The Incredibly Common Upper Trapezius “Knot”

I’ve written about the incredibly common upper trapezius knot before. It’s the tender, tight, and sometimes painful spot in what most of us call our upper back or neck.

I’m not exaggerating when I say this knot is an EPIDEMIC. If you go to your husband, wife, daughter, son, or whomever and pinch their mid-upper trapezius I can almost guarantee you they’re going to say “ahh, that’s the spot.” The number of patients I treat in my chiropractic office who have symptoms in this spot is incredible. I think massage therapists and physical therapists would say the same.

See some of my other content on upper trapezius pain relief here –> Upper Trapezius Pain Relief

One of the Reasons Why is the Trapezius is Causing Neck Pain

Take a look at this photo that points out the trapezius muscle. The sheer size of your trapezius muscle is one of the reasons it causes neck pain. It’s not just a neck muscle, or an upper back muscle, or a shoulder muscle. It’s a muscle that’s traversing and acting on ALL OF THESE REGIONS.

The trapezius attaches to a long list of boney structures: your occiput (skull), cervical and thoracic spinal segments (C7-T12), your scapula (shoulder blade), and your clavicle. Besides boney structures, you can also add the Nuchal ligament (a spinal ligament) and supraspinatus ligaments to the list. An issue with the trapezius muscle can have a wide range of effects near and far.

In this video I explain dry needling for the upper trapezius muscle(s) and I also show some upper trapezius dry needling so you can see what it’s like!

The Usual Upper Trapezius Pain Culprit

So, about that knot that I referred to earlier… In medical lingo, it’s called a myofascial trigger point, more simply referred to as a trigger point. A trigger point is a group of muscle fibers that are essentially “stuck” together in a contracted position. Despite being insanely common, this is not a normal phenomenon or a good thing.

If you want to read more about trigger points, make sure you see my content where I explore them more in-depth here –> What is a Trigger Point?

Despite not having today’s technological disadvantages, acupuncturists figured out this spot thousands of years ago and gave it a specific name. They named your upper trapezius trigger point Gallbladder 21 (GB 21.) GB 21 is part of a channel of Gallbladder acupuncture points. For the sake of this article don’t get too caught up in the fact that it’s named after an organ. The pertinent point is that they realized needling this point could provide relief of different symptoms and help the body heal and restore balance.

A Perfect Environment for Neck Pain

Is a trapezius trigger point causing your neck pain all by itself? It’s not likely. Instead, it’s probably the perfect combination of a few factors:

  • The aforementioned trapezius trigger point (GB 21) causing muscle and fascia knotting, abnormal muscle physiology, and dysfunctional action of the muscle.
  • Bad cervical (neck) neck positioning and posture that shifts the load of your head forward causing inefficient loading to the cervical spine and possibly straightening of the spine.
  • Weak middle back and shoulder muscles that can no longer fight the good fight to maintain the balance between your flexors (think chest and front neck muscles) and extensors (think shoulder and upper back muscles.)
  • Poor muscle activation and deconditioning that results in usually active and healthy muscles becoming underactive and weak.

The trapezius trigger point is often the key to address pain, but it’s only one factor in very complex musculoskeletal and neurological systems. Estimates tell us that a quarter of people are suffering from neck pain at any given time, and that neck pain tends to be episodic. If you have neck pain now or you’ve had it before, you’ll likely experience it again. The silver lining, however, is that it’s so common that there’s been plenty of strategies to address it.

How Upper Trapezius Dry Needling Can Get Rid of Your Neck Pain

Massage, stretching, and foam rolling can all address your upper trapezius trigger point (GB 21,) but in my opinion, the absolute best way to address it is with dry needling.

Dry needling is a treatment that uses acupuncture needles to release and eliminate trigger points that are causing tension, pain, and poor function of a muscle. In the case of neck pain, dry needling the upper trapezius can make the most dramatic change in your neck pain and many times does so immediately.

Releasing your upper trapezius trigger point really is the key to treating neck pain, and it works even better together with treatments like spinal manipulation and a stretching and corrective exercise rehabilitation program.

I’ve written a lot about dry needling for upper trapezius pain, mostly because it’s one of the most common complaints I see in our Cary chiropractic center. If you’re hungry for more content on the subject you can read this –> Dry Needling for Upper Trapezius Pain

Don’t take my word for it! Read some research. Here’s a study that found upper trapezius dry needling improved mood, function, and level of disability –> Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects with Chronic Myofascial Pain


As an evidence-informed and rehab-based chiropractor, dry needling is a big part of my practice. If you’re struggling with other complaints, see some of my other content on dry needling below.

Dry Needling for SI Joint Pain
Dry Needling for Ankle Pain
Can Dry Needling Help Frozen Shoulder?
Dry Needling for Shoulder Tightness
Dry Needling for Shoulder Injuries
Dry Needling for Quadriceps Tendonitis
Dry Needling for Shin Splints

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.