Trapezius: Muscle Pain & Trigger Points

The trapezius muscle is troubling many people that suffer from shoulder pain, arm pain and/or headaches.

1. Pain Patterns & Symptoms

If the trapezius contains trigger points, you can experience headaches as well as arm or upper back pain, depending on the localization of these points.

It can contribute to the following pain symptoms. Click on the corresponding link to learn how to achieve relief.

For a better localization of trigger points in this muscle, just compare the trigger point number – displayed as “X” – in the pain zone pictures with the one in the picture shown under attachment points.

This way you will have no problems to locate them – if present -.

Trapezius trigger points and pain patterns


1.2 Impaired or painful movements

Any movements or activities that are mentioned in the “Function chapter” and under “Trigger point activation” may be painful or impaired when your trapezius contains trigger or tender points.

Furthermore, with too much tension in this muscle you may experience a stiff neck. The upper part of this muscle helps to rotate the head to the other side. Thus, if it is tense, it impairs this movement and can contribute to a stiff neck.

2. Trapezius Muscle: Attachment Points

The trapezius consists of three parts – upper, middle and lower part – and covers a large surface on the upper back.

The upper part extends from the cervical spine down to the collarbone while the middle part originates from the first four thoracic vertebras and attaches at the acromion – the bony landmark the top and very outside of the shoulder.

The lower part extends from the other thoracic vertebra to the spine of scapula – the bony and horizontal line on your shoulder blade.

3. Function

When all parts of the trapezius muscle contract, they extend the neck and upper back – not shown below -.

3.1 Upper part

The upper part of the trapezius pulls the shoulder blade upwards and outwards and thus helps to elevate/raise the arm.

Additionally it bends the head towards the same side – lateral flexion –  and rotates it to the other side.


Abduction at the shoulder


Extension at the neck


Lateral flexion at the neck


Rotation at the neck

3. 2 Middle and lower part

The middle part draws the shoulder blade towards the spine whereas the lower part pulls it downwards and towards the spine – not shown -.

4. Trapezius: Trigger Point Activation

… Of the whole muscle

Acute and strong traumas like a car accident can activate trigger points in the whole trapezius muscle.

When you hit an object with your car, you get hurled into your seat belt until it stops the motion.

This way your head gets bend over hard and fast.

The trapezius gets stretched so fast and forcefully during that movement – as this is the opposite movement that the muscle as a whole performs – that trigger points can be activated.

… Of the upper and middle part

The upper and middle part of the trapezius muscle are probably THE trouble zone.

These parts can get overworked by the mechanical stress of the straps of a heavy backpack pushing into the muscle.

A similar effect can occur to women with large breasts that wear bras with narrow straps. Again, those straps are pulling/pushing on/in the muscle, thus place mechanical stress on it and may overload it over time.

Also watching TV with your head constantly turned, puts lots of stress on the upper trapezius as it stays in a shortened position for a prolonged time. The reason for this is that one of its functions is to turn your head.

… Of the middle part

The middle part of this muscle is mostly overworked when doing any kind of work with the arms elevated in front of you.

This is because your shoulder blade needs move outwards a bit if you raise the arm in front of you. Thus, the muscle gets stretched on the one hand but on the other hand still needs perform stabilizing work.

Doing this over longer periods of time can activate trigger points.


  • playing the violin
  • playing the piano
  • working on your computer without an arm rest
  • working as a bar tender – constantly reaching drinks over the counter –

… Of the lower part

The lower part of the muscle usually gets overworked when working in a bend over position for long times, as it may happen in gardening or cutting hair.

5. Trapezius Muscle: Palpation

You won´t have a hard time feeling this muscle as it is so big and.

5.1 Palpation of the upper part

The upper part can be sensed with the fingers. Just grab some skin and underlying muscle tissue at the side of your neck and you will have the upper part in your hands.


  • The upper part is small and narrow.
  • Do not expect a big muscle. In circumference it is not bigger than a pen.
  • At times it can be difficult to feel the upper part of this muscle, because often it is very tense and then “snuggles” even more to the cervical spine.
  • It makes sense to start the palpation a bit lower as the muscle gets bigger in circumference the lower you get.

Place your hand next to the cervical spine.


Try to pinch the muscle in the "back portion" of the neck.

There is only one muscle that you can slightly pull away.

5.2 Palpation of the middle part

Feeling the middle part might be the easiest for you as it is so large.

Place your fingers on top of the shoulder and pinch the big roll of muscle. Now you have the middle part of your trapezius between your fingers.

5.3 Palpation of the lower part

To feel the lower part, reach at your back as if you were about to scratch the area between your shoulder blades.

If you now move your shoulders a little towards your spine you can feel the lower trapezius contracting.

6. Trapezius Muscle: Self-massage

Depending on what part of the trapezius muscle you want to massage I recommend using your hands, the Trigger Fairy or a massage ball.

For navigation you can use the muscle picture shown above.

6.1 Self-massage of the upper part with your hands

  • Pinch the muscle as you did already during the palpation.
  • Search for tender spots.
  • As soon as you find one, slowly roll it a couple of times between your fingers.
  • But stop before your hands are getting tired.

6.2 Self-massage of the upper & middle part with the Trigger Fairy

Using the Trigger Fairy for massage allows you to massage the muscle in a very intensive way, without straining your hands. This is an advantage. You can use precise massage strokes as well as the pressure-motion technique.

You can use precise massage strokes as well as the pressure-motion technique.

Precise massage strokes

  • Place the Fairy on the lower part of your neck, right on top of the muscle.
  • Execute pressure and slowly move down the muscle, all the way to the outside of your shoulder.
  • Vary the direction of the pressure and the position of the Trigger Fairy, respectively.
  • Try to massage with pressure from the front, from above and from behind.

I exert pressure with my palm and index finger...


... and I initiate the the massage stroke with my thumb.

My thumb lies at the side of the Fairy´s bow.

Pressure-motion technique

This thechnique is especially suitable in the “front of your lower neck”.

  • Pressurize the muscle from the front.
  • Then move your shoulder and search this way for tender spots in the muscle.
  • Lift or depress your shoulder or use circular motions.
  • Concentrate on the most painful ranges of motion …
  • … but never maximize the pain.

Make sure to inspect the whole area of the “front part of your lower neck”, which ranges from right next to your cervical spine all the way out where your trapezius meets your collarbone.


6.3 Self-massage of the middle & lower part with a ball

Massaging the rest of your trapezius muscle – middle and lower part – is done best with a massage ball.

  • Place it on the area you want to massage.
  • Push yourself against a wall and then slowly search for tender spots.
  • As soon as you encounter one, stay there and slowly roll the ball over it a couple of times.
  • In order to massage the whole trapezius muscle, you might have to readjust the ball and your position on the wall a couple of times.


  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print