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Upper Neck Pain with Sore Top of Shoulder

Your Pain Pattern,
What Aggravates It,

The Underlying Anatomy
How to Get Relief,
and more…


How People Describe This Pain Pattern

People often complain of pain in the upper neck with soreness on the top of the shoulder. Most often, they are focused on the pain in the upper neck than the top of their shoulder. Many patterns create pain and tension at the top of the neck. This referral pattern is not among the most common patterns that refer to the upper neck. However, when it becomes chronic when the whole shoulder becomes achy.

The soreness of on top of the shoulder is usually less bothersome than the neck pain. They will often rub it and say that it is tender when they press on it. It is mentioned more often when they carry a handbag or backpack that presses onto the sore spot.

People often describe the upper back referral as tension. Conversely, they refer to the spot at the top of the shoulder soreness. This pattern can have a focus of deep, achy soreness near the base of the neck. This combination of pain in the upper neck, aching near the base of the neck, and soreness at the tip of the shoulder can lead to chronic aching. Commonly, this leaves the person irritated and exhausted. Moreover, it creates an underlying tension that diminishes their quality of life. The background pain shortens their tolerance for tedium.

People may start out describing this as stiffness in the neck. When asked for more details, they actually talk about the constant ache. When asked for more details, the “stiffness” seems to be more of the inability to find a comfortable position.



How You Activate and Intensify This Pain Pattern

Bob Barr in the classic negotiating lawyer posture from cdn.vox-cdn.com

This problem can feed on itself and become quite chronic when people change their posture to avoid aggravating it on the back of the chair. This muscle is shown to be more active in stabilizing the shoulder blade against tension rather than pull it back.

One client suffered chronically from this trigger point. Daily, 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 the muscle tension between his chest and back. With regular stretching and bodywork and to open his chest, we were able to get lasting relief.

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.

The combination of these alternating these postures can really aggravate this trigger point. Leaning forward feels like a good stretch but weakens the muscle. Leaning into the chair presses activates the pattern with pressure.

Often, this trigger point activates when the arm is jerked forward, as when you’re holding the leash of a dog that sees a squirrel. However, several muscles can get aggravated by a jerk forward. When the muscles around the shoulder joint are strong, this trigger point gets irritated as the muscle tries to stabilize the shoulder blade.


The Musculoskeletal Anatomy Behind Your Pain

The trapezius has three sections that perform different functions. As a whole, it provides movement and stability to float and retract the shoulder blade.

You can read more detail about this in this post about trapezius anatomy.



Getting Relief on Your Own

Clinically Proven
Self-Care Recommendations.

This post has strategies for getting relief on your own. Explore how to change your activities, stretch and other strategies that relieve the pain associated with this trigger point.


Treatment Notes for Massage and Bodywork

Better Bodywork,
Through Shared Expertise.

This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.



This site is undergoing changes. Starting in early 2020, we began improving the format. We are also adding more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We appreciate your input and feedback. You will see us adding posts and updating older posts as time permits.


Weekly Featured Post

This post is about the watershed moment that changed the direction of my bodywork. People would say that it is about treating at the source. I’d say that it is about understanding the governors and accessories in a pattern. This gives the therapist and client choices on how to plan on treating for relief or treating to create a body that is self-correcting.


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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*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistency in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.


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