Discover tips and exercises to alleviate shoulder pain within the upper trapezius and regain your comfort.
Table of Contents
Chiropractic Care for Upper Trapezius Shoulder Pain: A Comprehensive Guide to Relief
Office workers, sports, and those dealing with everyday stressors are all affected by shoulder discomfort, which is most common in the upper trapezius muscle. This discomfort may impair general quality of life, interfere with sleep, and restrict movement. Chiropractic treatment addresses the underlying causes of upper trapezius discomfort and encourages long-term rehabilitation, providing a non-invasive, comprehensive approach to pain management. The architecture and function of the upper trapezius, the reasons behind related shoulder discomfort, the function of myofascial trigger points, and evidence-based nonsurgical treatments—such as chiropractic adjustments—are all covered in this comprehensive book. We will discuss how integrative therapy may change the lives of people with shoulder discomfort, based on clinical insights from Dr. Alexander Jimenez, DC, APRN, FNP-BC, a dual-licensed chiropractor and family nurse practitioner.
Understanding the Upper Trapezius Muscle: Anatomy and Function
Anatomy of the Upper Trapezius
The trapezius muscle is a large, triangular muscle spanning the upper back and neck, divided into upper, middle, and lower regions. The upper trapezius originates from the occipital bone at the skull’s base, the ligamentum nuchae (a fibrous neck structure), and the cervical vertebrae’s spinous processes (C1-C7). It inserts into the lateral clavicle, acromion, and scapular spine (Ziaeifar et al., 2019).
Located close to the skin’s surface, the upper trapezius is easily palpable and susceptible to tension or tenderness. It is innervated by the spinal accessory nerve (cranial nerve XI) and receives blood from the occipital artery’s branches, making it a critical structure for shoulder and neck stability.
Biomechanics and Function
The upper trapezius plays a vital role in upper body movement and stability:
- Scapular Elevation: It lifts the shoulder blade, as seen when shrugging shoulders.
- Scapular Upward Rotation: It aids in rotating the scapula upward, essential for overhead arm movements like reaching or throwing.
- Neck Extension and Lateral Flexion: It supports backward head extension and side tilting.
- Stabilization: It stabilizes the shoulder girdle during arm movements, ensuring proper alignment.
These functions make the upper trapezius essential for tasks like carrying heavy bags, typing, or engaging in sports like swimming or CrossFit. However, repetitive or static activities can strain this muscle, leading to pain and dysfunction (Brandt et al., 2014).
References:
- Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
- Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
Causes of Shoulder Pain in the Upper Trapezius
Upper trapezius-related shoulder pain can arise from multiple factors, often related to lifestyle, injury, or biomechanics. Identifying these causes is key to effective treatment.
1. Repetitive Strain and Overuse
Prolonged activities like typing or overhead sports can overwork the upper trapezius, leading to muscle fatigue and tightness. Office workers, for instance, often maintain static postures, increasing strain, while athletes may experience overuse from repetitive motions (Ayd?n et al., 2021; Silva et al., 2022).
2. Poor Posture
Forward head posture, common among those using computers or smartphones for extended periods, places excessive stress on the upper trapezius. This posture forces the muscle to overcompensate to stabilize the neck and shoulders, leading to pain (Brandt et al., 2014).
3. Stress and Muscle Tension
Psychological stress triggers involuntary tightening of the upper trapezius, as the body responds by tensing neck and shoulder muscles. Chronic stress can perpetuate this tension, causing persistent discomfort (Cleveland Clinic, 2025).
4. Trauma or Injury
Acute injuries, such as whiplash from car accidents or falls, can strain or tear the upper trapezius, resulting in pain and limited mobility. Whiplash-associated disorders (WAD) are particularly linked to trapezius dysfunction (Voerman et al., 2007).
5. Myofascial Trigger Points
Myofascial trigger points are hyperirritable spots within the muscle that cause localized or referred pain. These points often develop in the upper trapezius due to overuse, poor posture, or injury, contributing to shoulder and neck pain (Ziaeifar et al., 2019).
6. Occupational and Ergonomic Factors
Sedentary jobs and poor workstation ergonomics increase the risk of trapezius pain. Inadequate chair support, improper monitor height, or repetitive tasks can exacerbate muscle strain, particularly in office workers (Brandt et al., 2014).
References:
- Ayd?n, N. S., Çelenay, ?. T., & Özer Kaya, D. (2021). Muscle activation of the upper trapezius and functional typing performance during computer typing task: A comparison of two different wrist immobilization methods. Journal of Bodywork and Movement Therapies, 27, 472–476. https://doi.org/10.1016/j.jbmt.2021.05.001
- Silva, E. R., Maffulli, N., & Santos, G. M. (2022). Function, strength, and muscle activation of the shoulder complex in CrossFit practitioners with and without pain: A cross-sectional observational study. Journal of Orthopaedic Surgery and Research, 17(1), 24. https://doi.org/10.1186/s13018-022-02915-x
- Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
- Voerman, G. E., Vollenbroek-Hutten, M. M. R., & Hermens, H. J. (2007). Upper trapezius muscle activation patterns in neck-shoulder pain patients and healthy controls. European Journal of Applied Physiology, 102(1), 1–9. https://doi.org/10.1007/s00421-006-0215-8
- Cleveland Clinic. (2025, February 4). For relief, pull the trigger on a trigger point massage. Health Essentials. https://health.clevelandclinic.org/trigger-point-massage
- Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
Myofascial Trigger Points and Their Impact on Shoulder Pain
What Are Myofascial Trigger Points?
Myofascial trigger points are tight, sensitive areas in skeletal muscle that form palpable nodules within taut muscle bands. These points can cause localized pain or refer pain to other areas, such as the neck, head, or shoulders. In the upper trapezius, trigger points are common due to the muscle’s constant engagement in stabilizing and moving the shoulder girdle (Ziaeifar et al., 2019).
How Trigger Points Cause Shoulder Pain
Trigger points in the upper trapezius contribute to shoulder pain in several ways:
- Localized Pain: Trigger points feel like tender knots, causing sharp or aching pain when pressed.
- Referred Pain: Pain can radiate to the neck, head (causing tension headaches), or arm.
- Restricted Mobility: Muscle tightness limits neck and shoulder movement, making tasks like turning the head or lifting painful.
- Muscle Weakness: Chronic trigger points may weaken the upper trapezius, leading to compensatory overuse of other muscles and worsening pain (Stieven et al., 2021).
These points often arise from repetitive strain, poor posture, or stress, creating a cycle of pain and dysfunction if untreated (Cleveland Clinic, 2025).
Clinical Impact
Research shows a strong link between neck/shoulder pain intensity and trapezius muscle tenderness, with higher pain levels corresponding to greater tenderness severity (Brandt et al., 2014). This underscores the importance of targeting trigger points to alleviate chronic shoulder pain.
References:
- Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
- Stieven, F. F., Ferreira, G. E., de Araújo, F. X., de Medeiros, F. S., da Rosa, L. H. T., de Oliveira, M. X., & da Silva, M. F. (2021). Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 95–102. https://doi.org/10.1016/j.jmpt.2020.07.003
- Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
- Cleveland Clinic. (2025, February 4). For relief, pull the trigger on a trigger point massage. Health Essentials. https://health.clevelandclinic.org/trigger-point-massage
Chiropractic Care for Upper Trapezius Pain: Clinical Rationale
Chiropractic care is a non-invasive, patient-centered approach to managing upper trapezius pain by addressing musculoskeletal dysfunction and promoting healing. Experts like Dr. Alexander Jimenez, DC, APRN, FNP-BC, leverage advanced diagnostics and integrative therapies to provide effective relief.
Why Chiropractic Care Helps
- Spinal and Joint Alignment:
- Misalignments in the cervical spine or shoulder girdle can exacerbate upper trapezius tension. Chiropractic adjustments restore proper alignment, reducing muscle stress and improving biomechanics (Jimenez, 2025).
- Adjustments enhance nerve function, minimizing irritation that contributes to trigger points.
- Myofascial Release and Soft Tissue Therapy:
- Chiropractors use myofascial release to target trigger points, relieving tension and improving muscle elasticity (Stieven et al., 2021).
- These techniques enhance blood flow and reduce stiffness, supporting recovery.
- Postural Correction:
- Poor posture significantly contributes to upper trapezius pain. Chiropractors assess and correct posture through exercises and ergonomic guidance, reducing muscle strain (Brandt et al., 2014).
- Pain Reduction and Mobility:
- Chiropractic interventions reduce pain intensity and restore range of motion by addressing muscle and joint dysfunction, enabling patients to resume daily activities (Crookes et al., 2023).
- Holistic Approach:
- Chiropractors consider lifestyle factors like stress or repetitive activities, offering strategies like stretching or strengthening to prevent pain recurrence (Jimenez, 2025).
Dr. Alexander Jimenez’s Clinical Approach
Dr. Alexander Jimenez, a dual-licensed chiropractor and family nurse practitioner, is renowned for his integrative approach to musculoskeletal health. His practice emphasizes:
- Advanced Imaging and Diagnostics: Using X-rays, MRIs, and ultrasound to identify structural issues in the spine and shoulder, such as misalignments or soft tissue damage (Jimenez, 2025).
- Dual-Scope Procedures: Combining chiropractic adjustments with diagnostic tools like electromyography (EMG) to assess muscle activation and pinpoint trapezius dysfunction.
- Personalized Treatment Plans: Tailoring interventions based on diagnostic findings, incorporating adjustments, myofascial release, and rehabilitative exercises.
- Patient Education: Empowering patients with ergonomic advice, posture correction, and lifestyle modifications to prevent pain recurrence.
Dr. Jimenez’s approach aligns with research supporting chiropractic care and soft tissue therapies for reducing shoulder pain and improving function (Jimenez, 2025; Crookes et al., 2023).
References:
- Stieven, F. F., Ferreira, G. E., de Araújo, F. X., de Medeiros, F. S., da Rosa, L. H. T., de Oliveira, M. X., & da Silva, M. F. (2021). Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 95–102. https://doi.org/10.1016/j.jmpt.2020.07.003
- Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
- Crookes, T., Ewald, A., & Jennings, M. (2023). Chronic shoulder pain. Australian Journal of General Practice, 52(11), 753–758. https://doi.org/10.31128/AJGP-04-23-6790
- Jimenez, A. (2025). LinkedIn profile. https://www.linkedin.com/in/dralexjimenez/
Nonsurgical Treatments for Myofascial Trigger Points in the Upper Trapezius
Several nonsurgical treatments effectively reduce myofascial trigger point pain in the upper trapezius, supported by research evidence. These can complement chiropractic care for optimal outcomes.
1. Dry Needling
Dry needling involves inserting a thin needle into a trigger point to elicit a twitch response, which releases muscle tension and reduces pain. It significantly decreases pain intensity and improves neck and arm function, with effects lasting up to three months (Ziaeifar et al., 2019). It also produces local and distant pain relief (Stieven et al., 2021).
2. Trigger Point Compression
Trigger point compression applies sustained pressure to a trigger point until the muscle relaxes. This technique reduces pain and disability in the upper trapezius, with benefits persisting for months (Ziaeifar et al., 2019). It’s a non-invasive option often used by chiropractors.
3. Myofascial Release
Myofascial release uses gentle, sustained pressure to release fascial restrictions. A single session can increase pressure pain thresholds, reducing pain sensitivity in the upper trapezius (Stieven et al., 2021). It’s commonly integrated into chiropractic treatments.
4. Thermal Ultrasound
Thermal ultrasound uses sound waves to heat and soften trigger points, reducing tissue stiffness. It significantly increases tissue depth (indicating less stiffness) compared to sham treatments, offering a comfortable intervention (Draper et al., 2010).
5. Stretching Relaxation
Daily stretching exercises targeting the upper trapezius reduce tension and stiffness while improving elasticity. A two-week regimen showed significant improvements in muscle properties (Li et al., 2024).
6. Mechanical Vibration Massage
Mechanical vibration massage uses oscillatory devices to decrease tension and stiffness. Applied daily for two weeks, it enhances trapezius muscle elasticity and reduces pain (Li et al., 2024).
7. Pulse Massage
Pulse massage, involving rhythmic pressure, similarly reduces tension and stiffness in the upper trapezius, offering benefits when used consistently (Li et al., 2024).
8. Trigger Point Massage
Trigger point massage applies direct pressure to relieve tension and pain, improving circulation, mobility, and sleep quality. It can be performed at home or by a licensed therapist (Cleveland Clinic, 2025).
9. Rigid Taping
Rigid taping limits wrist movement to reduce upper trapezius strain during tasks like typing. It improves typing performance compared to splinting, making it a practical option for office workers (Ayd?n et al., 2021).
References:
- Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
- Stieven, F. F., Ferreira, G. E., de Araújo, F. X., de Medeiros, F. S., da Rosa, L. H. T., de Oliveira, M. X., & da Silva, M. F. (2021). Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 95–102. https://doi.org/10.1016/j.jmpt.2020.07.003
- Draper, D. O., Mahaffey, C., Kaiser, D., Eggett, D., & Jarmin, J. (2010). Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles. Physiotherapy Theory and Practice, 26(3), 167–172. https://doi.org/10.3109/09593980903423079
- Li, G., Liu, D., Yang, D., & He, L. (2024). The impact of different muscle relaxation techniques on the upper trapezius and its relationship with the middle trapezius. Journal of Physiological Investigation, 67(4), 225–232. https://doi.org/10.4103/ejpi.EJPI-D-24-00041
- Ayd?n, N. S., Çelenay, ?. T., & Özer Kaya, D. (2021). Muscle activation of the upper trapezius and functional typing performance during computer typing task: A comparison of two different wrist immobilization methods. Journal of Bodywork and Movement Therapies, 27, 472–476. https://doi.org/10.1016/j.jbmt.2021.05.001
- Cleveland Clinic. (2025, February 4). For relief, pull the trigger on a trigger point massage. Health Essentials. https://health.clevelandclinic.org/trigger-point-massage
What is Upper Cross Syndrome- Video
Integrating Chiropractic Care with Nonsurgical Treatments
Combining chiropractic care with nonsurgical treatments creates a comprehensive approach to managing upper trapezius pain. Examples include:
- Chiropractic Adjustments + Dry Needling: Adjustments restore spinal alignment, while dry needling targets trigger points for immediate relief.
- Myofascial Release + Stretching: Chiropractors perform myofascial release in-office and prescribe stretching for home maintenance.
- Thermal Ultrasound + Postural Correction: Ultrasound softens trigger points, while chiropractic care corrects posture to prevent recurrence.
- Patient Education: Guidance on ergonomics, stress management, and exercise complements in-office treatments (Jimenez, 2025).
This integrative strategy addresses both symptoms and underlying causes, promoting lasting relief.
References:
- Jimenez, A. (2025). LinkedIn profile. https://www.linkedin.com/in/dralexjimenez/
Preventing Upper Trapezius Pain
Preventing recurrent shoulder pain involves proactive measures:
- Ergonomic Adjustments: Use a supportive chair and position monitors at eye level to maintain neutral posture (Brandt et al., 2014).
- Regular Stretching: Perform daily upper trapezius stretches to enhance flexibility (Li et al., 2024).
- Stress Management: Practice relaxation techniques like deep breathing or yoga to reduce muscle tension (Cleveland Clinic, 2025).
- Strengthening Exercises: Strengthen scapular stabilizers, such as the lower trapezius, to reduce upper trapezius strain (Silva et al., 2022).
- Routine Chiropractic Care: Regular adjustments prevent misalignments and maintain muscle function (Jimenez, 2025).
References:
- Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
- Li, G., Liu, D., Yang, D., & He, L. (2024). The impact of different muscle relaxation techniques on the upper trapezius and its relationship with the middle trapezius. Journal of Physiological Investigation, 67(4), 225–232. https://doi.org/10.4103/ejpi.EJPI-D-24-00041
- Silva, E. R., Maffulli, N., & Santos, G. M. (2022). Function, strength, and muscle activation of the shoulder complex in CrossFit practitioners with and without pain: A cross-sectional observational study. Journal of Orthopaedic Surgery and Research, 17(1), 24. https://doi.org/10.1186/s13018-022-02915-x
- Cleveland Clinic. (2025, February 4). For relief, pull the trigger on a trigger point massage. Health Essentials. https://health.clevelandclinic.org/trigger-point-massage
- Jimenez, A. (2025). LinkedIn profile. https://www.linkedin.com/in/dralexjimenez/
Conclusion
Upper trapezius shoulder discomfort may greatly interfere with day-to-day functioning and is often caused by myofascial trigger points, poor posture, stress, or repeated strain. A potent way to reduce pain and regain function is to combine chiropractic therapy with nonsurgical procedures like thermal ultrasound, myofascial release, and dry needling. Specialists such as Dr. Alexander Jimenez stress evidence-based, integrative methods to treat underlying causes as well as symptoms, enabling patients to achieve long-term health.
Notice: This material is not intended to be medical advice; rather, it is just informative. Shoulder discomfort may have many different causes, and a trained healthcare professional should be consulted if the symptoms are severe or chronic. To get an accurate diagnosis and a customized treatment plan, speak with a chiropractor, doctor, or physical therapist. If symptoms get worse or are persistent, get help from a specialist right away.
References:
- Ziaeifar, M., Arab, A. M., Karimi, N., & Nourbakhsh, M. R. (2019). Dry needling versus trigger point compression of the upper trapezius: A randomized clinical trial with two-week and three-month follow-up. Journal of Manual & Manipulative Therapy, 27(3), 152–161. https://doi.org/10.1080/10669817.2018.1530421
- Stieven, F. F., Ferreira, G. E., de Araújo, F. X., de Medeiros, F. S., da Rosa, L. H. T., de Oliveira, M. X., & da Silva, M. F. (2021). Immediate effects of dry needling and myofascial release on local and widespread pressure pain threshold in individuals with active upper trapezius trigger points: A randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 44(2), 95–102. https://doi.org/10.1016/j.jmpt.2020.07.003
- Ayd?n, N. S., Çelenay, ?. T., & Özer Kaya, D. (2021). Muscle activation of the upper trapezius and functional typing performance during computer typing task: A comparison of two different wrist immobilization methods. Journal of Bodywork and Movement Therapies, 27, 472–476. https://doi.org/10.1016/j.jbmt.2021.05.001
- Silva, E. R., Maffulli, N., & Santos, G. M. (2022). Function, strength, and muscle activation of the shoulder complex in CrossFit practitioners with and without pain: A cross-sectional observational study. Journal of Orthopaedic Surgery and Research, 17(1), 24. https://doi.org/10.1186/s13018-022-02915-x
- Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Research and Treatment, 2014, 352735. https://doi.org/10.1155/2014/352735
- Voerman, G. E., Vollenbroek-Hutten, M. M. R., & Hermens, H. J. (2007). Upper trapezius muscle activation patterns in neck-shoulder pain patients and healthy controls. European Journal of Applied Physiology, 102(1), 1–9. https://doi.org/10.1007/s00421-006-0215-8
- Crookes, T., Ewald, A., & Jennings, M. (2023). Chronic shoulder pain. Australian Journal of General Practice, 52(11), 753–758. https://doi.org/10.31128/AJGP-04-23-6790
- Cleveland Clinic. (2025, February 4). For relief, pull the trigger on a trigger point massage. Health Essentials. https://health.clevelandclinic.org/trigger-point-massage
- Draper, D. O., Mahaffey, C., Kaiser, D., Eggett, D., & Jarmin, J. (2010). Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles. Physiotherapy Theory and Practice, 26(3), 167–172. https://doi.org/10.3109/09593980903423079
- Li, G., Liu, D., Yang, D., & He, L. (2024). The impact of different muscle relaxation techniques on the upper trapezius and its relationship with the middle trapezius. Journal of Physiological Investigation, 67(4), 225–232. https://doi.org/10.4103/ejpi.EJPI-D-24-00041
- Jimenez, A. (2025). LinkedIn profile. https://www.linkedin.com/in/dralexjimenez/
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