Trapezius Pain Symptoms

Dry needling for upper trapezius pain is focused on addressing trapezius Myofascial Trigger Points (MTrP), which are taut bands of skeletal muscle fibers that can cause muscle pain over the MTrP and also to areas around them and farther away. The upper trapezius is one of the primary muscles that cause muscle pain, called myalgia. Specifically, muscle pain of the trapezius muscle is called Trapezius Myalgia. Upper trapezius trigger points are frequently completely or partially the cause of discomfort in the upper back, neck, and head and can be treated with dry needling.

Dig in deep to what a trigger point is and why trigger points are unique in my content here –> What is a Trigger Point?

There is some research regarding dry needling for upper trapezius trigger points, you can read a synopsis of its effectiveness here –> Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects with Chronic Myofascial Pain


If you have trapezius muscle pain, you may experience some or all of the following symptoms:

  • Muscular pain in your upper back and neck.
  • Tender knots in your upper back and neck.
  • Knots that are temporarily relieved when pressing or rubbing on them.
  • Unrelenting tightness in your upper back and neck.
  • Headaches that seem to come from your upper trapezius, neck, and suboccipital muscles.
  • Muscles that feel weaker than they should be.
  • Spinal stiffness and pain in the neck and upper back.
  • A difficulty with daily tasks like working at a desk or using a computer because of discomfort.
  • Postural changes in your neck, upper back, and shoulders that are obvious when looking in a mirror.

If these symptoms sound familiar, you may be experiencing Trapezius Myalgia, or trapezius pain most commonly in the upper trapezius muscle.

Dry Needling Treatment for the Upper Trapezius

Upper trapezius pain is a condition that typically responds very well to dry needling treatment. Since dry needling is a relatively new treatment, you may not be familiar which the treatment process or what it feels like. Dry needling for upper trapezius pain typically goes similar to this:

  • A chiropractor will palpate the upper trapezius muscle and identify tender and painful trigger points (knots) in the muscle.
  • Small and thin acupuncture needles are inserted into the trigger point.
  • When being stimulated with the needle, the upper trapezius trigger point will produce a dull and achy discomfort.
  • Upper trapezius trigger points will involuntarily twitch or spasms and the chiropractor will piston the needle until they stop twitching.
  • Needles can be left in for a period of time or may be removed immediately.

After a dry needling treatment, the muscles typically feel sore and sometimes feel tight immediately. This may last anywhere from 12-48 hours. A lot of times patients will get immediate relief or relief after the soreness subsides. Every once in a while there are small bruises where the needles are inserted, which is not an abnormal side effect.

To address upper trapezius pain I typically combine dry needling with other treatments and rehab for better and faster results. Some of the other treatments I use in combination with dry needling trigger points include:

  • Therapeutic ultrasound to upper trapezius trigger points to mitigate post-treatment soreness by providing deep heat.
  • Graston Technique IASTM to work through trapezius muscle fibers and increase blood flow to the area.
  • Kinesiotape to lift upper the skin and promote increased blood flow.
  • Stretches and corrective exercises you can do at home to keep the upper trapezius muscle from getting tight and forming trigger points.
  • Chiropractic manipulation if the upper trapezius pain has a joint restriction component that’s contributing to your muscle pain.

Want to read more about how to relieve upper trapezius pain? See this content I wrote a little while back on the subject –> Upper Trapezius Pain Relief

Upper Trapezius Trigger Point Pain Referral Patterns

Upper trapezius trigger points or “muscle knots” can refer pain, tightness, and feelings of weakness to other areas. Some common upper trapezius trigger point referral areas include:

  • The area between the shoulder blades
  • Upper, middle, and lower neck
  • The back of the shoulder
  • The back of the head, side of the head, temples, or forehead

The easiest way to understand where upper trapezius trigger points refer to is by looking at a photo of common referral patterns:






The BLUE area is a common and general area that shows where trapezius trigger points can cause discomfort.

The GREEN arrows show common trapezius trigger points that can refer to the blue areas.

Keep in mind this only shows a portion of the painful areas trigger points in the upper trapezius can cause pain. There are more places in the front of the neck, shoulder, and head that aren’t shown here.

Dry needling treatment durations are usually 30 minutes from start to finish and I like to advise a trial of dry needling for upper trapezius pain of 4-6 visits. When patients are dedicated to their home exercise program we can often shorten the trial of care.

If dry needling isn’t effective, there are other treatments available to you as well including other chiropractic treatments, physical therapy, or medical care. After your exam, if dry needling isn’t the right treatment, I always make a referral to someone I think can help with your upper trapezius pain.

 If you have shoulder muscle tightness as well, dry needling may be a good treatment for that too. Read about that here –> Dry Needling for Shoulder Tightness

Maybe you’ve injured your shoulder? See what shoulder injuries may be treated with dry needling and which shoulder injuries dry needling is not a good fit for here –> Dry Needling for Shoulder Injuries

Dr. Jason Williams DC is a chiropractic physician practicing at AccessHealth Chiropractic in Cary, NC. He treats neuromusculoskeletal pain and injuries using chiropractic manipulation, dry needling, acupuncture, rehab exercise strategies, and other supportive therapies. Primary areas of focus include back pain, neck pain, muscular pain, extremity pain, and orthopedic injuries. Dr. Williams is experienced in treating athletes, especially those in the CrossFit, Brazilian Jiu-Jitsu, Muay Thai, and MMA community.

If you’re interested in whether he or another AccessHealth provider can help you, navigate to our contact page or follow this link to request an appointment.