Understanding Trigger Points – Neck Pain with Sore Shoulder

Clinical experience reveals that a neck pain with a shoulder pain usually comes from other trigger points. The sore shoulder usually comes from the middle trapezius trigger point. The trigger points activated by a displaced atlas, as a part of forward head posture, commonly create upper neck pain. Infraspinatus, a rotator cuff muscle, also creates pain in the neck and shoulder a the same time. Look at these posts and the similar patterns sections to see if they are a better description your pattern.

fi-headache-at-the-base-of-the-head-one-side fi-pain-on-the-top-of-the-shoulder fi-pain-in-the-shoulder-and-upper-neck

Client Description


People complain of pain in the upper neck with a sore shoulder. They are usually focused on the pain at the top of their neck. The soreness of on top of the shoulder is usually secondary to the neck pain but can be strong. They will often rub it and say that it is tender when they press on it.

The upper back pain is more often described as tension and the spot at the top of the shoulder is often described as soreness. It can have a focus of deep, achy soreness near the base of the neck.

People find that this tight band of muscle is very tender when a seat digs into the mid-back. When the muscle is chilled by a cold stadium seat, the neck and shoulder pain are worse.


Self Care

middle lat stretchLook at the picture of lower trapezius below. For some relief, rub ice along the edge that runs from the top of the shoulder to the spine near the base of the ribs. Then stretch the arm forward, like reaching to the back of a tall shelf. Use a door frame to get a grip for a better stretch. Stretch overhead as well, like you are reaching for the ceiling above your other shoulder.

This is a tougher one to figure out on your own and the pain is really aggravating. Your body worker can figure this out with trigger point assessment and offer you longer lasting relief by balancing the pelvis as well as muscles of the chest and back.

Therapy Notes

 oit-trapezius-posterior oit-trapezius-anterior

oit-trapezius-posterior-lower oit-trapezius-anterior-lower

This lower section of the trapezius is most active in retracting and stabilizing that superior angle of the scapula. When this is active, there is usually a stiff band of muscle running along the border of the lower trapezius. This strip is sensitive and the band relaxes with a little swipe of ice or hot stone.

This muscle is also overpowered by pecs and can stay aggravated when pecs are overdeveloped. I had one client who suffered chronically from this trigger point. He was a negotiator who would tighten his chest and lean onto his elbows at the conference table. Releasing this trigger point directly only offered temporary relief. We had to balance his chest and back with regular stretching and bodywork and on his chest to get lasting relief.

referral-trapezius-lower-root-croppedWhen this pattern in lower trapezius us treated, the client often returns with another lower trapezius pattern that creates burning along the edge of the shoulder blade. Treatment of that trigger point, before it becomes active can prevent this return visit.

Trapezius is complex and this section releases more easily when the lamina groove has been worked to release the mid-thoracic vertebrae.

Similar Patterns

Again, these symptoms are usually from a combination other trigger points.

Click on these categories to see if there is a referral pattern that better describes your concerns.

tags-neck tags-upper-neck tag-stiff-neck tags-upper-back tags-shoulder tags-top-of-shoulder


Tony Preston has a practice in Atlanta, Georgia where he sees clients.

He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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