A “knotted” spasm in trapezius muscles is a common pain complaint. You can tell if you have one simply by squeezing the fleshy area between your neck and your shoulder. If this area is sensitive, tight, and painful, then you have “knots” in your trapezius. People often seek out massages, injections, medications, and more to get rid of these painful knots. We like to blame it on stress, backpacks, and all kinds of other reasons for this pain. Unfortunately, few people ever offer solutions that actually work because they do not understand why the knots develop in the first place. Massages and injections may not work because the reason for the spasm in the muscle is not addressed. For example, the trapezius is becoming tight and “knotted” for a reason. The reason may be because it is responding to a slight dysfunction at the acromioclavicular joint (AC joint), which is a place where the muscle attaches and a joint the trapezius moves. The problem is that the AC joint does not actively hurt, so it may not be in our awareness that there is a problem there and it may not be in the awareness of the massage therapist, physician, practitioner, or person giving you an injection. Therefore, the trapezius spasm gets massaged, squeezed, injected, and lots of other therapeutic interventions, but the spasm is still there. Why? Because the trapezius muscle is contracting the protect the dysfunction at the AC joint. Unless the AC joint problem gets resolved, the trapezius will continue to spasm. The solution, therefore, is not to work on the tight trapezius “knot,” but commonly may be to work on the AC joint problem the trapezius is responding to.
The trapezius attaches on the clavicle and shoulder blade. The clavicle articulates with shoulder blade at a structure called the “acromion.” Together they make the “acromioclavicular” joint. Although not the ball and socket joint of the shoulder, the AC joint is part of the shoulder and can have an effect on shoulder range of motion. A contraction of the upper or lower trapezius can produce motion at the AC joint. Therefore, even a slight problem at this joint can produce a reflexive contraction to protect the joint from becoming more problematic. The end result is a spasm or “knot” in the trapezius. Think about what may be happening when people wear backpacks that are too heavy. The straps will put a lot of pressure on these joints and cause them to stop working properly. Then the trapezius muscles will contract and a permanent knot will be there unless the AC joint dysfunctions are resolved. Too often, specialists are looking in the wrong area.
Trapezius Knot: Self-Treatment Steps
- Check the trapezius: Grab onto your trapezius between your neck and shoulder joint and give it a squeeze. Tenderness here may be indicative of an AC joint dysfunction. Also, it gives you a starting point to know how things have changed afterwards.
Find your collar bone and trace it outward until you feel the end of it. There may be a digit there or a bump. That is your AC joint. Another way of finding it, is simply to on the top of your shoulder and look for a bump.- Grip your AC joint with your thumb and index finger and slowly wiggle it back and forth. You may notice that at first it is not tender, but as you do this an underlying tenderness will show up. Do this until you feel that the bump can move a little more freely.
- Recheck your trapezius and see if it feels different.
- Do this once a day until it stops feeling tender and is freely moveable. You should notice your trapezius will likely feel less knotted and less sensitive.
Hopefully this will help you to understand why other treatment methods have failed to produce results. It is important to ask why a muscle is producing an active spasm or “knot” and dealing with the reason. The other option is living with the pain that this unresolved issue produces. Which sounds like the better option?
[loveclaw_graph]
Dear Dr.Lopez, it did help. Thank you for sharing.
You’re welcome. Thanks for your input.
Seriously! This is so effective…THANK YOU SO VERY MUCH!
You’re welcome! Glad it helped:)
Hi Dr. Lopez,
How long should I wiggle the AC joint? 30 seconds, a minute? Only once a day? And what amount of pressure? Thank you so much for your help, and for writing this article.
Hi Dain, Thanks for your questions. The point is to free up the AC joint and get it functioning well again so the answers can depend on how severe the problem is. Probably 30 seconds to a minute once a day should work. However, if you do it a few times and it does’t help, then the answer probably lies somewhere else.
Wow. I’ve been going to physical therapy (ompt) since April 2014… Prior to this I did it for 6 months (regular pt) in 2013. Im in Michigan. PT has helped a ton but hasnt fixed the problem to the point of living bearably. We tried trigger point injections and that seemed like they helped temporarily. Although due to some recent stress and the weather I’ve been miserable. I just tried this since im grasping at straws at this point and the size of the knot went down dramatically. Ive been telling my doc that this knot was the cause of my pain since the beginning. I’m extremely impressed. Thank you so so much! This post has literally saved me from going to bed in tears like I usually do with this pain.
Hi Eva, thank you so much for your comment. I’m sorry about all the pain you have been through. I’m glad this information was able to help you. There are certainly other factors that can be contributing to the knot, but I’m glad the information helped release the knot dramatically. Good luck with the rest.
Holy cow! I’m amazed at the instantaneous relief I have in my trap. Thank you!!!!
Thank you Doc. It is a useful suggestion. I found the video very handy
Wow! No wonder the massages only last three days. The muscles loosen and then the guarding comes right back.
Is it advisable if there are no obvious injuries on the MRI to get a cortisone shot to relieve the trapezius muscle spasm?
Thank you!!!
Hi Wendy, thanks for the comment. Although I cannot give medical advise and tell you what to do, I personally would not get a cortisone shot for a muscle spasm without an obvious injury. Ultimately steroids can weaken the structures and there’s no guarantee it would work. If it goes unresolved still, I would look for a good osteopathic physician that specializes in osteopathic manipulative medicine. I hope that helps.
I have to say I had cortisone injections for many many years. Ended up with shoulder surgery 5 years ago and now need another on same shoulder for bone spurs, bursitis and slight tear. Yes Cortisone is no good and no doctor ever told me that until it was too late. I had at least 20-30 between shoulder, elbow and in a couple of nerve blocks for the neck.
Hi,
I’m from long island and live in NC now. I’m willing to fly home to make an appointment with you. Long story short, I’ve been dealing with this shoulder, neck trap issue for 25 months. It came out of nowhere. No injuries. I was doing a bootcamp /crossfit class and was fit, healthy and happy at the time all this happened. Now, 50 Duke doctors later, 4 mris, 20xrays, 4 physical therapists, 3 massage therapists (relaxing, medical, tmd, and myofascial), tons of blood work… I’m still in pain. All tests came back normal. Whatever was on the normal low side, such as vitamin d, I fixed.
It started in March 2013 with a tight jaw, then may 2013, I had a one-time weird sensation of someone pouring cold water on left side of my head. In Nov 2013, I woke up with shooting pain behind my ear and down (or up) my shoulder trap. I immediately went for help to docs and Chiropractors. I was hurting worse with Chiropractor adjustments. Over a year span after that, the pain grew down my spine and into my hip muscles with barely any range of motion in my neck. Through massage and physical therapy, my hips are back in alignment and back called down. However, my trap muscle on the right side are constantly in spasm. Showers, 8 hours sleep, and heat help it temporarily go away fully. Car rides make it spasm more. An osteopath did an ultrasound a few months ago of literally of all my pain spots,L and shoulder and he found nothing. Some docs told me to give up or wanted to call it fibromyalsia, but I refuse to do so. Through all my research (I’m a former reporter), fibromyalsia doesn’t dissappear with showers and sleep. I have very small muscle twitches all over, especially in neck. My scalp is constantly tender straight up the middle, and when my shoulder/trap/neck is aggravated, my jaw gets tight. We tried the tmd route with massage and I’m still the same after a few days after therapy. Each time I go to therapy, it helps for a few days, then, it comes back. Massage therapy just “pops” the knots I have around my shoulder blade, shoulder and neck.
I’m not a super high stressed person. I practice medication, eat organic and non-gmo. I try to exercise and working on strengthening my back muscles just in case it’s forward head syndrome. I do believe this MAY be related to a bar with weights on my shoulder while doing back squats before this happened. I didn’t hurt or have an injury though. All docs are stumped on how to fix this pain. Have you ever heard of this?
Hi Danielle,
Thank you for the message (I’m glad that was the short version:)). I’m sorry about all you have been through with no relief. I haven’t heard of this happening to other people but from my perspective it does not matter necessarily because I would treat you based on you. I would like to see you if possible sometime. This doesn’t sound like it will be simple necessarily, but I have some ideas on things that may be affecting your trapezius and body based on what you have written that others may not have considered. Regardless, I hope you are able to find some relief soon. I hope to meet you soon,
Dr. Lopez
I had a rotator cuff repair (split deltoid) about 6 years ago. I have a really weak shoulder and woke up and could barely move my head to the right, as the neck was so tight and knotted. My husband found a really large knot right where the picture shows. I now have a “strand” of muscle that sticks out along the length of the edge of the trapezius so clearly that it can be easily seen, running from the left base of my skull to my shoulder. I tried this and it seemed to help. Thank you! Maybe this will help. Any other thoughts on the strand that is so obvious?
Hi Patti, I could not say for sure, the left over strand could be from many things. It could be coming from a dysfunction at the base of your skull or neck. A torn rotator cuff could her causing that or the muscle could be responding to the scarred tissue from the surgery. Otherwise there could be too many things to speculate. I’m glad you were able to get some relief.
Hi- stumbled across this in a Google search. Been having a tremendous amount of pain/discomfort in that neck, lower neck/upper shoulder area. In the shoulder area around the Trapezius I can feel a marble sized “knot”. Me or my wife rubs that and the pain seems to subside briefly. I also apply Icy hot patches to the area from time to time (not making that a habit).
I just started trying the recommendation above today and it seems to be helping. I’m praying it continues
Here is my question. I broke my collar bone twice. I was a youth when they happened but do you think this is a side affect from that?
Hi Frank,
Yes, breaking your collarbone twice will have an effect on this because the anatomy is altered. Part of that depends on how it has healed. The muscle may have to knot to respond to that issue and so you would want to do whatever you can to keep the area from worsening. Whatever is working for you, keep it up. Hopefully the tip will help.
Hi Dr Lopez. I wonder if you could shed some light. I regularly have knots on the right side of my upper back. On my collar bone on that side, near the shoulder, is a hard lump. It feels like it’s part of the bone. It’s large enough that you can see it. Ive had this lump for years, but I have no recollection of damaging my collar bone. Will this be causing the knots? And what is it??
Many thanks for any help you can give me in this.
Lindsay
Hi Lindsay, it would be impossible for me to say for sure without evaluating and treating, but from what it sounds like, your collarbone and shoulder blade may not be sitting on your rib cage in the correct position. It may be slightly off, but the muscles would have to respond just the same. Either way, that would cause knots throughout those areas. That would be my guess based on what you have written but as I mentioned, it would be impossible to know without evaluating.
Thanks,
Dr. Lopez
Thanks so much for replying, I’ll look into what I can do about that.
Best Regards,
Lindsay
Dr. Lopez,
In your experience have you ever seen this pain pop up in conjunction with something else getting hurt in the neck. About a month ago I hurt my neck as I was looking off to the side. Initially I though the pain stemmed from my neck since that is the area with the deepest discomfort. Additionally, even though my torso looks horizontal it feels like my body is tilted to the right.
A little diagram I made here shows the discomfort as red (the right side as a whole had much more discomfort than the left), and gold is the area with most discomfort and the deepest pain.
http://i.imgur.com/dtPu5dD.png?1
I just came across your post and babying the AC joint already feels like it’s helped alot with the tightness and pain already, but is seems like it has no effect on the golden section. Is there some other injury that likes to come in pairs with this type of problem.
Dear Sky,
It sounds like your neck is still maintaining the pattern of injury and probably something is still not right in your upper cervicals. The rest of your body is responding to what is not working right in your neck and that’s why it likely feels twisted. The AC joint is likely not the biggest issue in this case and although the treatment may help, the other areas influencing your neck will need to be addressed. The golden area you’re pointing to looks more like splenius capitis rather than trapezius. This would have to be something I would have to evaluate and treat you for. It sounds more complicated than the typical trapezius knot. I hope that this helps. Let me know if I can answer any other questions.
Hi Dr. Lopez,
I found your website from google search. I’ve been dealing with left trapezius knot and pain since 7-8 moths ago due to bad posture during night breastfeeding (co-sleeping). I’ve tried the self treatment and it gave me instant relief, I wiggled my AC joint around 60 seconds until sweating, is the sweating normal? Can the dysfunction of AC joint cause clicking sound when moving arm back and forth? Thank you for your kind attention.
Hi Derania,
Thank you for the questions. Sweating does not commonly take place with this, but it suggests that releasing it is having an effect on your autonomic nervous system, which runs your body processes unconsciously. Either way, it can be a normal response and is not something to worry about. Yes, the AC joint can cause a clicking sound when moving the arm back and forth, but there can be other places that cause the shoulder to click as well.
Hi Dr. Lopez
I’ve been having what felt like a vibration in the back of my head. It seemed to affect my vision, making my dizzy and decreasing my ability to concentrate. After seeing my campus health services I was told that this was due to trapezius tension and given stretches to do.
After doing these stretches the sensation happened less and felt like more of a tingle in the back of my neck, but it still persists.
Does this sound like a case of a problem with the ac joint to you?
Hi Karissa,
Thank you for the question. I’m sorry about this issue you have been dealing with. The trapezius has many other points of attachment that could have it causing problems. What you describe sounds like the AC joint would be the unlikely issue, but you could always try it out and see if it helps. If it does not, then there is a problem elsewhere. I hope that helps. I hope you are able to find relief.
I was fixing my hair and something cracked behind my ear and It feels like it is locked it is closer to my head then shoulder any ideas what it is
It could be the occipito-mastoid suture but that’s the best I can do given the description.
Dear Dr Lopez, i have had fibromyalgia for decades and lots of pain in all trigger points and lately injections. i tried your suggestion of massaging the ac joint and found some relief on the first attempt. will it help the lower trapezius in the upper back which has an unrelenting very painful spasm for years? if not, what is the help for that area? i just tried the tip today. thank you so much.
Dear Breni,
Thanks for the message. I’m glad that the AC joint technique worked. It may not help the lower trapezius and middle trapezius in the upper back. Those can be a result of problems elsewhere and very likely the spine itself, where it is attaching. I don’t know a self-help technique to get to that specifically. That may require more professional help with a qualified osteopathic physician. Best of luck with finding relief.
Chrinic upper left trap and neck pain remedies cervical epidural shot on may 20th not solution thx
I have had shoulder/trap pain since 2009. Back then, I went to a chiropractor, a massage therapist, and my regular physician. They all said it was stress. For 6 years I’ve been dealing with it and it has become absolutely unbearable now. I wake up several times a night, I’m in pain while driving, sitting doing nothing, at work, walking down the street, swimming, you name it.
I’m overweight, but I eat entirely plant based and severely limit any oil intake (I’m not a junk food vegan). I go to the gym in the mornings at least 3-4 times a week for resistance training. I walk one to two times a day for 20-35 minutes with my dog. I do not work after 5pm or off the clock, as I did that a lot when I was younger and paid the price for it. I’ve had one anxiety attack in my life, and it was about a month ago (related to deadlines at work). I’ve used ice, heat, a handheld massager, topical pain relieving rubs, and tylenol to help with my shoulder, and on occasion have taken a muscle relaxer JUST so it would knock me out enough that I wouldn’t feel the pain and could sleep. NSAIDS severely upset my stomach, but I’ve resulted to taking those lately, too, and then taking something for my stomach a short while later. Now I am starting to drink after work to loosen things up.
I went to the doctor today, again, begging for relief. She told me I’m having trapezium muscle spasms. I’ve never had a spasm. She wanted me to go to physical therapy and take muscle relaxers 3 times a day. I told her I have a professional job to uphold – muscle relaxers will put me to sleep for 24 hrs. I also told her I’ve been taking muscle relaxers to sleep some nights, and it’s not doing anything to relieve the pain the next day. I told her I wanted to find the root of the problem rather than drugging myself up and living with this indefinitely, and that my insurance doesn’t cover physical therapy. “Well, that’s what I think it is,” she tells me, and “we’ll try this first and if it doesn’t work, then we’ll maybe consider looking at the skeletal issues.” Can’t go to physical therapy because it’s not affordable. Can’t afford weekly massages. Don’t want to drug myself up on muscle relaxers. But can’t get anyone to take me seriously. I just want to cry; I’m in so much constant pain.
I used to be a vegan as well and had lots of back problems that wouldnt heal no matter what I did. You might not like my advice because i’m aware its very hard to transition diet since ive done it myself..ethically it was hard but physically it is the best thing ive ever done. you need protein to heal muscles, specifically animal protein. It’s also very hard to access the calcium in plants such as kale and chard unless theyre very well cooked, i learned this from a vegan nutritionist and eating them raw doesnt allow you to absorb the nutrients. Your body is probably lacking calcium, vitamin b-12, vit D3 and many other important nutrients to heal and stop spasms. Just my two cents since i want to help and see youre in pain. Good luck!
I highly recommend the book, “Treat Your Own Neck”, by Robin MacKenzie. Its highly unlikely to do any harm if it doesn’t help. The MacKenzie method is a very interesting type of PT on which the focus is learning to treat yourself. I’m having amazing results with it. Of course you should consult with your doc over your specific problem before trying it.
Hi Jamie, I apologize for the really delayed response. I just realized that I never responded to your comment. Thank you for taking the time to write. Your pain sounds awful and I’m sorry that you’re having it. I hope you have managed to find some resolution of your trapezius pains and spasms. Unfortunately, I cannot specifically know what is happening without evaluating and potentially treating. If your trapezius is knotting and you haven’t had much success, then there is possibly some kind of anatomical problem in the shoulder that cannot heal itself and no one has been able to help your body resolve it. Calling it stress will not help as it tends to stay tight even if you relax. That’s the best I can do given the information, but I wish you the best of luck finding real relief.
I have been experiencing neck and shoukder pain which then transferred to my trapezius. The dr diagnosed trapezius muscle spasm seven weeks ago. I have been to physio and acupuncture but still have nerve pain which moves and right shoulder bicep tightening could this be some underlying spine issue? Stress and poor posture seens to be the cause but should be experiencing relief by now. Any advice would be appreciated.
Hi Sandra, thanks for the comment and the question. Unfortunately, the trapezius is a complex muscle anatomically with many points of attachment and influenced by many factors. Unfortunately, it would really be difficult to know exactly what would need to be done without being able to evaluate.
It’s not often that I bother leaving a comment but I’ve been suffering from a knotty trapezius for months. I’ve just tried the advice in this article. Amazing results, simply amazing. Thank you so much , Dr. Lopez.
OMG! it absolutely makes a difference. Being that I always have what I call “golf balls” right in the trigger point , middle of my traps, this is a god send.
I do notice an immediate difference and not in that placebo , kinda sorta feel something way. I really do feel the trigger points ease up and shoulders moving more freely. awesome. Being I took 900 hours at massage school, I cannot believe they didn’t show us this. !
Thank you SO much for this information.
I went to a private school, here in Australia, and the amount of books you have to carry back and forth is back breaking. I generally would carry my bag, mainly with one strap, on my right arm. Since year 7 (age 12) I have had this extremely saw knot in my shoulder/trap.
After 11 YEARS of managing the pain (most days I ball my eyes out) I have tried this technique whilst at work and it’s been immediately helpful. I have many other problems that I think may be related to this. If you could shed some light on whether or not the AC could be the main reason I can avoid many $$ going to unnecessary chiro/osteo and Massage therapists!
I’ve had the knot in my shoulder for many years. I was unable to get it looked at because of family issues. As the years went on I only had the knot pain. Once I could afford to get remedial and deep tissue massages that’s when the other problems started.
Now, Instead of the only the knot being the issue, the pain radiated and more knots were found. My neck causes me A LOT of pain. I get headaches that radiate from my shoulder(apparently, only learning now, that’s where the AC is), nerve pain down my arm on the inside from the arm pit, then goes via my right trap, through the right side of my neck into this small bump above my ear. This bump causes me too much pain.
The doctors aren’t worried about it and it’s tender to touch. But this is only when my shoulder/neck/trap/arm is playing up; inevitably giving me a headache. These headaches affect my right sided vision and last for days at a time. I feel violently ill because of the severity of the pain and he only source of relief is to have it massaged.
There are times when I will randomly have a feeling of my arm/arms falling out of their joints. This has only been going on a few months. During that time nothing could relieve this feeling. A few weeks ago the doctor told me my trap was spazming for the last 12 years and the pain relief would be stretching and massage. After knowing to massage the trap asap to avoid it causing me a prolonged period of pain, I thought to do it to relieve the feeling that my arm had fallen out of it’s socket. This worked and has saved me many sleepless and frustrated nights. although it’s still occurring and I’d like it to stop.
When I have the right side, trap, shoulder, arm massaged I can barely feel it unless they apply a great amount of pressure. The muscles almost feel numb when it’s in pain. I can barely feel my muscles in my right side shoulder but my neck has a lot of pain and feels like It needs to be massaged, always.
There are many super tender points on my neck starting from the base of the neck to the base of the skull. But in particular, I feel the need to rub the base of my neck, next to my collar bone as well as certain lumps on and around the collar bone. This is extreme pain but it sometimes subsides my headache and pains.
At anytime, no matter if I’m in pain or not, I apply a touch of pressure and it feels like I’m having all of the aches and pains at once. I can feel this in the lower trap, Neck, the bump above my ear and in my shoulder (around the AC) and sometimes running down my arm. There are little bumps through out the side of my neck which hurt even more so when I isolate them with my finger and very slightly go up and down over it. After I do this I feel cracks in my neck which I think are ligaments clicking and when I breathe deepish I can hear little cracks and pops from mid back (right side only) and up through to my neck. Only when my neck pops and cracks I can move it more freely. I generally have very limited movement in my neck as it is so this is a great relief but lasts only a few seconds.
The other issue is that I have is hip problems. I get extremely sore hips that I’ve tried many times to get a GP’s help but they’ve only informed me that I do not have osteoarthritis. I was born with a ‘clickity hip’ and this was due to have outgrown my mothers womb and being 2 weeks over due. The nurse told my mother that it would go away, and it never did. As I believe I didn’t know any different as a child, it never went away and I was used to the uncomfortableness I feel day in and day out. As I did dancing and was always active as a child and teen I didn’t have severe problems until I was about 17. This is when things went down hill. My hips crack at the back at the tail bone, my legs feel like they’ve fallen out of their sockets (causing excruciating pain) which takes me a couple of minutes of hugging my leg to subside, my legs have very little rotation and can’t get turned inwards or lay too far apart from each other because they would then have the pain of feeling like they’re dislocating. When My legs crack in the socket is extremely painful for a brief second then I feel relief as I can then move my leg more freely. I get lower back pain from the hips that hurt through out the gluteus Maximus. Some day’s I can’t walk at all but I limp every day because of constant pain. The muscle pain is generally in the right hip but both hip sides crack and make my body almost fall because of the popping action. This is almost as if they’re ‘popping into place’ but still causes pain.
How this related to my shoulder is that when I’m having the pains and aches on the right side of my upper body I tend to manipulate my hips to help my upper body pain subside. This actually works for me and even though the pain is still constant it helps me bare for a little while longer.
NOW if you’ve made it through this essay of issues and have some advise for me I would forever be in your favour!
Thank you,
Briony.
Hi Briony, thanks for the message. I’m glad you were able to get some help with the material. I’m not sure that the AC joint would be the problem here. There’s likely other issues that would have to be addressed that go beyond what I can show. Unfortunately, I can’t really give you much feedback without being able to evaluate and treat. It sounds like there are more global issues as well as some cranial problems that are causing some of your knots as well that need to be addressed by a professional. I’m working on a book and online course to help with some of the head issues but as of now, they’re not ready. The only other thing I could suggest trying is looking for tender areas beyond where it actively is painful. Sometimes these can be more tender when you find them and help resolve the ones that do bother you.
I have been suffering from severe painful muscle spasms in the trapezius especially on the left side for about a year and a half now. I have had several cervical blocks with Kenalog injections, which helped with the pain, but the last injection was not very effective. The last round of physical therapy did not help much either. I told my pain management doctors about this article, and they don’t seem to be convinced that the AC joint is the problem and think it is mostly from my herniated cervical discs. This “wiggling” of the AC joint seems to help, but I am still unclear on how exactly to grab this joint and wiggle it, as it does not seem to be a very easy joint to grab and move around. Is it possible that a video can be made showing how to actually grab the joint and wiggle it around? Thanks!
Hi Jason, thanks for the comment. I am working on putting together some videos. Technically, you’re trying to get a hold of the collarbone as close to the joint as you can. That’s what you are wiggling. It is not easy and may not be the only issue you have, but may be a part of it.
Dr. Lopez
Like many others, I found this forum from a google search. I am a 27 year old male and I have had a nagging knot/inflammation in my left upper trapezius muscles for years now. In addition, I have a separated shoulder on the same side but I can’t remember a specific injury that caused it. I played contact sports (football and lacrosse) in high school and also used to lift (heavy) weights throughout college, so it could be a progressive injury?? I’ve been dealing with these issues for years now due to my high deductible insurance policy. Putting this injury off for a long time of course wasn’t the best idea because now it seems like my entire shoulder girdle has been repositioned to where I have a noticeable bump from my clavicle. It feels like the weight of my arm over the years has pulled my shoulder girdle down.
Now that I have better insurance, I went to an orthopedic specialist yesterday. He took some x-rays and said they looked “great.” Not sure how, but okay. He mentioned that I have a grade 2 separated shoulder and was very concerned with the swelling in my trap muscle. He referred me to a physical therapist to help resolve my issue. My question to you is Other that physical therapy, What else can I do to help address this issue and alleviate the swelling/knot in my trapezius? I know the ac joint needs to be addressed but will physical therapy be the answer get my shoulder girdle back in alignment? Thank you so much for taking the time to help!
Hi Rob, Thanks for the comment. I’m not sure I can answer your question. From my experience as long as you have the shoulder separation, you will have a knot in your trapezius. In this case, your trapezius is going to be tightening to protect and deal with the shoulder separation. I cannot say if PT will get your shoulder girdle back in alignment. You could consider something like prolotherapy but I generally cannot give specific medical advice based on the the comments. I hope this helps.
I have to say i have suffered from knots for a long time and have been lifting weights for some time now as well. i would always get knots in my trap and it would pinch a nerve causing some uncomfortable pain. After reading about this and trying it out myself the pain went away immediately and instance relief. This was a god sent.
Thank You Daniel Lopez
Worked a treat! Thank you! :)))
AC JOINT TENDER TO TOUCH.
KNOT IN MID BACK UNDER DELTOID SHOOTS PAIN TO AC JOINT
CORTISONE SHOT IN AC JOIN DIDNT HELP
NECK AND TRAP TENDONS SORE.
NOT EXCRUCIATING PAIN BUT MORE LIKE AN ANNOYING JUST THERE PAIN
ANY IDEAS?
-jOEY
My guess would be there could be some rotator cuff muscle problems or tension including the subscapularis muscle. That’s what it seems like it could be but it would be impossible for me to know without assessing and treating.
Hi Dr. Lopez,
Glad to find your post on Trapezius. I was diagnosed [originally] by my doctor as having a Rotator Cuff injury, which has been very painful at times and to the extend i cannot swing my arm around , it is very stiff. Anyway, after another visit I have found out it is not a Rotator cuff injury as previously diagnosed but a Trapezius Muscle Spasm. When I press it it is like a hard lump and tender. Although i can do normal things I still have to think about every movement i do. For example if i was to throw a quilt over the bed I have to be careful how i do this. Months ago I would be in great pain doing so. Now it is not so bad however I still have limited movement in my right arm. If I rotate it around, for example, my left arm can swing around in one big circle whereas my right arm can only do so in half and not a complete swing without having to stop slightly.
Do you have any advice what sort of exercises i can do to gain strength back?
Hi Carina, Thanks you for taking the time to write. I am sorry for the delayed response. I cannot say for sure but it sounds like there’s probably more going on there that a trapezius spasm. My guess would be that there is some kind of injury not picked up that is causing the trapezius to spasm that is slowly healing. As it improves, the trapezius will relax to the extent that it can. That would probably be why you have limited movement. The question you have to ask is “why is the trapezius spasming?” If there is an underlying injury, then it is that which you will have to go after. I can’t say I have any specific exercises. More than exercises, I would look to restore the normal structure to your shoulder. Otherwise exercises will either not do much.
dear Dr Lopez
hello I have tense upper and low trapezius muscles when carrying a heavy back is where I get some pain kind of rarely and I have tense trapezius muscles ever since last year. but I don’t know if I should get it checked by a doctor or get a scan of some sort because I don’t really get pain much so should I get it checked and do you think it might be a knot or not
thank you
from dani
Dear Dr. Lopez -So……I constantly have those knots on my left side. Massages help a little . Whenever I press the knot or get them massaged, I will feel pain or pinching right under my clavicle on that side. So I did your recommendation, albeit I too like another reader, had a little trouble figuring out if I was actually grabbing the AC joint and it did not seem to move like I thought it should. BUT I have to say I could tell a difference immediately!!! Then when I watched the video, oh my goodness I did that other part of kind of pushing the clavicle up. I actually have some swelling there too. Then watching you find the AC joint made me feel better that I was at the right area. ANYWAY – after doing it just twice – I went back to the knot and it was so much better feeling. So I will be doing this daily and want to thank you and am so glad I found this article.
Hi L Reid, Thanks for the feedback. I’m really glad that you found the information helpful. It really makes my day to hear that you felt an improvement.
Dr. Lopez – When I have the opportunity to visit my niece in Manhattan, I am hoping I have the opportunity to visit you also. Hope you don’t book too far in advance. 🙂
Sounds great! Hope to meet you then.
Thanks Doctor,
This does the trick for immediate pain relief! I’m going to keep doing this for my long-lasting trapezius tension.
Thanks again!
Awesome! Glad to hear it helped.
Can the trapezius cause pulling from the top of the head and cause neck and shoulder tightness?
Hi Toni, thanks for the question. I’m not exactly certain what you’re asking but structural problems and tensions in the head can cause neck and shoulder tightness, including trapezius. In that case, the best approach would be to address the tensions in the skull.
Hi,
I recently took a knock to the left hand side of my chest playing rugby, in the same game I was also tackled high hurting my neck and head. After the game the neck was alright but around my collar bone was sore to the touch, a little inflamed and hurt to sleep on my left hand side for a few days. A couple of days later I developed a tight trap then a day later my neck began hurting with shooting pains going up my neck to behind my eye. I saw a physio and she said I had a trap spasm.
I went to the A&E and all they did was give me codeine and a valium type muscle relaxant so I could sleep, and send me on my way.
I am still sore and almost out of meds. Should I bother waiting 2 hours at the A&E again or do you recommend another course of action?
Thanks
Hi Donald, Thanks for your question. Your tight trap is probably an effect of the trauma to the rib cage and head and neck. It sounds like you have injured your clavicle, which would cause the trap to spasm as an effect to the injury. The trap also attached to the thoracic spine that is commonly affected by the rib cage so a trauma there could also have an effect on the trap. If you’re still in pain, you will probably need meds and proper rest. Once the acute pain has calmed down, you may want to look for a good osteopath who may be able to help resolve any rib and clavicle issues you may have. I hope that helps.
Hello Doctor, I’ve been having a spasm in the part near the rhomboid major right besides the spine. I’ve checked with my doctor and there is no spine damage. I had a tab for 2 weeks which is more associated for a spasm along with a muscle relaxant to be applied on the back. Nothing has happened by now it’s been 2 months. My left spasm has almost gone on its own but the right one is with the same intensity until now.
Tried almost all sites and stretches but I don’t find any difference. While walking I need to twist my back often to the left so that I feel the muscle relaxed a bit and I feel better.
You think I should opt for an MRI or please help me doctor.
I’ve also had electrolytic drinks with water but no change.
Hi Mihir, Thanks for writing. The area of the rhomboid can be the rhomboids, but also the trapezius or paravertebral muscles. Commonly in the area, pain there is often from a rib problem. Probably you might try releasing your chest and pec area and more importantly try to get under your shoulder blade from the side and hold pressure on any tender areas. See if that helps, but without being able to assess, that’s the best I can do. An MRI probably won’t show a whole lot. You could try to look for an osteopath as you may also have rib issues that may need addressing. I hope that helps.
Hello Dr. Lopez!
I’m 20 years old and have noticed throughout the past few months a sharp stabbing pain near my right rhomboid bone. I first noticed if whenever i would be sitting for awhile reading or writing. I would stand up, and it would go away. For some reason now it’s a dull aching pain all the time and it hurts to even press down on the area. It also shoots up into my upper neck. I’ve never had any issues like this and it’s becoming so painful!
Thanks!
Jennifer
Hi Jennifer, pain over the rhomboid area could also be a rib that has become stuck or not working underneath. They often will refer pain up into the neck. You might try looking for tender areas on your chest on the same side as your pain. Sometimes resolving those will help get rid of the pain. Otherwise, I could not help you without seeing you and you would probably need to see a qualified osteopathic physician that does osteopathic manipulative medicine. I hope that helps.
Dr. Lopez
Hi Dr Lopez,
I have been dealing with neck, shoulder and upper back pain for a better part of 2 years now.
The occurrence is on a daily basis.
I have gone to a number of doctors over time. None with any real success.
A few times, assigning me to phys therapy with exercises that I do within a normal workout.
At times, I get headaches associated to the neck pain.
As of late I have had spasms on the top of my shoulder (specifically to the trapezius).
I have also has pain down my (left) arm, a tingling sensation. At times, during movement, it feels similar to when an arm has fallen asleep with an odd uncontrolled movement.
Can you suggest anything for treatment, exercises, etc.
I do have lovely knots at the top of my traps, that are a challenge to work out on my own.
Not sure if this is the culprit. But I do roll on top of a ball on my upper back to try and work out knots and relieve pain.
Help.
Hi Lee,
Thanks for writing. My guess is that there is something going on with your rib cage, collarbone, and shoulder that is causing your problems. Sometimes the 1st rib can get pressed up under the collarbone, the collarbone can get pushed down into the 1st rib, or a combination of both. That can compress nerves and blood vessels between the two. Those problems don’t usually resolve with exercises and sometimes can be made worse by them. You could try placing a hand under the collarbone and pushing up and out to lift it of the first rib. Sometimes that can help. Otherwise, you would need to see a specialist like myself because of the complexity of it.
Dear Dr. Lopez
I have enjoyed reading your posts. Four months ago I had a full thickness rotator cuff repair. My physician explained my tear was bad and kept my shoulder immobilized for 5 weeks before any therapy was started. Once therapy was started my neck (trapeze) muscle became terribly tight. Within the week my hand in the same arm as surgery became swollen and my fingers hurt to bend. The doctor had me stop shoulder therapy and put me on steroids for 4 weeks. Swelling went away in my hand. It came back when I started therapy again. I also have a lot of shoulder hiking when I try to left my arm above shoulder level. I just cannot get my range of motion back as the muscles in my back are so knotted and my shoulder cannot move independent of my scapula. My doctor just thinks it will resolve over time. Meanwhile, I now not only am dealing with stiff and swollen fingers, but now I get some numbness and pain in two of my toes in both feet. What is your opinion,?
Hi Kimberly,
Thanks for writing. I’m sorry to hear about your shoulder pain. I cannot say for certain but without being able to evaluate and treat, but it sounds like the nerves and vascular branches may be getting compressed. A common place is between the collarbone and first rib. You can try lifting your collarbone up and out to lift it off the first rib. Otherwise, it seems like something is irritating the shoulder that is causing the muscles to clamp down. It may resolve if there are still areas that need to heal, but otherwise, you may need to see a specialist to help correct the anatomical problems not working correctly in your shoulder and see if that helps.
I hope that helps,
Dr. Lopez
Hi. This is a good read. My wife was in a car accident where she now suffers with a continually contracted upper trapezius (it’s very hard and almost bulges from the skin) causing finger numbing and difficulty with shoulder mobility. Have you ever come across anything similar and found a treatment that works as regular physio really isn’t helping!
Hi Sam,
I don’t necessarily have anything to show. This sounds like it would be beyond what I could show and would be the kind of thing I would want to see the person for. If there’s nothing torn, then the anatomy likely just isn’t right. It sounds like there could be problems from the neck down to the hand. It sounds like the shoulder may not be sitting in the socket right as well. Best of luck.
Dear Dr. Lopez,
I’ve had painful knots in my trapezius for years along with neck pain on the same side. My shoulder gets tired very easily when I left my arm (for wxample when reaching for something above my head). Now I’m getting mid back pain on the same side. Could that be related?
Also, I tried the rubbing the ac joint last night and very soon became quite tender even though it didn’t bother me before. Today it’s red and very sore. Do I continue? Thank you.
Hi Maria,
I’m sorry to hear about your pain. Yes, the pain in your mid back could be related. The trapezius attaches into the mid back and that could be a reason for that pain. I would leave your AC joint along for a while until the soreness gets better. That may be a sign that it’s too much or the actual problem is elsewhere and not the ac joint.
Thanks,
Dr. Lopez
I found this interesting. I tore my labrum in May, diving for a baseball. Since then, the primary pain has dissipated but ive had terribly sore/tight upper and lower trap muscles, I’ve been going to get massages and she says my lower trapezius is in spasm. I am beginning to think it could be related to my injury 7 months ago. Anyways, what you’ve written here seems to help out! Much appreciated.
Dr. Lopez, this was a wonderful article. I had been having issues with my right shoulder for weeks. To the point where it hurt to do anything. I have been trying to find anything and everything to help, because it was like one big spasm, across the shoulder blade. Massage helped for a bit, but it wasn’t until I found this article, and did what you suggested, that I can say that this is the most pain free I’ve been in awhile, I feel like I have a range of motion that I haven’t had in a long time. I can’t remember when it started, but … this is something I’ll remember when I have those issues. So, thank you for sharing your knowledge, it worked for me!
Thanks Cherri, glad to hear it made a difference for you!
do muscle relaxers help to?
Hi Stephanie, muscle relaxers may provide temporary benefit, but they will not correct any anatomical problems that have taken place. I do not find those can be corrected with medications most of the time.
Hi Dr Lopez
When ‘wiggling’ the ac joint, does this mean grabbing the bone itself and wiggling it or the muscle surrounding it?
Thanks
Matthew
Hi Matthew, thanks for your question. “Wiggling” the ac joint is not clear and that was a mistake on my part. You want to the wiggle the bone as close to the joint itself to free it up at the joint if it is stuck. It will only work if it is a problem for you. Otherwise, it won’t do anything. I hope that helps.
I’ve been having this issue for about a year now,
Everyday I feel pain up my neck and at my upper trapezoid… Been to multiple doctors and specialist and no one can tell me what’s wrong so I just learned to live with it.. I just did what you said and it’s the first time I’ve felt so e type of relief… Thank you! Can you please tell me what to tell my doctor as far as treatment for a permanent fix!?
Hi Jon, I’m glad that you were able to get some relief with the maneuver. Unfortunately, there could be many other things involved maintaining tension in the trapezius so I wouldn’t know what it would take to get a permanent fix in your case. Also, you doctor likely wouldn’t have the training to resolve it the way I do. You could seek out an osteopathic physician that specializes in osteopathic manipulation. They may be able to help you make more progress.
Hey Daniel,
For a long time I didn’t k ow what I had in my trapezeus and I thought it may have been an air bubble because every time I eat or drink a little to much all this pressure would build up around my left shoulder and side of my neck but it sounds like it might be a k of like you talk about. So can eating too much and getting too full cause pressure to build up on the knot. If not than is this a knot that I have or something else?
Hi Pascal, thanks for writing. I’m not sure what would be causing that. Generally eating or drinking would have no effect on the tension of a knot. The lung is underneath the area, but that’s the closest thing that I can think of that could explain the air bubble sensation. Otherwise if it continues, you should go see your doctor.
I found this very useful >> my issue – professional wrestler fractured clavicle, damaged ligaments, torn tricep, nerves and a whole load of pain.
Fast forward 2 years – hard tissue lump at the base of the neck and top of the trapezius muscle. After massage methods it appears to be less pronounced and softer,
Thanks Jordan, I’m glad to hear it’s improved.
Hey, I could use your expertise. I started having severe anterior deltoid pain which went away with a few days (rehab – external/internal rotation exercise 1-3 sets of 10 reps per exercise) followed by severe neck pain which also went away with in a few days (rehab chin tucks shrugs neck flexion and scapular depressions 1-3 sets of 10 reps per exercise). Now my right shoulder and AC joint sits higher then my left side like it needs repositioning. My pain on a scale of 1 to 10 is a 1 or 2 don’t notice it to much or if at all. Also sleep on a cervical pillow. Heavy resistance exercise is the only thing that really effects my shoulder pain which I stooped doing in an effort to let my shoulder heal, but nothing has really worked for me. My shoulder feels loose and I can get my joints to crack in multiple spots, they include 3 cervical vertebrae, AC joint, glenohumeral joint and sternoclavicular joint right side only and no other issues. Not sure what exactly is going on. I am confident its not a broken bone, not bursitis (had bursitis in my left shoulder and it was really painful). not a separated AC joint (no disformity) and i don’t have a connective tissue disorder. I think the problem stems form my Trapezius, Levator Scapulae and or maybe anterior deltoid in some way. What are your thoughts??? I would greatly appreciate any feedback.
PS: I have also tried getting x-rays and a referral for and orthopedic doctor but my physician just gave me an Rx for ibuprofen and sent me on my way which I think made the problem worse.
Hi Kevin,
Quite honestly, this sounds like your have many areas that from your neck to your shoulder that are structurally dysfunctional. If your neck and shoulder is “popping,” it usually means something is not working right structurally. This could be from a lot of different areas including neck, shoulder, rib cage, arm. Usually the anterior delt being tight has to do with the head of the humerus being stuck forward on the socket. Good luck with getting this resolved. This would be the kind of thing I would want to treat for.
Take care,
Daniel
A few months a go when I was squatting at the gym, i hurt my shoulder by not racking it correctly. The bar missed the right side rack and the weight slip on my right shoulder. For two minutes I couldn’t move my shoulder, I thought I dislocated it. I walked to my friend and told him I couldn’t even lift my shoulder or my arm. He grabbed my shoulder and move it slightly and I felt no pain. I was able to lift it after that. I did several arm circling excersises after. I felt alittle pain the next few days but no enough to keep my arm from moving. I was able to do everything the same just with an annoying pain. Every since then my shoulders seem unaligned and my trapezius muscle constantly feels like it’s a “knot” everytime I straighten up my posture, I have the urge to pop my upper back because it feels tense. So the only way it feels alittle better is by pinching my shoulders back and pushing the back of my neck aligned with my spine and my spine will pop and crack. It feels good but I’m constantly doing this every 5-10 minutes. Constant pops and cracks near my spine ( idk if it’s my spine, shoulder, trapezius, rhomboidus muscle) but I just want to be normal again. I hate it. Who can I go to to help me fix this immediately?
Hi Rebecca, I’m sorry to hear about your shoulder. It sounds like the injury left your shoulder structurally incorrect. It may work, but not the way it’s designed to. That’s probably what is causing the knotting and tension that is requiring your to have to crack your joints all the time. This would probably be the kind of thing I would want to see a patient for if it did not resolve.
Dear Dr Lopez,
Thank you for posting this! My particular case is that I get pain on my left shoulder after prolongued time sitting down either looking down reading a book or leaning my arms against the desk as I am typing. I’ve been told I have a lot of tension on my upper traps (knots) and my scapula are wide apart (and that I tend to crane my neck as well), I’ve worked with a PT 2x on back exercises and bringing scapula together which partially help but it makes it awkward looking down to read with my back straight and sometimes get the pain/tension just by sitting anyway. Ever since it started 2 years ago studying has been a real struggle (I’m 26). Anyway its hard to wiggle the AC joint but i find that if I press down on it as I move my shoulder around it clicks back and the pain is gone for some time then I have to repeat. Does this sound like an AC joint problem (is it out of place?) or is it my posture or are they related if so how? Is there anything more I can do? Thanks, I just want to understand this pain more, it makes me feel like an old person.
Hi Daniel,
Thanks for your question. It sounds to me like there is probably some rib cage and thoracic spine involvement as well with this whole issue that is affecting your shoulders. You might want to check or have someone capable help release your pec major and minor and serratus anterior muscles. That could be helpful. I hope this helps.
Dr. Lopez
Hey doc, I am a bodybuilder, so this being said I’m always in the gym. I am deployed right now overseas, not a lot of medical attention here. I have had a knot on my right trapezeus muscle, along side of my shoulder blade. I have tried a foam, roller, tennis ball, deep tissue, heat, an injection 7 months ago, nothing seems to shake it what do I do?
Hi Seth,
Unfortunately, there’s not much more I can show that wasn’t already on the video I posted. There are many other factors that can cause the trapezius to knot and I can’t know without being able to evaluate. Keep trying different things and going to different areas that don’t bother you as much.
Thanks,
Dr. Lopez
I had a collar bone fracture 35 years ago. It formed an overlap of nearly an inch in the middle. I developed a trapezium knot the past 5 years and is getting more painful every day. Can the collar bone, which did not heal/linked correctly, be the cause for this? If yes, can it be healed in an operation and will it help. I’m 58 years and of good health.
Hi Pieter,
Sorry for the long delay. Yes, a collarbone that did not heal properly can cause the trapezius to be knotted and tight. Unfortunately, I don’t know if an operation would help overall or not. Theoretically, if they were able to make the collarbone closer to its normal shape, then, yes, it could help.
Thanks,
Dr. Lopez
Hi Dr Lopez
I am 55, female and post menopausal ( hysterectomy at age 41) and I have OA and osteoporosis and fibromyalgia plus trochanteric bursitis and Heberdens nodes in some of my fingers – its all a vicious circle. I have a mild hypermobility which i have had all my life and i pronate so my arches have all dropped. My SI joints have mostly fused and I have OA in my lower back and upper back too. Every time I walk my dog my trapezius spasms and by the the next day i end up with massive headaches. I also get headaches if i sit in front of my PC screen too long ( its raised and my set up is ergonomic) I also have cervical spondylosis and shortened disc spaces. Bit of a mess really LOL. I want to walk my dog ( he is a small breed terrier and likes to pull on the lead) and be active but everytime i do – i pay for it the next day with muscle spasms in my neck and shoulders and headaches and hip pain from the trochanteric bursitis. I take amitrip ( 20 mg) daily for the fibro and NSAID’s ( not often – sometimes) for the headaches and diazepam ( 2 mg) at night to stop the muscle and nerve spasms and so I can sleep. I go to a chiropractor and a massage therapist regularly. Any suggestions? 🙂 I try to stay positive – but honestly at age 55 I sometimes dread what I will be like at 65 or older – if I make it that long!
Hi Laura,
Unfortunately, there’s not a whole lot more I can suggest. It sounds like you’re doing a lot already and it sounds like there’s a lot going on so it would be really hard for me to give a good answer without being able to evaluate. Keep trying different things and don’t give up.
Sincerely,
Dr. Lopez
Hi the doctor has told me I have a locked trapizius on both sides of my neck causing chronic headaches and back/neck pain. I work in an office do you think I should have been signed off work as whilst sitting there I’m in so much pain. Thanks
Hi Catherine, I could’t say for certain. I don’t necessarily find that sitting causes trapezius spasms, but if you’re too uncomfortable, then it may be necessary. Best of luck.
Daniel
I recently started piano lessons(2nd lesson) at 47 years old. The first lesson I had no pain, but this morning I woke up and my right trap muscle and shoulder felt like it was broke.
My daily routine didn’t change except for the piano lesson, which was 30 mins.
Local doctor told me I had strained the muscle. Could a 30 min piano lesson strain the muscle that bad?
Hi Carlton,
I suppose if you kept your shoulders up the whole time, it could have strained your trapezius. Seems extreme but i suppose its possible or there are other factors already there that contributed to the severity.
Cheers,
Dr. Lopez
I believe I get these knots from sleeping with my right arm under my pillow all night. Do you think its possible? I have been having this pain for a few years now.
Hi Tanya, yes it’s possible if has an effect on the joints in your shoulder and collarbone.
Thanks,
Dr. Lopez
What started as a small knot in my neck a week ago proceeded to spread to the other side of my neck, across the tops of both shoulders and crept up my scalp-I couldn’t even touch the skin. I was trying icing the areas at first, and then heat and finally it let up enough to settle in my left trapezius. I am having a lot of trouble getting rid of that dull ache, the tenderness and whatnot-I can’t sleep and have almost resorted to pain pills. Will manipulating this AC joint work for this?
Hi Emily, unfortunately, I don’t know if freeing up the AC joint will help. The only way to know would be to try it if it’s not too sensitive. There can be lots of other causes of trapezius knots that it would be too hard for me to say what it’s from without evaluating you. I hope you are able to get some relief.
My trapezius on the left side has had a huge knot for about 10 years now. It causes a lot of pain in my neck and head. I’ve been on muscle relaxers and anti-inflammatory medications. I’ve also seen a chiropractor. Nothing helps. recently I started having tingling and numbness in that arm. Can this problem be from the knot? I just started seeing a new doctor and she was very concerned about how unusual my shoulder is as well as the numbness. She said the numbness could be caused by nerve damage but wasn’t sure if it was related to the shoulder problem. She is sending me to a neuromuscular doctor. Just wondered what your opinion might be. Thanks!
Hi April, my suspicion would be that the tingling and numbness are caused by what is causing your trapezius to form a knot on the left side. The knot would not likely be the cause of the numbness and tingling but indicates an underlying problem that has been there are least 10 years and has been unresolved so far and has been progressively been worsening. That could be what is causing the numbers and tingling. That’s the best I can do without performing an exam. Best of luck.
Hi Doc
I suffer from this. I will try what you say. Looks good.
Is application of kinesiology tape a scientific approach?
Thanks
Hi Dr, I don’t use kinesiology tape in my practice and haven’t done much in terms of research to be able to give a great answer.
Hello Doctor,
I am 22. I have a knot in my left shoulder that is as hard as a bone. On the left side of my neck, I have what feels to be 2 or 3 little jelly filled lumps. Would that be the reason why my trapezius muscle is tight? That part of my neck is also tightened. I keep seeing everyone’s testimony having to deal with some sort of sensitivity but that is not the case with me. The knot isn’t painful it’s self, its just tightening up my left shoulder and neck. When I get massages to help relieve the pain, I can barely feel it, unless the person is putting an insane amount of pain.
Thank you for your time!
Chelsea
Hi Chelsea, I’m not sure what to make of this. Usually the neck being tight, also makes it painful to touch. Perhaps you have a high pain tolerance which I have seen before. You may want to mention the jelly filled lumps to your doctor if you haven’t just to see if there’s anything else there they need to consider. Sorry I can’t be more help.
-Dr. Lopez
Hi Doc, was happy to find your site as I have been suffering from a neck/left trap pain for the last year that has been affecting everything I do throughout the day.
I’ve had a shoulder clean up on both sides due to an abnormal chromium being hooked. Both surgeries seemed to have been a success but I’ve had this incredibly tough knot in my left trap where the pain shoots up my neck just behind my ear.
I’ve been seeing a chiro, done acupuncture, taken Anti spasm/inflammatory meds, had trigger point injections and an injection into my spine to reduce inflammation. NOTHING gets rid of the pain. I can’t exercise, play golf/basketball… Any activities because of constant spasming in my neck/trap.
I spend several hours in the car each day for work which contributes to the pain, but I don’t know what else to do.
Im going to try your video instructions today, but any additional suggestions?
Thank you!
Hi Mark, there’s not much else I could tell you. Hopefully the things on the video helped. There’s not a ton else to try other than maybe trying to look for sensitive areas under your armpit and under your scapula. Put pressure on sore spots and hold them for about a minute. Besides that, I can’t tell you much else since I would have to evaluate to see what is actually taking place. Best of luck.
-Dr. Lopez
Hey I have a similar problem but mine is seriously a lot more complicated but I think very simple at the same time. So I had a shoulder injury about 3 years ago October, I was put Ima sling for 4 weeks. Didn’t exactly find out what was wrong with me or give me a clear diagnosi (Kaiser medical car) bad practice, but long story short is they just gave me a sling and told me I had a grade 1 Ac joint sprain. I wasn’t sure if that was exactly it because I also felt pain within my shoulder joint, and not just at the top where the clavicle and acromium meet. So I wa sin the sling for about 3 weeks. Towards the 3rd week I started seeing a chiropractor and saw some improvements in terms of pain. He did conventional stem and therapy on me and whatever. At the end of each treatment he would perform this AC joint adjustment and I would i was feel like he was adjusting it too hard or soemthing and it would feel worse temporarily then the sensation would subside later in the day. So I came back and started playing football and then I began to realize some instability in my ENTIRE joint, mainly the scapula. I also started overcompensated with many many muscles. My trap would be CRAZY right. There’s muscles crazy tight. LAT MUSCLE crazy spasm and tight. It also because extremely hard to abduct my arm, like its a mission to simply get my arm up. Through the course of 3 years I’ve been seeing doctor after doctor therapist after therapist with no resolution. I did PT and scapular stability exercises, also did rotator cuff exercises. I had several EMG tests and my nerves are fine, all working. Coming to my last resort and I need major help. My MRI said I had partial tiny supraspinatus tear and chondral label fraying/tear or something but I’ve seen soooo many athletes like me tear their labrum or even rotator cuffs but face half the symptoms I feel. I really want to figure out if the AC joint could be the culprit of everything. To add, when I abduct my arm, my anterior deltoid is always contracting harder than it needs to be and I can feel it overworking to compensate. My medial deltoid tendon is also extremely smaller than my left unaffected arm. Is there any specific way I can tell what is going on with me. I also have a bone spur and extra growth right next to my Ac joint at the very tip where the acromium and clavicle attach which could be indicating the joint is unstable (hence my body growing extra bone to compensate for poor cartilage) I honestly need your help and I’m in desperate need of an answer. What can you tell me.
Hi Pat, it would be hard for me to say for certain, but based on my experience, it would be very unlikely the AC joint is the only issue for you. The actual shoulder joint sounds like it’s not working well either which would account for the tight lat muscle and instability in the scapula. All that would make your lat have to spasm to help splint and protect the problems with your shoulder. I don’t know that there would be a clear way to specifically say and do much about it. You may try looking for sore areas in your arm pit and under your scapula and try and hold pressure in any sensitive areas there. That might help. Same with the chest and the pectoral muscles. Hope that helps. I’m sorry that you’re having such a difficult time. Best of luck.
-Dr. Lopez
Hi doc. 8 months ago I had a massage and she worked a lot on my neck and back. 2 days after that I had a lot of pain on my head and neck and shoulders, I have 2 trigger points in my shoulders,I had a lot of physical therapy sessions but I am still in pain. I dont know what should I do.
Thanks.
Hi Lilly, I’m sorry to hear about your pain. Perhaps a joint in your neck or back was affected. I would have to evaluate to see if there was anything I could effectively do. You may have to do some research and look for a good osteopathic physician that specializes in osteopathic manipulative medicine. If not, keep researching who near you is getting good reviews for your particular problem. Sorry I couldn’t be more help.
Great advice. I’ve had all kinds of back tightness for the past year. I’m 30 and had been carrying a heavy backpack everywhere I went since high school, I never realized how much damage it could do. The cramps all started with a pinched nerve between my left shoulder and T4. Since then most of my back will cramp up and causes all kinds of other issues (headaches, no energy, and pains all kinds of places, T4 syndrome on and off). The doctors said my T4 is slightly misaligned but it shouldn’t be causing any kind of severe problems, but as I am currently in China, there is a bit of a language barrier and some confusion between eastern and western medicine here (I respect Chinese medicine but there is all kinds of crap mixed in with the good stuff…) A massage and pushing my shoulders backwards are the only thing that provide relief but 3-5 days without massage and it starts getting real bad again. The problems all seem to stem from that one spot next to the T4 though, is this also related to the AC joint or can you point to some other underlying cause? It’s like my muscles WANT to cramp up which is strange because I am not particularly stressed.
Hi Zack, it can all be related because the trapezius does also attach to T4. If it is not working correctly, it can cause some of these problems. You could trying to push your left shoulder blade away from your rib cage to where it feels comfortable. Sometimes this can help the area.
Ho Dr. Lopez. I have a knot in my trapezius. I have pain where it shows it on the illustration and I get some relief from bio-freeze, but have a hard time sleeping. I’ve tried putting pillows under my shoulders when I’m sleeping on my back. I can’t turn on my side, because when I do the pain is so intense that I wake up. It almost feels like a burning sensation too. It’s hard to move my neck to one side, when I’m turning my head. It’s strange, but I feel the only time it feels someone ok is when I’m up walking around and not sitting. No matter where I sit, it feels like it becomes stiff and really starts to hurt. Any suggestions on what to do? Thank you.
Hi Tammy,
It’s possible the culprit in this case may be that your first rib is not able to function correctly and is stuck in a way that won’t allow your head to turn.. Because the trapezius lies on top of it, it can cause it to tighten. This can happen. In this case, you would have to look for someone who could evaluate and treat that sort of problem, whatever they actually determine it to be.
Hi doc.am a paramedic.am experiencing acute burning pains along the trapezius muscle for 3 weeks now.not triggered by movement. But there is significant relief when I lie down.pain intensity keeps varying.the pain is near neck,shoulder blade and deltoid. I also feel a sharp intermittent pain in the sternocleidomastoid base near attachment to the clavicle.when it pains they’re is also muscle tenderness which is not there when the pain subsides.no pain in the arm . I am doing physio and taking pain meds as needed. Last mri reveled c3-4 c5-6 root indentation.could you pls advise.
Hi Lloyd, it sounds like there is an issue with at the sternoclavicular joint. If that is not the underlying issue, it sounds like it is involved. The sternocleidomastoid is innervated by the cranial nerve 11 so a c3-4, c5-6 should not necessarily directly be the cause of this. It would also be important to consider treatment of the temporal bone. I would seek out an osteopathic physician that does osteopathic manipulative treatment including cranial osteopathy to see if they can help get this issue sorted out.
I’m a LMT in IL and my upper trap spazzed out on me a couple days ago and nothing I was doing was bringing relief (cupping, heat, massage, ibuprofen) so I turned to the almighty Google and found this post.
THANK YOU! I did the mobilization moves on the AC joint and the pain and tightness has subsided. It’s still sore due to being locked up for 3 days, but it’s bearable. I’m seeing my chiropractor in a couple days and will have her check my AC joint again.
I will be sure to share this info with clients that present with this type of pain.
Hi Beth, you’re welcome and I’m glad this helped. Thank you for sharing.
I have had trap spasms since the age of 15 and am now 38….thank you so much for being the first clinician to share this treatment with me, I’m amazed by how quickly it works to reduce the spasm. I was told by a masseur that my shoulder blades ‘wing out’ and I wondered if this could be related to the trap spasms or if there are any exercises you’d suggest to reduce this?
Hi Ruth,
Really glad to hear it helped. Any issues with the shoulder blades could be related to traps, but there may be more to work on. I don’t have any exercises otherwise.
Hi Doc,
I am a 30 year old female. I am of normal weight and was never in a car accident. My issues started after working at a stressful desk job for a few years, I experienced pains in my back, neck, jaw and head. I went to a chiro and had x-rays done which revealed my cervical spine had a reversal from the stress my body was going through. Chiropractic treatment has helped but I still have many knots throughout my back, specifically my trapezius muscles. They make crunching sounds when being massaged and feel like rocks under my skin. I also get anxiety and difficulty breathing in stressful situations which I guess is attributed to my muscles tensing up because I notice my anxiety alleviates when massaging my back or neck. I also get dizzy when walking quickly or running and a feeling of fullness behind my ears. I know this is from tense muscles but I am unsure where these issues are stemming from and how to go about getting them resolved. I stretch and exercise daily and have noticed a lot of pain and tightness in my clavicle and also my arms and hands regularly get tingly and numb when stretching my arms. It is extremely sore and sensitive on my back right below my shoulders. Any advice you can offer on areas I need to work would be extremely appreciated!
Hi Linda,
My guess is that your sacrum might be jammed which could be from prolonged sitting and stress. There is likely some tensions in your head that may be producing all the tension you’re describing. Unfortunately, that’s the best I can do. You may try looking up a cranial osteopath through cranialacademy.org to see if there is someone near you that may be able to help. Best of luck.
Hi,
I started having neck/left shoulder pain after dental work in sept/2014. I slept on my left side and woke up one morning in Jan 2015 with my sinus area numb and my left shoulder in severe pain.
Had a multitude of MRI’s, cat scans and flexing X-rays and the docs said “there’s nothing wrong”.
Recently in Jan 2016 I woke up yet again to extreme pain in my left shoulder feeling like a sledge hammer hit me.
Docs again said nothing is wrong.
Finally started to see a PT but don’t really feel I’m getting anywhere.
I tried your method and the knot feels to be gone for the moment. I did start to feel aching on top of my shoulder afterwards.
I’m hoping this works. my ears also started ringing after the dental work. Recent hearing test said they couldn’t find anything.
I’m going to show this to my PT and see what she says. Everything in the video is EXACTLY what’s happening to me.
Dr. Lopez,
I am a 55 years old male and recently started working out 5 – 6 days per week. Part of my workout routine includes shoulder muscles. Within the last two weeks I realized a discomfort in my Trapezius muscle of my right shoulder. The pain/ discomfort is not constant. However, I feel a sharp pain and hear a slight click if I rotate or move my arm in a particular rotation. For example: putting on a tee shirt, drying my back with my towel or a sudden turn in bed.
I suspect my workout may be responsible for my pain. What do you think could be responsible for my condition and how may I be able to treat/ resolve this at home?
Thank you,
Russell
Hi Russell, unfortunately I could not say exactly what is going on based on what you’ve described. The clicking could be caused by many things and may indicate a shoulder instability. I don’t know that the workouts caused the problem or aggravated a problem that was already there but you did not test your shoulder enough to notice it. You could try putting pressure on the undersurface of your shoulder blade looking for painful areas and separate your shoulder blade a little from your rib cage. Otherwise, I would not be able to give you clearer advice on what is happening.
Thanks,
Dr. Lopez
Dr Lopez, I’m nearly out of my mind with pain & no one seems to know how to help! I’m told it’s trapezius muscle spasm, it feels like I’m being stabbed with a knife in my shoulder blade & the pain goes down around under my armpit, it shakes & quivers like crazy; I try heat, ice, anything I can think of but it keeps coming back. I recently had disc replacement surgery in my neck hoping that would stop this but 2 weeks after surgery I got it back. Pain meds make it bearable for about an hour & Pain Management shots have had no effect at all, I don’t know what else to do! Sometimes the jabbing pain is so bad it makes my whole body tremor, can you HELP???
Hi Tina, I’m sorry to hear about all the pain. It sounds really frustrating. My feeling from everything your describing is that there is more going on than a simple trapezius spasm. Unfortunately, the only way for me to figure out how to help would be to evaluate. You might try checking the area under your armpit, under your pectoralis muscle, and under your shoulder blade as best as you could get to it. There likely will be tender areas affecting this whole process as well. Best of luck,
Dr. Lopez
Hi Dr. Lopez,
I have been suffering from knots in my trapezius, neck pain, (3 herniations but not bad), for the past 18 months. Also, migraines and tinnitus for the past 20 years. No significant injury lately that I can pinpoint other than lifting our garage door (automatic opener broken). I have tired acupuncture, cupping, chiropractor, physical therapy, massage, MRI’s of my neck, spine, and brain, cortisone injections, muscle relaxants, anti-inflammatories, a new mattress, and countless new pillows. Last week the MRI arthrogram found a tear in the posterior inferior labrum, same side as my trapezius pain. Other than clicking upon rotating or moving my arm, I have had no significant pain in my shoulder joint. My orthopedic doctor seems confident that once repaired, I could have relief in my trapezius. Could these two be related, referred pain, or simply two separate issues?
Thanks in advance,
Geraldine
Hi Geraldine, it’s possible that the posterior labrum tear could be causing the trapezius to spasm because that will affect your shoulder. The trapezius is involved with the shoulder. There could be other places that affect the trapezius but if you have a definite pathology, then the tear could definitely be causing the knot.
Hi Dr. Lopez, I’ve been struggling with huge knots in both sides of the trapezius for many years. Enough to make massage therapists, chiros and acupuncturists yelp upon feeling. There are smaller knots at the base of the neck that also radiate through the upper back next to the scapula. Also tender points nears the AC joint. Same for both sides. I’m looking for someone in the Los Angeles area, like you, who would like to understand the root of the problem while treating rather than simply trying different methods that may provide temporary relief without truly understanding the problem. Please advise! Any referrals for out on the west coast?!
Hi Ashley, thanks for the questions. Sorry for the delayed response. If you can make it out to Phoenix, I would go see Stephen Davidson, D.O. (www.healthabounds2.com). If you cannot, you should consider Dr. Ken Lossing although he’s not out in the LA area. I know there are people there, but don’t know how they are. You could also try http://findomm.org to find someone.
Hi dr lopez, the pain of my knot is in the lower bit of the trapizius next to the spine, how to I heal that and how long will it take to heal. Please get back to me urgently because I have an international climbing competition in 3 days. Yours sincerely Joseph Xiberras
Hi Joseph, I’m sorry to hear about your knot. If you have a particular injury that it causing the knot, then it will depend on how long the injury will take to heal. Otherwise, I cannot say for certain. Usually resolving the issue of why the knot is there, will make it go away, but most people don’t know how to go about doing that. The best I could suggest is to look for an osteopath somewhere in your area. Best of luck,
Dr. Lopez
Hi Dr. Lopez,
For years now I’ve been dealing with pain and tenderness on my shoulders and trapezius which has actually created rounded shoulders and rounded traps. I’m not certain where the knots even came from but there is a noticeable difference in pictures from about 6 years ago until now. I used to have straight and flat traps, but now they are unevenly raised, with the top of my left shoulder appearing bigger than the right, giving me a manly appearance as if I worked out extremely. My traps are rounder/more raised than the average male. They are very tender and definitely knotted and I am in fear they are permanent or will eventually grow larger. What do I do??
Hi Kristina, thanks for writing. My suspicion is that if your spine is getting more and more forward bent, then that could be adding to the issue. I’m not sure if that’s happening to you. If it is, that could explain a big part of why your traps are knotting. I realize this is all speculation. I would consider going in to see a specialist that could help you with these issues. I’m not sure I could teach you a way to prevent this. You could try self massaging your chest muscles and in the arm pit areas. That could help. Best of luck,
Dr. Lopez
I have been experiencing pain in my traps for about 6 mints now and it just keeps getting worse. I sit at a desk a lot at work and scan files repeatedly as well as walk around a vault and pull files from high shelves (I’m only 5 feet). My job is very repetitive and to relieve the tension and pain in my back and shoulders I do a lot of Yoga, which helped at first but now it does nothing. I saw a chiropractor a month ago and the pain went away for a day or two then gradually came back. I was in so much pain yesterday I was in years so my boyfriend booked me a 100 dollar massage and it felt great (deep tissue) but now today after waking up the pain is even worse and I can barely move my dominant side and my shoulderson are very tender to the touch. Also I have something moving in my right shoulder blades, I’m assuming a knot, and when I roll it back and forth it crunches. Not sure what to do at this point, I’m 27 female and in the worst pain of my life, help??!
Hi Leah, thanks for the message. I’m sorry to hear about all of your pain. It sounds like this is more than just the trapezius and includes issue with your ribs and other places. You might need to give yourself a few days to recover from the massage. Once you’re better, then you may want to look for places that hurt in your chest where your pecs are and under your shoulder blade as best as you can. Hold steady pressure where it’s painful for about 30 seconds. If that doesn’t help, you may need to look for an osteopathic doctor that specializes in osteopathic manipulation near you. You can try http://www.omtdirectory.com or findomm.org.
Dr. Lopez, I just wanted to thank you for the advice on trap knots due to ac joint problems. I’m a dentist who has suffered with neck pain for the last year. Went to message therapy, and chiropractic professionals weekly. All with no help. I saw your website online and this article. Never even thought to message further downstream (ie. The ac joint). Just did it for 5min. Complete relief. Even further up into my scalp (where I’ve had tremendous pain lately). Any advice on a D.O. I might become a patient with in the Austin TX area, (or nearby). Someone with the same philosophy as yours? You can P.M. in the private email listed.
Thanks again,Dr. Stephens
Hi Dr. Stephens, I’m glad to hear that helped. You might check omtdirectory.com, but I personally do not know the people practicing near Austin unfortunately.
Sincerely,
Dr. Lopez
Hello Dr. Lopez,
I had C4-C7 discectomy with right iliac crest graph and plate and screws for fusion in January for spinal canal stenosis. The pain I had before the surgery is gone but since the surgery I have had pain to my left trap that is sharp and burning which is made worse when reaching out or up, i.e. I reached into my microwave to get something out and a sharp pain shot through my left trap bringing me to tears. I had talked to my neurosurgeon about this pain about 3 months after the surgery and he said that it could be a pulled muscle. My question is it is now 5 months since the surgery, wouldn’t it have healed by now? Any insight into what maybe happening?
I greatly appreciate it,
Lisa
Hi Lisa,
I’m sorry to hear about this. I don’t know that I can make any useful comments. It’s possible that the alteration of the anatomy from surgery (even if the surgery is necessary) can have effects on the body afterward that is not dependent on time. What that means is that the soft tissues have healed but they still have been changed and your trapezius may be having to tighten as a response. This would require more professional help.
Best of luck,
Dr. Lopez
Hi Doctor,
My 14yr old son has huge lump in the Trapezius muscle. It is very visible. He is saying when he press the area it is hurting a bit. I would like to get advice from you. Thank You.
Hi Uresha,
It’s possible that the lump is caused by the 1st or 2nd rib underneath the trapezius, but I could not know without evaluating it. This would require more than the AC treatment for a solution most likely. I would try seeing an osteopathic physician that does osteopathic manipulation and seeing if they can help.
Best,
Dr. Lopez
Hi, I separated my AC joint in a fall on my elbow January 2015. I am still plagued with daily pain in my trapezius and some referred pain in the elbow and at the side of the midbicep where it meets the tricep on the outside of the arm. I also still have some pain under my scapula. Can I manipulate the AC as you suggest if my joint is separated? Should I be trying any other manipulation in the arm or shoulder to relieve the pain. I can’t take this and am getting no relief from PT, doctors including chiropractic or massage therapists.
Hi Nichole,
You probably would be find trying this, but I would approach it with caution and lightly first to see how it feels. However, an AC joint separation ends up having larger effects than just there. The biceps pain may be influenced by the issue at the coracoid process and acromion near the bicep attachments. There is probably also a problem still at the elbow that would need addressing. Unfortunately, this is something I would need to see you for. You can try searching for tender points anywhere from your elbow to shoulder to chest and holding steady pressure on them. That’s the best I can do.
Best of luck,
Dr. Lopez
Do you know of anyone in Calgary, Alberta, Canada? I have been a dental assistant for 15 years and am mindful of posture. I also lift weights. I am a 41 year old female. Have been to chiro, no help. Ultrasound showed tendinitis in shoulder, sports medicine doctor says problem is my traps. Gave me stretches, when I do them I have recently started to hear crunching sounds. Have tried muscle relaxers and anti inflammatories, massage, minimal relief. Will start your AC recommendation, do symptoms also include tingling throughout the bicep to the thumb?
Hi Michelle,
Unfortunately, I do not know anyone out there. My guess is you have a lot more going on besides a purely AC issue. Tingling is not a usual sign of this. I would also think there is something going on in your elbow as well, but could not say without examining. This is the kind of thing that I feel I would probably need to see you for.
Best of luck,
Daniel
Hi Dr Lopez
3 months ago, I did a backward bend stretch and a sharp pain pulled behind my shoulder. Later that day, my neck was affected and suffered from stiff neck. I went for accupunture and thevpain has eventually gone, but 2 weeks later i experienced vertigo. After recovering from vertigo, I have imbalance since.
I did a MRI but nothing is pinching on the cervical nerves, however I do feel some soreness on my traps when I roll a tennis ball against it. At this point, not one doctor could give a conclusive answer or a method to relief my imbalance.
I wonder if your excercise above would help. If not what do you think i should do next. Your kind advise is much appreciated. Thank you.
Hi Zee, it’s possible the exercise would help although I would doubt it honestly if you’re having vertigo as well. You may considering seeing an osteopathic physician that does cranial osteopathy at this time. You can try to find one through the Cranial Academy website (www.cranialacademy.org).
Best of luck,
Dr. Lopez
Hi & thanks for a great article.
I have suffered with an ache in my right shoulder for a few months now and also tightness in my back in what i think is my trapezius area but more central. If i twist my back and occasionally also shrug my shoulders i get a snapping sensation in my trap area. This gives me some temporary relief but soon again it tightens & i can make it snap again by twitsting/shrugging.
Any ideas as to what is going on?
Thank you
Hi Dan, my sense based on what you’re describing is that one of your upper ribs and thoracic spine is dysfunctional. Part of that could cause a snap when doing that. To resolve that, you would probably need to see an osteopathic specialist. You can try through findomm.org or http://www.omtdirectory.com.
Best of luck,
Dr. Lopez
Hello Dr. Lopez,
I have trouble contracting my lower traps so I can strengthen my scapula and stretch my upper traps. I have very poor shoulder mobility and am wondering what I should do so can strengthen this area. Thank you very much.
Sincerely,
Sam Nesbit
Hi Sam, this could be related to a forward bent posture in your thoracic spine and rib cage that don’t allow your scapula to glide down. If that is going on, it won’t matter much what strengthening you do. The structure needs to be corrected. Otherwise exercises that bring your arms in a pose of startle (up and back) would strengthen the area.