Muscles
Upper trapezius
Also known as: shoulder shrugger, coat-hanger muscle, neck-shoulder ridge
The upper fibers of the trapezius are one of the most common sources of tension headaches, neck stiffness and referred temple pain.
Overview
The upper trapezius runs from the base of the skull and cervical spine to the lateral clavicle and acromion. It elevates and upwardly rotates the scapula and helps stabilize the head. Trigger points here are widespread in desk workers and anyone holding sustained shoulder elevation.
Trigger point locations
Two classic locations: TrP1 in the midpoint of the upper fibers along the shoulder ridge, and TrP2 slightly more medial and posterior. Both are easy to palpate as taut bands.
Referred pain pattern
Pain refers up the side of the neck to the temple and angle of the jaw, often described as a unilateral tension headache. May also refer to the back of the ear.
Palpation & testing
Pincer grip the upper fibers between thumb and index finger. A taut band reproduces local pain and often the patient's referred headache.
Common causes
Sustained shoulder elevation (laptop work, carrying bags), forward head posture, stress-related bracing, whiplash, asymmetric monitor or phone use.
Self-care & clinical treatment
Sustained pressure release with a ball against a wall, slow chin tucks, scapular setting drills. Clinically: dry needling, manual ischemic compression, and ergonomic correction of monitor and chair height.
Stretching & mobility
Side-bend the head away from the painful side, gently rotate the chin toward the same shoulder, and apply mild overpressure with the opposite hand for 30 seconds. Keep the painful-side shoulder pinned down (sit on the hand) to lengthen the upper fibers. Repeat 2–3 times per side, twice a day.
Watch a demonstration
Symptoms commonly linked
FAQ
- Why does my temple hurt when the pain seems to come from my shoulder?
- The upper trapezius has a well-documented referred pain pattern that travels up the neck to the temple — pain felt in the head can originate from a trigger point on the shoulder ridge.
References
- • Travell & Simons — Myofascial Pain and Dysfunction, Vol. 1
- • Dommerholt & Fernández-de-las-Peñas — Trigger Point Dry Needling