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Managing Myofascial Pain Syndrome: Breaking the Spasm Cycle

For individuals who have to be in one position for long periods, have poor postural alignment, and perform repetitive motions, what are myofascial pain syndrome spasm cycles?

Myofascial Pain Syndrome Spasm Cycles

Myofascial pain syndrome is a common condition that causes pain symptoms in a particular body area (Jafri M. S. 2014). A myofascial pain syndrome spasm cycle is a recurring pattern in which muscle tension and spasms in affected regions, caused by myofascial pain syndrome, lead to pain, triggering more muscle spasms. This creates a vicious cycle of discomfort and tightness that can be difficult to break without treatment; the pain perpetuates muscle spasms and vice versa.

Spasm Pain Cycle

Left untreated, myofascial pain is often experienced as a recurring cycle of spasm, pain, and spasm. (Kojidi M. M. et al., O2016) The exact cause of the spasm is not known. It may be related to excessive accumulation and release of acetylcholine, which causes sustained muscle contraction. (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Another theory is that repetitive small muscle trauma helps create a trigger point or knot in the muscle. (Thorne. 2021)

Active trigger points in muscles characterize myofascial pain syndrome. (Shah J. P. et al., 2015) These trigger points cause pain in the area where they are located and sometimes in other places, known as referred pain. Each muscle has a particular referral pattern of pain that goes from a trigger point in that muscle to another place in the body. (Shah J. P. et al., 2015) Medical providers and massage therapists trained in this area can identify trigger points by their pain patterns. With myofascial pain syndrome, muscles tense, and joint range of motion may decrease. (Jafri M. S. 2014)

Trigger Points

  • Myofascial pain syndrome is characterized by trigger points and sensitive knots within muscles that can cause referred pain when pressed, contributing to the spasm cycle.

Muscle Tension

  • A repeatedly tense or injured muscle can develop trigger points, which can lead tocle tightness and potential spasms.

Pain-Spasm-Pain Cycle

  • The pain from a trigger point can cause the muscle to further contract and spasm, leading to even more pain and perpetuating the cycle.

How Spasms and Pain Present

Myofascial pain is often caused by long periods of poor postural alignment, muscle injury, and repetitive motions. (Cleveland Clinic, 2023) For example, the upper body slumps forward when sitting at a desk workstation all day. The upper section of the trapezius muscle is located on the back of the neck and top of the shoulder. The upper trapezius muscle works to raise the head. (Yoo W. G. 2015) The trapezius muscle now has to work more than it is used to. This overuse may cause microscopic muscle injury, leading to muscle spasms and pain. (Bron C., & Dommerholt J. D. 2012) (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Without treatment, the muscle spasms, pain, and microscopic muscle injury may persist or worsen, leading to trigger points and chronic pain. (Jafri M. S. 2014)

Causes

Repetitive Motions

  • Repeating the same movement, like typing on a computer, can trigger muscle tension and points.

Poor Posture

  • Maintaining incorrect posture for extended periods can strain muscles and contribute to trigger point development.

Muscle Injury

  • Past injuries can leave muscles susceptible to developing trigger points and pain cycles.

Stress

  • Psychological stress can lead to muscle tension and exacerbate existing trigger points.

Break the Cycle

Physical Therapy

  • A physical therapist can use stretching, massage, and trigger point therapy to release muscle tension and address trigger points.

Exercise

  • Regular exercise, including gentle stretching, can help improve muscle flexibility and reduce tension.

Heat Therapy

  • Applying heat to affected areas can help relax muscles and alleviate pain.

Ergonomics

  • Modifying work habits and posture to reduce strain on muscles.

Stress Management

  • Techniques like deep breathing and meditation can help reduce stress-related muscle tension.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Personal Injury Rehabilitation


References

Jafri M. S. (2014). Mechanisms of Myofascial Pain. International scholarly research notices, 2014, 523924. https://doi.org/10.1155/2014/523924

Kojidi, M. M., Okhovatian, F., Rahimi, A., Baghban, A. A., & Azimi, H. (2016). Comparison Between the Effects of Passive and Active Soft Tissue Therapies on Latent Trigger Points of Upper Trapezius Muscle in Women: Single-Blind, Randomized Clinical Trial. Journal of Chiropractic Medicine, 15(4), 235–242. https://doi.org/10.1016/j.jcm.2016.08.010

Nicol A, C. M., Hsu E, Ferrante M. (2018). Myofascial Pain Syndrome. Science Direct, 207-212. https://doi.org/https://doi.org/10.1016/B978-0-323-40196-8.00025-5

THORNE. (2021). Understanding Muscle Pain, Fascia, and Myofascial Release. https://www.thorne.com/take-5-daily/article/understand-muscle-pain-fascia-and-myofascial-release?srsltid=AfmBOop3Pp0wWEeiQEqpfPgAaTOpLvU7lOAGUv5VRYQdoH8OBcW4D_wk

Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R: the journal of injury, function, and rehabilitation, 7(7), 746–761. https://doi.org/10.1016/j.pmrj.2015.01.024

Cleveland Clinic. (2023). Chronic myofascial pain (CMP). https://my.clevelandclinic.org/health/diseases/12054-myofascial-pain-syndrome

Yoo W. G. (2015). Comparison of activation and change in the upper trapezius muscle during painful and non-painful computer work. Journal of Physical Therapy Science, 27(10), 3283–3284. https://doi.org/10.1589/jpts.27.3283

Bron, C., & Dommerholt, J. D. (2012). Etiology of myofascial trigger points. Current pain and headache reports, 16(5), 439–444. https://doi.org/10.1007/s11916-012-0289-4

Learn How to Perform Trapezius Self Massage for Pain Relief

Can individuals who sit for long hours daily prevent tight neck and shoulder muscles by improving their posture, regularly stretching, and massaging their trapezius muscles?

Trapezius Self Massage

The trapezius muscle is a triangle-shaped muscle in the upper back that starts at the base of the neck, spans the length of the upper shoulders, and extends into the middle back. This muscle’s main function is stabilizing and moving the scapula/shoulder blade. The trapezius also helps to move the head, neck, arms, shoulders, and torso, stabilizes the spine, and plays an important role in posture. Physical and mental stress can tighten the trapezius muscle, leading to neck and shoulder pain. Learning to perform a trapezius self-massage can ease tension and provide pain relief. (Domingo A. R. et al., 2017)

Anatomy

The trapezius consists of three parts in three different areas of the back. The bottom of the skull, across the shoulders, and down to the mid back. A trapezius self-massage focuses on the upper portion of the traps. This part is located at the top of the shoulders. To find the upper trapezius, cross one arm in front of your body so that you can place the palm on top of the other shoulder.

stock photo trapezius anatomy muscles isolated on white d illustration

For a trapezius self-massage, you need to know that there are two areas where your upper traps start and where the muscle connects to a bone. The first point is on the bottom of the skull, close to the center of the back of the skull. Start there with your fingers and trace the muscle down the back of the neck to where the shoulders widen. If you get lost, You can walk your fingers up or down the muscle on either side to relocate its origin at the base of the skull, the vertebra at the base of your neck that sticks out. This is C-7, another of the upper trapezius’s origin sites. (University of Washington Department of Radiology, 2025

Massage Technique

Massage oil is optional but can hydrate the skin during a massage. You can perform the trapezius self-massage using your hands.

Start at the Base of The Neck

Choose one shoulder to work at a time.

  • Raise the arm on the opposite side of your body.
  • Reach this arm across your body and fold it around your neck so that your fingers rest at the back base of your neck.
  • Apply a decent amount of pressure to the muscle while moving your fingers in a circular motion.
  • The action is similar to kneading dough.
  • Massage this area at the base of your neck for about 30 seconds to start.
  • If this part of your muscle is sore, you can massage it longer.

Slowly Work Out Towards The End of The Shoulder

Once you have spent about 30 seconds massaging the muscle at the base of the neck, work your way out toward the end of your shoulder.

  • In close increments, in your fingers across the trapezius muscle, spending at least 30 seconds at each point.
  • Follow the muscle until you reach the end of the shoulder.
  • Apply enough pressure, and use slow, rhythmic movements so that you feel relief.
  • If the pressure is not relieving or makes you wince, it’s too much.

Repeat as Needed

Repeat each side two to three times before switching to the other shoulder. After massaging, you may notice a certain trapezius area is particularly sore or tense. Zero in on those areas a little longer. Remember to relax throughout the trapezius self-massage. This is an opportunity to learn where tension is in your neck and shoulders and how to apply pressure to relieve it. This knowledge can also help you be mindful throughout your day, whether sitting, doing chores, or other physical activities. If you notice scrunching or slouching, massage the trapezius and remind yourself to keep your shoulders relaxed.

Benefits

Tension and tightness in the trapezius muscle are common, particularly among individuals who work in an office, do manual labor, or deal with a lot of stress. (Marker R. J. Campeau S., & Maluf K. S. 2017) Trapezius strains are a common overuse injury that is more likely to happen when the muscle is tight. (Salavati M. et al., 2017) The injury can cause unhealthy posture to avoid the pain. This poor posture will place more stress on the muscles, leading to a cycle of poor posture and chronic pain. A trapezius self-massage can benefit in many ways, including:

  • Improved blood circulation
  • Better quality of sleep
  • Improved posture
  • Improved range of motion
  • Decreased swelling
  • Faster recovery after workouts
  • Reduced risk of injury

Seeing a Healthcare Provider

Like any other muscle in the body, the trapezius can be injured and requires special treatment to recover. Sometimes, the neck or shoulder pain may not come from the trapezius muscle. Consider seeing a healthcare provider if you have pain in your neck or shoulder that doesn’t get better within a week or two, especially if it isn’t responding to at-home treatment. Regardless of how long you have been experiencing pain or stiffness, contact a healthcare provider if it prevents you from getting adequate sleep or interfering with daily activities. Reasons to see a healthcare provider immediately for neck or shoulder pain include: (Mount Sinai, 2025)

  • There is sudden pressure or pain in the left shoulder, which can sometimes signal a heart attack.
  • A fall or accident resulted in pain, swelling, or problems moving the neck or arm.
  • If there is shoulder pain, a fever, swelling, or redness.
  • The skin on the shoulder area appears discolored.

It’s important to take regular breaks to stretch and move your muscles. You can release tension in the trapezius by doing shoulder shrugs throughout the day and stretching regularly. When the trapezius feels tight or sore, give yourself a massage.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Whiplash Chiropractic Massage Therapy


References

Domingo, A. R., Diek, M., Goble, K. M., Maluf, K. S., Goble, D. J., & Baweja, H. S. (2017). Short-duration therapeutic massage reduces postural upper trapezius muscle activity. Neuroreport, 28(2), 108–110. https://doi.org/10.1097/WNR.0000000000000718

University of Washington Department of Radiology. (2025). Trapezius. https://rad.washington.edu/muscle-atlas/trapezius/

Marker, R. J., Campeau, S., & Maluf, K. S. (2017). Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius. Journal of Neurophysiology, 117(1), 457–466. https://doi.org/10.1152/jn.00448.2016

Salavati, M., Akhbari, B., Ebrahimi Takamjani, I., Ezzati, K., & Haghighatkhah, H. (2017). Reliability of the Upper Trapezius Muscle and Fascia Thickness and Strain Ratio Measures by Ultrasonography and Sonoelastography in Participants With Myofascial Pain Syndrome. Journal of Chiropractic Medicine, 16(4), 316–323. https://doi.org/10.1016/j.jcm.2017.06.003

Mount Sinai. (2025). Shoulder pain. https://www.mountsinai.org/health-library/symptoms/shoulder-pain