Having Neck Pain? It Could Be a Strained Trapezius Muscle

Today, the average lifestyle involves the increasing use of technology devices in the form of smartphones, tablets, gaming devices, and computers. The more someone uses these devices, the more likely they are to experience issues with their neck. Neck (cervical) issues such as pulled muscles, neck strain, and neck pain abound throughout the population. 

Of course, it’s also possible that other factors could be the source of a person’s neck pain. Anyone with severe or persistent neck pain should obtain a diagnosis from a medical professional to determine the cause of their pain. 

Understanding the Trapezius Muscle

One muscle that can cause neck pain is the trapezius muscle. The trapezius, or trap muscle, begins at the base of the neck and then broadens to encompass both shoulders. It gradually narrows again as it travels down either side of the spinal column, eventually forming a point just above the mid-back region.

The trapezius muscle is divided into three separate regions: the upper trap is part of the muscle that starts at the base of the neck and then extends to attach to each shoulder; the middle trap region resides just below the upper trap area, from shoulder to shoulder; and the lower part of the trap muscle is the area further down the spine where the muscle begins to narrow.   

What is a Trap Strain? 

Although upper trap muscle spasms and strain are becoming more frequent, a person can also have issues in the middle and/or lower trap regions. While technology use is a frequent culprit of trapezius strain and pain, issues can also stem from:

  • Poor posture
  • A sedentary lifestyle (leads to weak muscles)
  • Excessive lifting (using poor form) 
  • Overuse of trap muscles (jobs requiring certain repetitive movements/lifting heavy objects)

A strained trap muscle occurs when some portion of the trap muscle has been overstretched and/or its muscle fibers have been torn. The medical community uses a grading system to define the severity of a strained trap muscle. The grading system is as follows:

  • Grade I (mild) – some overstretching present, only a few fibers may be torn
  • Grade II – moderate overstretching, more torn fibers
  • Grade III (severe) – muscle components have completely separated, and frequently require surgical repair

Signs of a Trap Strain

Strains due to “wear and tear” usually present with mild symptoms, at least initially. Mild symptoms include:

  • Pain/discomfort when looking up or down and/or maintaining a static posture
  • Difficulty sleeping due to neck pain
  • Pain with shoulder shrugging movements, turning head to the left or right, or from side to side

Having difficulty lifting (heavy) objects can be a sign of a more advanced strain. Other signs of a more advanced issue include pain, burning, and numbness in the affected shoulder/neck area, even when seemingly at rest, or upon the identification of muscular trigger points. A very severe strain (grade III) is likely to occur only after some type of acute injury or blunt force trauma. This level of strain causes severe pain and loss of function and requires immediate medical attention.  

Determining the Root Cause of Neck Pain

The cervical/shoulder/upper back areas are complex regions, so people with trap pain should seek professional medical help for a proper evaluation. Determining an accurate diagnosis involves ruling out other issues, or in some cases, determining how much another cervical issue may be contributing to a person’s trap pain. Other issues to consider include:

  • Cervical disc herniation/stenosis 
  • A (shoulder) rotator cuff injury
  • A deltoid (upper arm muscle) injury
  • Kehr’s Sign – left shoulder pain indicating a spleen injury

Physical Therapy Goals

Physical therapy can assist in both the evaluation and treatment of trap injuries. Evaluating a patient presenting with neck pain may include:

  • Postural assessment/screening
  • Neurological screening
  • MMTs (manual muscle testing)
  • Other special tests 

Treatment to Relieve Neck Pain

Physical therapists have a variety of treatments available to them that are very effective in treating trap pain. The initial steps of treatment will involve addressing a patient’s pain. This is accomplished by employing a variety of pain-relieving techniques such as the application of heat/ice, taping, ultrasound treatments, and/or having the patient use a TENs unit.

A physical therapist will also likely use manual (hands-on) therapies designed to massage tight muscles and release trigger points. Lastly, a patient may be introduced to postural reeducation and gentle stretching exercises, followed by more intense exercises designed to strengthen the trap muscle itself, as well as other muscles that support the neck, shoulders, upper, and mid-back regions.  


If you or someone you know is experiencing neck pain, we can help! Contact Cawley Physical Therapy & Rehab at 570-208-2787, or email us at: cawleyptfrank@gmail.com. We look forward to hearing from you!