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Acupuncture for Trapezius Trigger Points

Theodore Levarda

A person with upper trapezius muscle pain

How to Get Relief from Trapezius Muscle Pain?

Do you experience pain in the back of your shoulder, neck, or have tension headaches? Are you struggling with mid-thoracic or upper thoracic back pain? Read on to learn about trapezius trigger points and why you should consider treating them with acupuncture and dry needling.

What is the Trapezius Muscle?

The trapezius muscle is a large, triangular muscle that runs from the base of the skull to the middle of the back, and from the spine to the shoulder blade. It is divided into three parts: the upper (upper trap), middle (middle trap), and lower (lower trap) fibers. This muscle is involved in many everyday movements such as shrugging the shoulders, moving the arms and head, and holding objects. It also helps to stabilize the shoulder joint and is active during activities such as lifting, pushing, and pulling.

Trapezius Muscle Actions

  • Upper fibers: Extend head and neck, laterally flex head/neck to the same side, rotate head/neck to the opposite side, elevate and upwardly rotate the scapula.

  • Middle fibers: Adduct and stabilize the scapula.

  • Lower fibers: Depress and upwardly rotate the scapula.

Trapezius Synergists and Antagonists

  • Trapezius Synergists: Pectoralis major and minor, Subclavius, Serratus anterior, Latissimus dorsi, Rhomboid major and minor, Levator scapulae, and SCM.

  • Trapezius Antagonists: Deltoid, Supraspinatus, Infraspinatus, Teres major and minor, Subscapularis.

Common Indications for Trapezius Trigger Points

  • Back of Shoulder Pain

  • Mid-Thoracic Back Pain

  • Upper Thoracic Back Pain

  • Back of Head Pain

  • Back of Neck Pain

  • Cheek Pain (like Sinusitis)

  • Headaches or Migraines

  • Temple and Eyebrow Pain

  • Temporal Headache (Temples)

  • Problems Holding Arms Up (as when folding sheets)

Trapezius Trigger Point Signs and Symptoms

Trigger points in the trapezius muscle can cause a variety of symptoms. For example, upper trapezius trigger points can lead to posterolateral neck pain and temporal headaches. Middle trapezius trigger points can cause burning interscapular pain, while lower trapezius trigger points can result in suprascapular, interscapular, or neck pain with little or no restriction of neck motion.

What Causes Trapezius Pain?

Factors that can perpetuate trapezius pain include sudden trauma, car accidents, overuse, and excessive shoulder elevation.

For the upper trapezius, factors like lower body asymmetries, tight shoulder straps, and heavy backpacks can contribute.

For the middle trapezius, overload from the arm being held up and forward for a long time can be a factor.

For the lower trapezius, prolonged bending and reaching forward while sitting can contribute.

Trapezius Trigger Point Locations and Referral Patterns

Upper Trapezius:

  • TrP1 Location: Posterolateral neck pain - constant, Temporal headache on same side, Angle of jaw pain

  • TrP1 Referral Pattern: Unilateral pain and tenderness - posterior lateral neck to the mastoid process. Spillover along the side of the head to temple. Also jaw/mandible area

  • TrP2 Location: Posterolateral neck pain without headache, Stiff neck

  • TrP2 Referral Pattern: Locally and behind the ear

Lower Trapezius:

  • TrP3 & 4 Location: Suprascapular, interspacular, acromial, or neck pain with little/no restriction of neck motion. TrP3: "joker" responsible for persistent upper back & neck pain after other TrPs in area have been released

  • TrP3 Referral Pattern: Refers pain to upper trapezius and GB21/GB20 area and the acromion area

  • TrP4 Referral Pattern: Refers steady burning pain downward along the medial vertebral border of the scapula

Middle Trapezius:

  • TrP5 Location: Burning interscapular pain

  • TrP5 Referral Pattern: Refers pain between the transverse process and spinous process C7 to T3

  • TrP6 Location: Localized pain over acromion

  • TrP6 Referral Pattern: Causes aching pain - top of the shoulder in the region of the acromion

  • TrP7 Location: Goosebumps on arm and thigh

  • TrP7 Referral Pattern: (Superficial) can cause goosebumps on the lateral aspect of arm

Differential Diagnosis for Trapezius Trigger Points

Related Trigger Points to Trapezius Pain

  • Levator scapulae

  • Masseter

  • Temporalis

  • Occipitalis

  • Pectoralis major/minor

Trapezius Treatment Options

Treatment for pain and tension in the trapezius muscle may include stretching and strengthening exercises, myofascial release, and trigger point therapy. Acupuncture and dry needling are effective methods for treating trapezius trigger points, as supported by various studies and literature.

What the Research Shows

There are numerous research studies that support the use of acupuncture and dry needling to treat trapezius trigger points and muscle pain. For instance, a study by Gerber et al. (2015) found that dry needling significantly reduced pain and altered the status of trigger points in the upper trapezius muscle. Another study by Turo et al. (2015) used ultrasound elastography to quantify muscle tissue changes after dry needling, further supporting its efficacy. Abbaszadeh-Amirdehi et al. (2016) also reported therapeutic effects of dry needling in patients with upper trapezius myofascial trigger points, emphasizing its immediate neurophysiological and clinical effects. Aranha et al. (2011) and (2015) explored the efficacy of electroacupuncture for myofascial pain in the upper trapezius muscle and found significant improvements in pain intensity and cervical range of motion. Lastly, a study by Garcia-de-Miguel et al. (2020) compared PENS with dry needling and found that PENS produced greater improvements in pain and disability in the short term.

Acupuncture and Dry Needling for Trapezius Trigger Points

Your acupuncturist will palpate for taut bands of muscle to find trigger points in the trapezius and then release them with an acupuncture needle. These trigger points can mimic a trapezius strain and be more intense than other trigger points in the body - especially the upper trapezius area. Trigger point dry needling for the trapezius muscles can release the trigger points and is one of the most effective ways to relieve pain in these muscles.

Final Thoughts

It's important to maintain good posture (both while awake and asleep), take frequent breaks when performing repetitive movements, and avoid carrying heavy bags on one shoulder to help prevent tension and pain in the trapezius muscle. If you're experiencing persistent pain in the trapezius area, consider acupuncture and dry needling as effective treatment options.

Over to you

If you liked this article, please share with friends and family who may be suffering with trapezius pain or tension headaches.

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Disclaimer: This web site is intended for educational and informational purposes only. Reading this website does not constitute providing medical advice or any professional services. This information should not be used for diagnosing or treating any health issue or disease. Those seeking medical advice should consult with a licensed physician. Seek the advice of a medical doctor or other qualified health professional for any medical condition. If you think you have a medical emergency, call 911 or go to the emergency room. No acupuncturist-patient relationship is created by reading this website or using the information. Morningside Acupuncture PLLC and its employees and contributors do not make any express or implied representations with respect to the information on this site or its use.

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