Trapezius Myalgia

Myalgia is generally known as a muscle ache or muscle pain.

Trapezius myalgia (TM) is the complaint of pain, stiffness, and tightness of the upper trapezius muscle. It is characterised by acute or persistent neck-shoulder pain.


Monotonous jobs with highly repetitive work, forceful exertions, high level of static contractions, prolonged static loads, constrained work postures or a combination of these factors are possible causes of neck and shoulder disorders (which include TM) in the working population.

As recent research suggests with most musculoskeletal conditions there is a strong relationship between psychosocial factors and the occurrence of TM

Clinical Presentation

  • Sudden onset of pain
  • Muscle stiffness and spasms
  • Tightness of the neck-shoulder complex
  • Heaviness of the head and occipital headache
  • Tenderness of the upper trapezius area

Other symptoms:

  • Low mood
  • Anxiety
  • Paresthesia

Medical Management

  • Analgesia
  • Ergonomic advice
  • Referral to physiotherapy
  • Injection therapy
  • Radiofrequency denervation

Physical Therapy Management

Raising awareness for at risk groups of people:

  • Repetitive movement jobs
  • Sedentary jobs (computer work)
  • High work demands
  • Work posture
  • Vibration
  • Stress
  • Low activity level outside of work
  • Gender (women)

Exercise Therapy

Different forms of exercise is recommended for acute or persistent neck pain

Physical activity and exercise have been proven to give the most immediate and long-term pain relief in patients with TM]. Both general fitness training and specific strength training generate significant effects on decreasing pain. However; strength training has been proven to be more effective compared to general fitness training.

High-intensity strength training relying on principles of progressive overload for 20 minutes has been shown to be successful in reductions of neck and shoulder pain.

Following a specific neck strengthening exercise program for up to 1 year can lead to long term reduction and further prevention of recurring pain even after the strength program has ceased.

  1. Shoulder shrugs:
    The subject is standing erect and holding the dumbbells to the side, then elevates the shoulders while focusing on contracting the upper trapezius muscle.
  2. One-arm row:
    The subject bends their torso forward to approximately 30° from horizontal with one knee on the bench and the other foot on the floor. The subject now pulls the dumbbell towards the ipsilateral lower rib, while the contralateral arm is maintained extended and supports the body on the bench.
  3. Upright row:
    The subject is standing erect and holding the dumbbells while the arms are hanging relaxed in front of the body. The dumbbells are lifted towards the chest in a vertical line close to the body while flexing the elbows and abducting the shoulder. The elbows are pointing out- and upwards.
  4. Reverse flies:
    The subject is prone on a bench at a 45° angle from horizontal and the arms pointing towards the floor. The dumbbells are raised until the upper arm is horizontal, while the elbows are in a static slightly flexed position (~5°) during the entire range of motion.
  5. Lateral raise:
    The subject is standing erect and holding the dumbbells by their side, and then abducts the shoulder joint until the upper arm is horizontal. The elbows are in a static slightly flexed position (5°) during the entire range of motion.

Manual Therapy

Ischaemic compression, stretching of the upper trapezius muscle, and transverse friction massage are manual techniques to help patients with TM. These techniques appear to have instant improvement on pain. 



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