The lower back gets a lot of attention as one of the leading causes of missed work days, disability and hospital visits per year. Although not as pervasive, upper back, neck and shoulder pain can be just as disruptive as lower back pain.
While sometimes a joint problem is responsible, the most common cause of pain in the neck, upper back and shoulder is muscular. There are a number of muscles in the upper back, the trapezius being the largest. It is triangular, stretching from the mid-spine up to the base of the skull and over to the scapula. Its unique shape makes it responsible for a variety of actions, including tilting the head, supporting the upper body, stabilizing the shoulder joints and serving as a base for arm movements. Since it is located in the neck, shoulder and upper back, the trapezius is a likely culprit for pain in these regions.
If you have injured your trapezius muscle, a number of movements will be painful, including shrugging your shoulders, rotating your shoulders and moving your neck. There are two common causes of neck, back and shoulder pain associated with the trapezius muscle.
Overuse
Overuse injuries can occur to any part of the body. They are caused by repetitive motions that tax muscles, ligaments and tendons without giving them adequate rest time in between actions. Even light repetitive use of the trapezius can cause an overuse injury. If your job or other activities demand constant movement of a shoulder, the muscle will be contracting frequently without sufficient time to rest between contractions. Rest time is essential, since blood flow depends on a contraction/relaxation cycle. When a muscle becomes chronically tense due to overuse, it does not receive ample amounts of fresh nutrients and oxygen from blood. Chronically tense muscles can develop knots called trigger points that make it even hard for a muscle to relax.
The trapezius can suffer an overuse injury if you use a computer with a mouse throughout the day. Holding a phone between your head and shoulder is another way the muscle becomes chronically tight. If your upper back, neck and shoulder hurt on one side of your body, it is likely that something you do with that side of your body is causing an overuse injury. Being creative about your work station can resolve these types of injuries. For example, using a mouse with a roller ball or investing in a headset or ear bud for your phone would allow the muscle to relax.
You will need to undo the damage done to your trapezius by forcing it to relax. This can be done by self-myofascial release (SMR), trigger point massage or deep tissue massage. See the video at http://www.youtube.com/watch?v=gCVowv5A66Q to learn more about SMR for your trapezius.
Postural Dysfunction
We’ve all been told as children to sit up straight, but how many of us practice proper posture at work, at home or on the road? The human body is not designed for prolonged sitting, yet modern life often encourages and demands it. Unless you have a very strong core and pay constant attention to your posture, you likely end up slouching part way through the day. This position entails hunched shoulder and a forward head.
Consider what happens to the muscles in the chest when held in this position. The pectoral muscles in the chest and the teres muscles in the armpit at the bottom of the shoulder blade are tight and shortened. Eventually, muscle memory develops to automatically tighten these muscles. Their shortened length and tension exert a pull on structures surrounding them, including the trapezius. The trapezius lengthens and weakens, and this tug-of-war further encourages stooped posture.
Overstretched muscles suffer tears that can cause pain. These muscles also react by attempting to tighten; this is to protect themselves from further tearing. An overstretched trapezius overworks to prevent further stretching, while it fails to perform its intended job of upper back and shoulder stability. Pain can be felt throughout the length of an overstretched trapezius.
Restoring proper length and strength to your muscle means relaxing the pectoral and teres muscles, then conditioning the upper back. SMR can be used on the chest muscles. You can stretch the pectorals by clasping your hands behind your back and pulling away from the body. The teres group may be stretched by lifting your arm above your head and bending to the opposite side. See http://www.livestrong.com/article/156529-home-exercises-for-the-trapezius-muscle/ for trapezius conditioning exercises.
Once balance has been restored to your upper body muscles, you can practice proper posture and prevent upper back pain from recurring.
Neck, shoulder and upper back pain are commonly caused by muscular problems related to overuse or posture. If your imbalance or injury is severe, you may need the assistance of a physical therapist. Otherwise, you can likely resolve the pain on your own with a little knowledge and motivation.
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