back the hair from the forehead with a sharp movement of the head. And by supporting our chin with our hands, we overload the trapezius muscle of the back. In general, drop by drop, water wears away the stone. Likewise, chronic microtrauma is insidious in its invisibility. By the way, this is why prevention exists - to eliminate accumulated overloads in a timely manner.
Regarding statistical issues, it should be noted that the trapezius muscle hurts more often on the left than on the right. Although, if you follow logic, it should be the other way around. After all, most people have a right hand at work. Therefore, it should hurt more often on the right side. However, the fact remains a fact. Most likely, the whole point is a compensatory overload that occurs in opposition to the working limb. This often happens - the compensating section is overloaded more than the main one. As for medicine, there is no difference - the trapezius muscle hurts on the right or on the left - the treatment methods are the same.
Trapezius muscle treatment
Treatment of the trapezius muscle can be divided into primary and auxiliary. The main thing is gentle manual therapy. It differs radically from conventional manual therapy not only in its softness and safety, but also in its higher efficiency. And this is not surprising, because gentle manual therapy consists of 90% muscle and fascial techniques. Even in the treatment of disc herniation and other diseases of the spine, gentle manual therapy does not act as usual - sharply and with a crunch, straightening the vertebrae, but through the so-called soft muscle “lever”, which completely eliminates any danger.
Auxiliary treatment of the trapezius muscle includes physiotherapy, massage and drug therapy, which, in our opinion, is appropriate only in extreme cases of acute pain. And, to conclude the topic, a few words about prevention.
Perform one preventative session of gentle manual therapy once every 3-6 months, and you will forget how the trapezius muscle hurts.
Neck stiffness: why it occurs
Stiffness and limited movement of the neck can be caused by damage or pathological processes of various structures of this part of the body - vertebrae, intervertebral discs, nerves, muscles, blood vessels, and circulatory disorders. In some cases, if a person has intense lymphadenopathy of the cervical lymph nodes, it may also be painful for him to turn his head and make other neck movements.
The pain can cover not only the neck, but also radiate to nearby parts of the body - head, shoulders, back, jaws, arms. In fact, pain is the main reason for the limitation of mobility - a person could move his neck if he were not stopped by intense pain.