The trapezius muscle, a large diamond-shaped muscle spanning the neck, shoulders, and upper back, plays a critical role in supporting shoulder movement and maintaining posture. However, its complex structure and frequent overuse make it highly susceptible to stiffness, pain, and dysfunction. This article synthesizes findings from three recent studies to explore effective treatments for trapezius-related discomfort, focusing on photobiomodulation (PBM), aerobic exercise, transcutaneous electrical nerve stimulation (TENS), and dry needling. By examining these interventions, we aim to provide practical insights for individuals seeking relief from trapezius muscle pain.
1. The Burden of Trapezius Muscle Pain
Trapezius pain is a common issue, often linked to poor posture (e.g., prolonged sitting at a desk), repetitive movements, or conditions like fibromyalgia. Chronic neck pain, a frequent complaint in adults, often originates from the trapezius due to its role in stabilizing the shoulders and neck. For instance, studies estimate that 63% of office workers and 68% of manual laborers experience active trigger points (painful knots) in the upper trapezius. These trigger points can cause localized pain, muscle tightness, and limited range of motion, significantly impacting daily life and quality of life.
In patients with fibromyalgia—a chronic condition characterized by widespread musculoskeletal pain—the trapezius is frequently affected. Fibromyalgia-related pain often radiates from the trapezius to other areas, leading to fatigue and reduced physical function. Addressing trapezius pain is therefore crucial for improving overall well-being in these individuals.
2. Key Studies on Trapezius Pain Management
Three recent studies have shed light on innovative treatments for trapezius pain. Let’s examine their methodologies and findings.
2.1 Study 1: PBM + Aerobic Exercise for Fibromyalgia-Related Pain
Authors: Vassão PG et al. (2024)
Journal: Lasers in Medicine Science
Objective: To evaluate the effects of PBM combined with aerobic exercise on pain and quality of life in women with fibromyalgia.
Methods:
• Participants: 40 women with fibromyalgia, randomly assigned to two groups:
◦ Group A: PBM (808 nm, 3 J/cm²) applied to the trapezius and other painful areas, 3 times/week for 4 weeks, plus aerobic exercise (3 sessions/week).
◦ Group B: Sham PBM (placebo) + exercise.
Results:
• After 4 weeks, Group A showed significantly reduced pain intensity (p < 0.05) and improved quality of life compared to Group B.
• PBM appeared to enhance mitochondrial function in muscle cells, reducing inflammation and promoting tissue repair.
Conclusion: Combining PBM with exercise is a safe and effective strategy for managing fibromyalgia-related trapezius pain.
2.2 Study 2: PBM vs. TENS for Chronic Neck Pain
Authors: Rampazo ÉP et al. (2024)
Journal: Brazilian Journal of Physical Therapy
Objective: To compare the effectiveness of PBM and TENS in treating chronic neck pain (often involving the trapezius).
Methods:
• Participants: 60 adults with chronic neck pain, divided into three groups:
◦ Group A: PBM (830 nm, 3 J/cm²) applied to the trapezius and cervical spine, 2 times/week for 4 weeks.
◦ Group B: TENS (high-frequency stimulation) applied to the same areas, 3 times/week for 4 weeks.
◦ Group C: Sham treatment.
Results:
• After 4 weeks, Group A reported greater pain reduction (p < 0.05) and improved neck function compared to Groups B and C.
• PBM was more effective in reducing inflammation and restoring normal muscle tone.
Conclusion: PBM outperforms TENS in alleviating chronic neck pain, likely due to its deeper tissue penetration and anti-inflammatory effects.
2.3 Study 3: Dry Needling + PBM for Myofascial Pain
Authors: Dalpiaz A et al. (2021)
Journal: Journal of Manipulative and Physiological Therapeutics
Objective: To assess the combined effects of dry needling and PBM on myofascial pain in the trapezius.
Methods:
• Participants: 60 women with trapezius myofascial pain, randomized into three groups:
◦ Group A: Dry needling (targeting trigger points) + PBM (810 nm, 3 J/cm²) 3 times/week for 3 weeks.
◦ Group B: Dry needling alone.
◦ Group C: Sham treatment.
Results:
• Group A showed significantly greater pain reduction (p < 0.05) and improved pressure pain threshold compared to Groups B and C.
• The combination therapy reduced muscle tension and restored normal nerve-muscle communication.
Conclusion: Dry needling combined with PBM is a powerful intervention for trapezius myofascial pain.
3. How Do These Treatments Work?
3.1 Photobiomodulation (PBM)
PBM uses low-level laser or light-emitting diodes (LEDs) to penetrate deep tissues. The light energy is absorbed by mitochondria in muscle cells, boosting ATP production and reducing oxidative stress. This process:
• Reduces inflammation: By decreasing pro-inflammatory cytokines like TNF-α and IL-6.
• Promotes healing: By stimulating collagen synthesis and blood vessel growth.
• Relieves pain: By blocking pain signals and enhancing endorphin release.
PBM’s effects are dose-dependent. Most studies use wavelengths between 808–830 nm and energy densities of 3–5 J/cm², applied 2–3 times weekly for 3–4 weeks.
3.2 Dry Needling
Dry needling involves inserting thin needles into muscle trigger points to:
• Release tension: By disrupting hypercontracted muscle fibers.
• Normalize nerve activity: By reducing abnormal electrical signaling in the neuromuscular junction.
• Stimulate blood flow: Enhancing oxygen and nutrient delivery to damaged tissues.
When combined with PBM, dry needling appears to amplify pain relief by addressing both mechanical (muscle tightness) and biochemical (inflammation) factors.
3.3 Aerobic Exercise
Regular aerobic exercise (e.g., walking, swimming) improves trapezius function by:
• Strengthening muscles: Reducing the risk of overuse injuries.
• Enhancing circulation: Delivering more oxygen and nutrients to the trapezius.
• Boosting mood: Exercise releases endorphins, which act as natural painkillers.
In the fibromyalgia study, participants in the exercise group performed 30–40 minutes of moderate-intensity exercise (e.g., cycling, stretching) three times weekly, complementing PBM’s effects.
3.4 TENS
TENS uses electrical currents to block pain signals at the spinal cord level. While effective for short-term relief, its benefits are often temporary compared to PBM. TENS may be less suitable for chronic pain due to habituation (the body adapting to the stimulation over time).
4. Practical Recommendations for Trapezius Pain Relief
Based on the studies, here’s a step-by-step approach to managing trapezius pain:
4.1 Prioritize PBM
• Frequency: 2–3 sessions weekly for 3–4 weeks.
• Target areas: Focus on the trapezius, upper back, and cervical spine.
• Combination: Pair PBM with exercise or dry needling for optimal results.
4.2 Incorporate Dry Needling
• Procedure: A trained practitioner inserts needles into trigger points.
• Timing: Combine with PBM sessions (e.g., dry needling followed by PBM on the same day).
4.3 Adopt a Regular Exercise Routine
• Types: Include low-impact activities like swimming, yoga, or brisk walking.
• Duration: Aim for 30 minutes of exercise 3–5 times weekly.
• Stretching: Perform neck and shoulder stretches daily to maintain flexibility.
4.4 Avoid Triggers
• Posture: Maintain a neutral spine while sitting or standing.
• Ergonomics: Use an adjustable chair and computer monitor to reduce neck strain.
• Stress management: Practice mindfulness or meditation to prevent stress-induced muscle tension.
5. Conclusion
Trapezius muscle pain is a widespread issue with significant impacts on daily life. The studies discussed here highlight the effectiveness of photobiomodulation (PBM) as a versatile treatment, particularly when combined with aerobic exercise or dry needling. PBM’s ability to reduce inflammation, promote healing, and relieve pain makes it a valuable tool for managing both acute and chronic trapezius discomfort. Dry needling, by targeting trigger points, further enhances outcomes by addressing mechanical tension.
For individuals seeking relief, consulting a healthcare provider to design a personalized treatment plan—incorporating PBM, exercise, and/or dry needling—is strongly recommended. By combining these evidence-based interventions with lifestyle adjustments, lasting improvements in pain and quality of life are achievable.
References:
1. Vassão PG, Credidio BM, Balão AB, et al. Effects of photobiomodulation and an aerobic exercise on the level of pain and quality of life in women with fibromyalgia. Lasers Med Sci. 2024;39(1):189. doi:10.1007/s10103-024-04126-8. PMID: 39039318.
2. Rampazo ÉP, de Andrade ALM, da Silva VR, et al. The effects of photobiomodulation and transcutaneous electrical nerve stimulation on chronic neck pain: A double-blind, randomized, sham-controlled trial. Braz J Phys Ther. 2024;28(6):101124. doi:10.1016/j.bjpt.2024.101124. Epub 2024 Nov 6. PMID: 39509929; PMCID: PMC11570946.
3. Dalpiaz A, Kuriki HU, Barbosa RAP, et al. Dry Needling and Photobiomodulation Decreases Myofascial Pain in Trapezius of Women: Randomized Blind Clinical Trial. J Manipulative Physiol Ther. 2021;44(1):61-71. doi:10.1016/j.jmpt.2020.07.002. Epub 2020 Nov 26. PMID: 33248747.
4. Lattar S, et al. Effectiveness of adding dry needling to conventional physical therapy for chronic neck pain in the upper trapezius: A randomized controlled trial with 7-week follow-up. Musculoskelet Sci Pract. 2024;115:102934. doi:10.1016/j.msksp.2024.102934.
5.Abbaszadeh-Amirdehi M, Ansari NN, Naghdi S, Olyaei G, Nourbakhsh MR. Neurophysiological and clinical effects of dry needling in patients with upper trapezius myofascial trigger points. J Bodyw Mov Ther. 2017 Jan;21(1):48-52. doi: 10.1016/j.jbmt.2016.04.014. Epub 2016 Apr 14. PMID: 28167189.
