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Myofascial pain patterns of the lower and middle trapezius muscle (TP-4, TP-5)

Essential (solid red) and spillover (stippled red) referred pain from the lower trapezius TP-4 (x) produces a steady burning pain along the medial border of the scapula. TP-5 (x) arises from the middle trapezius fibers and produces a superficial burning pain referred medially, near the spinous processes of the C7 and T1 vertebrae. (From: Travell JG, Simons DG. Myofascial pain and dysfunction, trapezius muscle, the trigger point manual. Volume 1. Baltimore: Williams & Wilkins, 1983:185, with permission.)

Associated Disorders

  • Fibromyalgia
  • Greater occipital neuralgia
  • Piriformis syndrome
  • Postexercise muscle soreness
  • Thoracic outlet syndrome
  • Whiplash