Complete Guide To Treating Your Own Trigger Points In Neck Muscles

neck pain from trigger points

If you suffer from neck pain, occipitalis muscle pain or stiff neck, you may be suffering from trigger points, or more commonly known as muscle knots.

What makes trigger points in neck so unique?

For one, did you know that myofascial trigger points are the most common causes of neck pain? In fact, nearly 85% of all people that showed up at a pain center had what we call ‘myofascial pain syndrome’, which consists of these muscle knots. For such a simple thing to treat, it's surprising that you get big fancy words such as scalene muscle release, or trapezius muscle pain and dizziness, to describe it. 

Secondly, they are surprisingly mistreated or misdiagnosed. For example, the 'scalene muscle pain' I just described can refer pain down the arm, shoulder pain pressure points can give you pain into the neck, and pressure points for neck pain can actually also cause shoulder pain! The goal of this article is to provide you a way to find out if your pain is coming from neck pain pressure points, neck pain causes, how to get rid of pressure points in neck with the right strategies for you to remain pain free.


85%
% Of Pain Caused By Trigger Points

Want to learn more about trigger points first? You can read our article 'Introduction to Myofascial Trigger Points'. It will provide you with all the information you need to know what a trigger point is. Simply click here to go to that article.


Why Is Pressure Points Neck Pain So Difficult To Treat? 

If trigger points cause 85% of muscle pain, then why are they so difficult to treat? There are 2 reasons why the pressure points for neck and shoulder pain are difficult to treat:

1

The source of pain is not always close to the painful area

The neck anatomy is complex. I previously described how shoulder pressure points can refer pain somewhere else. Same goes for the trigger points in neck. There are many muscles in the neck, and pressure points on the neck can refer pain to other areas. You don't need trapezius tension (shoulder muscle tension) to find the spots. Sometimes the most relaxed muscles can be painful. If you had a picture of trapezius muscle pain, you'd see it start in the shoulders, spread to the neck, spread down the arm, and so on. Now imagine trying to poke around each of the neck pressure points to find the pain. If you or your therapist are not patient enough to go through each and every one of the pressure points on neck muscles, you may miss that one spot that is causing your pain. Want to see the number of muscles (with each having multiple pressure points in the neck) that can cause neck pain? Don’t focus too much on the names of these muscles. Just realize how many muscles, and pressure points, neck area actually has!

image of muscles in the neck
2

A 'diagnosis' label can make everyone overlook trigger points

If you've seen a health professional, most likely you've been given a 'diagnosis'. The problem with a diagnosis is that your therapist may not take into account the presence of muscle trigger points. For example, if you were given the diagnosis of 'tension headaches', focus of treatment may be on the headache and not the knots in neck causing headaches that may instead be giving you pain. What can cause neck pain might surprise you! Although not found in any book, I've even seen a headache recreated from pectoral trigger points (chest pressure points). Here are some typical diagnosis' that may have pain associated with trigger points in neck:

image of neck pain differential diagnosis

Common Neck Trigger Point Symptoms

sign of doctor holding card with symptoms

You’ve just learned that there are many neck muscles that can be the source of trigger point pain. Believe it or not, they are very similar to acupressure points for neck and shoulder pain. You’ve also learned that as health professionals (myself included), we tend to label your pain as one thing and then forget to look at other underlying causes. (Trigger points for headache relief are a prime example)

No wonder trigger points in neck are so overlooked! It explains why the pain in neck muscle remains steady despite everything you try. Sometimes going a short distance down the shoulders (upper trapezius pain relief) can relieve some of your neck pain by working on those 'trap' trigger points. Let’s discuss what sort of symptoms of neck pain you can get from neck trigger points, including shortly also talking about those trigger points in trapezius muscles.

Trigger point pain is usually described as a deep or aching type of feeling. The pain can occur if you move your neck, or can occur if you keep your neck in one position, such as sitting in an improper position for hours on a computer. Getting a shot for muscle pain is something that is not often required. Rarely will you feel any numbness or tingling. If you do, its most likely a nerve. However, also note that ‘nerve’ pain is really not that common.

So far, we’ve discussed what pain can feel like in the neck area. Did you know that the muscles in the neck that give you trigger points can also give a wide range of strange symptoms, like the trapezius myofascial pain I was talking about? With a tight trapezius, headache can also occur. Trapezius pain and headaches can go together with neck pain. You may think your neck pain is something different than the trapezius headache, but they could be coming from the same source, such as the trapezius muscle, headache and neck pain being the product. For this trapezius muscle, picture getting treated by pressure points or myofascial release, trapezius pain will go down but also your headaches.  These trapezius muscle injury symptoms can easily be treated, if you know how. A typical trapezius muscle strain treatment can be done at home, using simple tools on your own. If you're patient enough, trapezius muscle pain symptoms can be greatly reduced over several home treatments. If you develop a daily habit, you can keep those trapezius pain symptoms under control.  

These are just some of the strange symptoms that are associated with muscle knots in shoulders and neck areas. However, most people will just have neck pain. The best way to target these knots is through what we call trigger point therapy. As in the previous example, trapezius pain relief is possible with your own self treatments to these muscles. In the next section, we’re going to show you how to find these trigger points in neck muscles yourself, and learn to get trapezius muscle pain relief in addition to all the other areas in the neck and beyond. And the great news is, you won't need any invasive, painful trigger shot for pain. 


How Do I Find Trigger Points In Neck That Cause Pain?

The good thing about neck pain is that most of the trigger points are in muscles that are close to the neck area, although there are some strange ones in shoulder blade trigger points. But most are around the front and back of the neck, and slightly extending to the shoulders, which is great news if you are going to perform self treatments. You're not going to go too far, like treating trigger points for hip pain. Now that would be a strange sight!

Since there are many areas to look, we like to divide the areas into sections to make it easier for you. The sections are the front of the neck, the back of the neck, the upper shoulder area and the mid back trigger points.  (No strange spots like ear trigger points!) Before we get into these sections, here are a few key points to remember when trying to find trigger points:

  • Always start in the area that you are feeling the pain, since muscle knots in neck muscles are usually close. If you don’t feel any pain here, then slowly move in a circular pattern around that area. That circle area will be small, and then gradually increased in size. The reason I like to start like this and then slowly map areas around it is because its easier to find the knot in neck muscle area here. Remember, there are many muscles in the neck. If you aren’t hitting every spot you can, like a muscle knot in back of neck, you may miss the one knot in muscle in neck that is causing your pain.
  • You may feel tenderness in the area you are pressing but it may not be the same type of neck pain you are getting. Take that muscle knot, back of neck, which may be tender but not the same pain as your original problem. That’s okay. You can begin treating these areas also. Remember, there will be many trigger points around the area of pain, and areas that are distant to it, like lower trapezius muscle pain sports. Its important to work on as many neck and back pain pressure points as you can. Let’s now break up into the different sections, including that lower trapezius pain (mid back) that I was talking about:

Find And Treat Causing Back Of Neck Pain:

girl using muscle wizard for neck pain

This is the first area that I usually look at when my patient complains of neck pain. You can usually poke around these muscles with your hands. For some of you, having a tool like the Muscle Wizard may be the best option for this. There are so many muscles back here that health professionals list out each muscle.

For self treatments, you don’t not need to know the names of all the muscles. Just remember to poke around all the areas back here to see what is causing you pain. This is the easiest area, compared to the front, where scm muscle trigger points get quite complicated. In the back, the muscles are layered on top of each other so we don’t want to worry about which muscle is causing the pain, so it doesn't matter if it's trap pain relief or some other muscle that is being affected. 

Now that you have knowledge of trigger points in hand, we want to just find a spot that is tender and may refer pain to other areas, press into that spot for a few seconds and then move on. trigger points in neck treatments really are that simple! Here’s a short video on how to target the back neck muscles with the Muscle Wizard. If you're wondering about trapezius muscle trigger points and getting rid of trapezius muscle tightness, we'll get to that shortly:

 In the video, you may not have noticed but we can use the Muscle Wizard to really dig into a trigger point, base of skull to all the way down the neck. It's often difficult to use the hands since they usually get tired quickly. Using a tool like the Muscle Wizard can save you from getting a more aggressive injection for muscle pain (ex. lidocaine injection for back pain). 

muscle wizard for neck trigger points

For those of you with strong hands, you can start off with just using your hands. I’ve found that it’s a great way to start, but not something you want to continue doing, since you’re hands will get fatigued and tired. 

man massaging his neck pain

Use at least 3 fingers together. This helps maintain stiffness as you're pressing into the muscles. Check out the following video on how to treat trigger points in neck by hand. ​

 


Find And Treat Pain In Front Of Neck:

woman massaging her neck pain

The front of the neck is the most sensitive area that you’ll find. (We'll discuss some of those complicated muscles here, like scalene referred pain) It’s also the area that will give most of the ‘bizarre’ symptoms that we just went over, like dizziness, difficulty swallowing, sore throat and sinusitis.

This area rarely refers to the back of the neck. However, if you are getting any of these ‘bizarre’ symptoms, the front of the neck is where you want to start. Unlike trapezius pain treatments that aren't as bizarre but may just come with referred pain to the neck and some trapezius tenderness. 

Otherwise, if it’s just myofascial neck pain that you’re getting, start with the back of the neck. The front of the neck area can also easily be poked around using your hands. I shot 2 short videos that demonstrates this. The first video goes through how to find and treat Sternocleidomastoid muscle trigger points. This is that muscle that gives the 'bizarre' symptoms, and can even give a trigger point migraine type of headache:

The second muscle in the front of the neck usually refers pain down to the shoulder and all the way into the arms. We thought we'd include a short video here since it's in the front neck area. Be careful when working on this muscle! You may feel like you're hitting a nerve, when in fact it very well may be the scalene muscle. I've seen patients get dry needle injection into this area. How much easier is it to actually just use your hands?!

We’ve also found the Muscle Wizard to be effective. The knobs are flat for a reason. We wanted to mimic the flat shape of a thumb. Check out the following video on how to use the Muscle Wizard to address anterior neck trigger points:


Find And Treat Trigger Points In The Upper Shoulder Area:

man massaging upper shoulder muscle pain

The upper shoulder area (in addition to thoracic trigger points) consists of what we call the upper trapezius and levator scapula muscles. For burning pain in trapezius muscle, (the angle between the neck and shoulder), you can use your hand, trigger points between your fingers to pinch the muscles to see if you can find some tender spots. I find these spots are easier to find than pressure points on back of head, but they're also harder on the hands, with the risk of getting tired much greater. 

Another spot is at trigger points in shoulder area, over the top corner of the shoulder blade, closest to the spine. This is one of the most common spots for trigger points to develop.

These spots are better found using a trigger point tool such as a cane shaped tool or the Muscle Wizard. (Would you believe a patient ended up getting elbow trigger points when they kept using their hands?! Watch the following video to show you all the options you can use (and avoid trigger shot injection alternatives):

The key with the Muscle Wizard is not to forcefully apply pressure with the knee. The pressure should be very slight, or else you can run the risk of developing hip pain trigger points! 

Note: Sinus trigger points are also something that are not to be overlooked, but are beyond the scope of this article since we want to focus on the most common areas that you'll find yourself getting affected. ​

muscle wizard self massage trigger point tool

Find And Treat Middle Back Muscle Pain:

man massaging mid back

The middle back area muscles include the middle and lower trapezius. This area is best targeted by using a trigger point ball. You can either roll over it while lying down, or use it against a wall. (You'd be surprised that these can cause muscle knots in neck symptoms, like pain to the back of the neck!)

I prefer the wall because its much easier for most people. It also allows you to control the amount of pressure you can place on the ball. You have less control lying down. Most of my patients end up pressing too hard to the point that its uncomfortable when they are lying down on a ball. (Note: If you ARE going to use them lying down (for example, trigger points for migraines), use a book on the ground and then place the ball on top of the book. It's easier to target trigger points in neck and shoulder muscles this way.

If you are not able to find any trigger points in neck or shoulder area, the lower trapezius pain symptoms are often overlooked. You’d be surprised how many people have neck pain coming from this area! Watch the following short video that shows you how to target this area. You'll notice we talk about how this can cause headaches. The area of headaches and neck pain are the same.


How To Relieve Neck Pain

Now that you know how to go about finding trigger points, what’s the best treatment for neck pain? Each part of the neck (like scalene muscles trigger points), shoulder trap pain and mid back respond well with different tools. There isn’t one tool that is effective for every muscle. Before we get into some of these techniques, lets go over a few points on what you should know as you’re treating your trigger points head on:

  • Don’t press so hard that you’re grimacing in pain or tensing up. Some patients complain of getting new trigger points head area from overdoing it. It goes back to the ‘no pain no gain’ philosophy that most people have. Apply just enough pressure that you can feel the tenderness or the referral of pain. (Not excruciating trigger points in head area or anywhere else!) You should not be tensing up at this time. As in the trigger points on head example, most of my patients end up getting frustrated that they are trying to treat their neck but getting headaches, and then stop all their self treatments. Once the pain begins to improve, you can then apply slightly more pressure. Do this anywhere from 30 seconds to a minute. After that, move on. Which brings us to our next point.
  • Don’t over treat a muscle knot, whether it's for trigger points in neck, for knee pain or head trigger points, or any pressure points on the body that cause painOnce you find a spot that you feel is giving you the pain, you’ll be tempted to just stay here and treat it. However, trigger point pain doesn’t come from just one spot. There are multiple knots in the muscles. You need to target all of them to see any pain relief.
  • Be careful of other structures. The only area to really be careful about is the front of the neck. (Remember, this area can give myofascial headache symptoms) This area also has arteries and nerves that extend down into the shoulder and arm. If you feel numbness going down the arm, it may just be a nerve. (And no, you wont need a trigger shot for back pain just because you have numbness) One of the best ways to know this is that the pain is not improving with your pressure. A trigger point that refers pain feels good when you press on it. It’s a sort of ‘good pain’, and one of the best ways on how to relieve trapezius pain, trigger points for shoulder pain, or any other type of trigger pain. A nerve will cause tingling, which will not get any better and will often get worse. If that’s the case, slide over to another part of the muscle until the tingling goes away. If you feel a pulse under your fingers, you can gently move to another spot. As with trapezius shoulder pain, trigger points in upper back can cause problems, but there are some nerves in that area that 'may' get irritated. Just remember that 'no pain, no gain' is not an option here. If it improves from pressure, you have upper back trigger points. If it doesn't, then move on to another area. It's as simple as that for trigger points, upper back pain, front of the neck pain, or anywhere else. 
  • Don’t expect to actually feel a ‘knot’. After treating trigger points in neck muscles for over 20 years, I’ve come to the conclusion that you can’t always feel a knot. Some patients come to me asking for an 'upper trap release' when in fact that muscle is not tight at all. Muscles that feel loose and relaxed may have the most painful trigger points of them all. The key is to feel around the muscles, find a tender spot, press down slowly into it and see if it recreates your pain, or refers pain to other areas. Then move on to the next spot. No muscle injections for pain. Just simple tools or your hands. 

Best Neck Stretches Targeting Trigger Points

woman stretching her neck

Do you already stretch your neck out but can’t find it being helpful?

Does it only give you temporary pain relief?

Do you actually ‘crave’ stretch?

Let's use the trapezius muscle as an example. 

There's a lot of misinformation about how to relieve trapezius muscle pain with stretching, or any other trigger point pain. If you have trigger points, legs, arms, back, or any other body part will not get relief with stretching alone. If that’s the case, then you’re either doing the stretching wrong, or you haven’t taken care of the trigger points first.

The standard response by most knowledgeable professionals is that one should treat trigger points first and then stretch. The rationale is that the trigger point is like a knot in a rope. If you stretch it, the knot gets worse, sometimes leading to more severe pain in trapezius muscle, for example. That’s why we recommend treating the trigger points first. Once you get pain relief from severe trapezius pain, you’ll get better results with the stretching, and the shoulder and trap pain can gradually reduce and improve over time. 

However, some of my patients respond really well to stretching. I can’t explain it.

It’s not supposed to feel good because you have a ‘knot’!

But this type of therapy is more art than science. The most valid reason is that I find most people don’t target the right muscles when they’re stretching. That’s why I’ve given my patients a multi angle stretch that can target all the neck muscles in the back. It's a lot better to do this than to get triggerpoint injections. 

Remember, there are quite a few different neck muscles, and they all go in different directions. Some give pain going down the arm, while others can become headache trigger points.  If you stretch in one direction, you may miss the others. Watch the video below that demonstrates how to do this multi angle stretch, and you can see how effective it is for ALL the neck muscles, and not just for trapezius muscle pain treatment:

We may be able to target nearly all the muscles in the neck with that one stretch. However, I like to be more specific with the muscles in the front of the neck. Apart from low back trigger points, these are the most challenging to treat. You can watch those videos after we go through some of the key strategies you need with your neck stretches:

  • In most cases, work on your trigger points first. Once you begin to see some pain relief, you can begin stretching. Hold the stretch for each tight muscle for at least 30 seconds, up to 2 minutes. How do you know a muscle is tight? Its not that easy. Just focus on the fact that when you stretch, it actually feels good and wants to stretch. How’s that for hard science?! Again, don't let any setbacks frustrate you. Remember, it's a lot easier than more aggressive things like lidocaine injection for neck pain. 
  • You should have a good idea how your trigger points in neck feels after your trigger points neck treatments. If you add stretching, your muscles should either stay at the same level of improvement, or you should experience more pain relief. If you feel more pain in upper trapezius or any other neck muscle, and discomfort, stop the stretching and continue to focus on the self treatments. You can begin stretching slowly again when the pain goes down. This allows you to really evaluate whether it’s the right time to stretch. 
  • Try stretching while taking a hot shower. Most muscles respond well with heat. Stretching in the shower is the best way to relax your muscle. It's better than invasive tpi injection and can even relieve some trigger points in arm muscles if you continue stretching into the upper limbs. 

The following video outlines a stretch for the front of the neck area. The muscles that are being stretched are the Scalene and Sternocleidomastoid muscles. These front muscles provide some really 'bizarre' symptoms. They can even contribute to tension headache trigger points. Although the video is about the Scalene muscle, both the Scalene and Sternocleidomastoid muscle knots (trigger points in the neck) can be stretched this way. 

I also find the chin tuck stretch effective for the front of the neck. This exercise also targets the little muscles in the back of the skull where trigger points in neck symptoms include headaches in the back of the skull. Some of my  patients feel the stretch in the back, while others feel it in the front of the neck. Sometimes, they don't feel anything at all! If you're not feeling anything with this trigger points in neck pain stretch. stretch on trigger points on, be patient and make sure you're doing it correct. Watch the following video on the proper way to do a chin tuck stretch. (Again, most of the stretch will be in the front, or back of neck, and rarely giving any traps muscle pain)


Best Strength Exercises For Neck Trigger Points

collage of strength exercise positions

The neck is often the most overlooked muscle when it comes to strengthening, yet it’s probably the most important, next to trigger points in lower back muscles. 

For the cervical trigger points (neck), I usually find that most of my patients respond better if I start them off with stretching before we get into strengthening.

Some may then do the same everywhere else. They may think that the trigger points in neck and shoulders are the same and will respond the same. However, trigger point neck and shoulder pain doesn't respond the same from my experience. In fact, trigger points in shoulder and neck muscles respond just the opposite.​

For shoulders, I tend to progress someone to strengthening before we even begin stretching. (Let's not even get into how the jaw trigger points respond!) Here are a few points to consider when you’re strengthening your neck (including upper trapezius muscle pain), including a video on the strengthening exercises you can perform:

  • Start with one strengthening exercise at the start. Don’t attempt to do them all. If you begin to feel better, you can do more. Once you understand this, the same principles apply everywhere else, even all the way to leg trigger points.
  • The goal of strengthening the neck is to build endurance, and not necessarily to get the neck of a wrestler! (Who also get things like shoulder trapezius pain even though their necks are quite strong!)
  • When not getting neck knots treatment, just remember that your neck muscles are designed to keep your neck in check, not lift sofas. You may sit and slouch in front of your computer all day with your head in a forward posture. (Which can also give rise to trigger points for lower back pain) Some of your neck muscles are constantly working to hold your neck in that position. If we can increase the endurance of those muscles, we’ll better be able to handle the stresses of these positions, without resorting to aggressive treatments like trigger points injections.
  • Increasing endurance requires higher repetitions and proper form. Don’t push yourself through the exercises. Some of my patients try to hold some of their positions as long as they can. However, their neck begins shaking and they begin to get out of the proper position. This puts stresses on different parts of the neck. The ideal way is to get into position ,hold it, and once you begin to feel like you can’t hold it, stop. Rest. And start again. Repetition with proper form is key. Even for trapezius muscle pain causes, repetition to increase endurance can be beneficial.
  • If you can’t decide which exercise to start with, here is the progression I usually recommend. I base this on starting with the easiest exercise (this includes trigger points for headaches in the back of the skull). Otherwise, they are all equally effective. Watch the video below. An explanation of each exercise follows:

Upper Trapezius Strengthening (Shoulder Shrugs) For Pain In The Trapezius Muscle

This is the easiest to do. Most people believe that with pain, trapezius muscle needs to be stretched because this area always feels tight. They are partially right. There's actually another muscle, the levator scapula, that is close to the upper trapezius muscle. The levator scapula is usually the one that gets tight. It’s been my experience that strengthening the upper trapezius provides better results, as long as you make sure you're not strengthening the levator scapula at the same time. The above video shows the specific technique I use to accomplish this. 

On a side note, lumbar trigger points are the same. In the low back, similarly to pain in trapezius muscles, certain muscles do better being strengthened, while others do better being stretched. ​


Craniocervical Flexion Exercises

Apart from pain in trapezius and neck muscles in the back, there are muscles in the front. These exercises are excellent at ‘waking up’ the muscles in the front of the neck. These muscles are often shortened because our heads are flexed all day looking down at a computer or texting. These are usually done lying down. If you don’t have time to exercise, try doing these before you go to bed, or early upon awakening. If you get trapezius and neck pain while doing it, you're doing them incorrectly. 

In the video above, I also discuss the correct and incorrect way of doing this exercise, so you can target the right muscles and not the neck and trapezius pain muscles. 


Mid Back Mobilization And Strengthening

woman extending her middle back

Most people are surprised that we put a mid back exercise here, when they're often complaining of neck and trap pain. That’s because its often overlooked. We focus so much on neck muscle trigger points and maintaining stability of the neck and low back, that we forget that any decrease in mobility of the mid back is going to affect the other two. Did you know that getting the mid back moving actually improves the neck and low back? It’s definitely something to add to your program, especially if you have neck trap pain. 

As we've shown in the video, you can lie down on a foam roller, or even 2 tennis balls tied up in a sock (which can also get to hard to reach spots like trap muscle pain). The goal is to gently extend your mid back a few times, making sure you got back to neutral position, and then back into gentle extension. I've seen a few patients that avoided getting any muscle pain injection after they started these simple exercises. Note: Stretching out your arms while doing this can also work on stretching your chest trigger points.

One word of caution with rolling on a foam roller though. It may be seen as a 'natural' technique, unlike maybe lidocaine injections for fibromyalgia or myofascial pain syndrome, etc. But with any natural technique, always assess how well your body is able to adjust to it the next day.  


​Isometric Neck Exercises

3d drawing of man stretching his neck

These are your classic strengthening exercises. The key is to not resist against your hand too hard. Use about 20% force to begin. It doesn’t require a lot of resistance to work your neck muscles.If you resist too much, there is a chance to strain your neck (not counting overworking those trigger points shoulder muscles). Work your way up over time. One of the things you should never do is resist while your neck is in a flexed position. This puts too much stress on your joints and must be avoided at all costs. Also make sure your head is in neutral when you perform these exercises. 


Prevention Strategies For Neck Trigger Point Pain

image of prevention strategies sign

I’ve listed some of the most common things that you can change today. These small changes can sometimes go a long way in improving your neck pain. Sometimes, its all that you'll need, meaning no need for aggressive lidocaine injections for trigger points!

I probably spend more time talking about things my patients do all day than I do examining their neck. Whether it's knee pain trigger points, trapezius referred pain, or tight trapezius muscles, the solution is sometimes so simple that it’s staring right in front of you. Left trapezius pain can come from simply looking to your left and down all day. Or a sore trapezius muscle can occur from having a computer too far away. See if any of these apply to you. If they do, make the small changes that we recommend. You may be pleasantly surprised.

woman turning head towards man
  • Avoid head positions where you are always looking at an angle (reading something to the side and / or down on table) or turned when talking to someone:
  • You may not realize it, but just fixing these issues can lead to significant pain relief, for such things as pain in trapezius muscle. Turn your body instead of your head when you’re talking to someone to eliminate some of the pain the trapezius or other neck muscles. Try reading a book in front of you rather than the side to relieve neck pain trigger points. This often happens when we read in bed and angle the book toward a lamp, aggravating neck trigger points. If you get a small book light, you’ll be able to read with the book directly in front of you and sore trapezius muscles. If you’re always reading papers that are off to the side as you’re typing, get a paper holder that you can attach to your computer. That way, your neck will not be turned. Such simple things can prevent more severe treatments like shot for muscle spasms or other tpi injections. 
bad ergonomics carrying backpack
  • Avoid carrying a heavy purse, briefcase or luggage to avoid trigger points for neck pain. (Not to mention onset of trigger points in legs and arms from all the carrying and dragging). I’ve had patients that couldn’t figure out why they kept seeing me after their vacations or business travels. They couldn't figure out how to get rid of trigger points until they followed these simple pieces of advice. Avoid carrying heavy objects on one side of the body, which can also aggravate shoulder pain trigger points. Use a backpack over both shoulders or a briefcase with wheels if you’re going to be carrying something heavy. Note: If you find your pain spreading to other areas, those are most commonly called 'satellite trigger points' and are one of the reasons why pain can spread even if you treat the area where your pain is coming from. 
  • Use a scarf in the winter time, or when you’re in areas that have cold drafts, such as an airplane. If not, the pain can spread to even arm trigger points, in addition to the neck trapezius pain you may be getting. Note: To get a great idea about all the different trigger points, you can Google 'myofascial pain syndrome trigger points chart' or 'muscle trigger points chart'. You can find free images for all these muscles, including trapezius trigger points. 
  • Avoid computer desks that are too high, or chairs that are too low. This forces your arms to work higher, tightening your neck muscles and putting long term stress on them. Treating trigger points alone may not hep. Adjust your desk or chair so that your arms are always at a 90 degree angle to your keyboard.
ergonomics with headset
  • Are you talking on the phone too long while holding the phone between your ear and shoulder? (Would you believe this can also cause facial trigger points?)Try getting a headset for hands free conversations, while being able to keep your head fixed in the middle. Some even talk on a headset AND look down and to the side. This can shorten the muscles in the front, leading to things like scalene myofascial pain syndrome, which consists of scalene trigger points that can lead to arm pain. 
  • Avoid sitting on a chair with a headrest that pushes the head forward. You may be sitting in a chair at work, or while driving, where the headrest is too far forward. In addition to lower back trigger points, this pushes the head in a forward head posture. I’ve had so many patients that obtained instant pain relief just by fixing this one little problem! Check your office or car seat to see if this applies to you. This can sometimes help avoid getting into an injection muscle. 
"Take a break" sign on a cartoon computer monitor
  • If you’re sitting at your desk for too long, get a timer to remind you to get up for about 5 to 10 minutes every hour. The body is designed to move, not sit in one position for long periods of time.  How to treat trigger points is not just about treatments. Just the simple act of moving around for a few minutes will produce significant health improvements in muscles of the upper back and neck, with relief of trap and neck pain. Too busy at work to get up? Try scheduling ‘walking’ meetings ever hour. Simply talk to someone while standing. Anything to get you out of your chair! Even for trigger points, face time is crucial. 
  • Use proper pillow height. For trigger points, arm, shoulder and neck comfort is crucial for proper relief. What causes trigger points when we talk about pillows is this. Having pillows that are too high will tighten certain neck muscles like the scalenes, and can be one of the most overlooked causes of trigger points. Having a pillow that is too low, or no pillow at all, will overstretch the very same muscles. Both positions will lead to trigger point pain. Want to know an easy way to figure out the height of pillow to use, and really learn how to relieve trigger points? Roll up a towel and lie down for about 5 to 10 minutes. How do you feel? Is it comfortable? If not, roll up a bit more and try again. If you do this a couple of times, you’ll get a good idea where your head is the most comfortable while maintaining a neutral position. Then you will know the correct height of pillow to buy! Having the wrong pillow is what causes trigger points to develop. 
bad overhead posture
  • Avoid working in positions where you’re looking up, like painting a ceiling or doing electrical work. Not only can this lead to shoulder trigger points and tight trapezius, it can also lead to lower back pain trigger points. Using a stool is just one option in getting your head to eye level of any work you are doing overhead. Make sure not to lean back or forward, which can activate trigger points, lower back and mid back included. These positions will not only lead to neck pain, but also produce secondary trigger points in the shoulder area. It's no wonder some of my patients describe pain in multiple locations. For some trigger points, foot pain can accompany tight calf muscles or even thigh pain. It's very important to modify your positions all the time to stay away from chronic trapezius pain. 
  • Avoid driving with the arms on top of the steering wheel. This keeps the shoulders hunched up and eventually tightens the neck muscles. One simple trick like this can prevent you from learning how to find trigger points, since you wont be getting any. An injection for muscle spasm will also not be required. 
  • Avoid chairs with no armrests, or armrests that are too high: This is something nobody looks at. Over time, your shoulders are going to be hunched up, tightening your neck muscles, leading to myofacial trigger points, trapezius neck pain and even back pain trigger points. Adjust the armrests so your neck and shoulders are relaxed, with no risk of trapezius pain. If you don’t have an armrest, make sure you change chairs to one that does.