why does heat make my upper trap hurt worse?

Hi Tracy,

Great question. We first need to assess when the pain started? When did the upper trap pain start?
Was there an accident involved? How do you deal with stress or coping strategies?
Do you stretch the upper traps?

Not all pain is neruological..Most pain that individuals experience is mechanical(soft tissue tightness, muscle, fascial, joint stiffness).

There is also nocioceptive or inflammatory pain which occurs right after an injury that tends to be swollen, warm, etc

Neuropathic pain is sharp, lucid typically involves a nerve that is either being compressed by a disc, or repetitive elongation of the nerve(like tractioning it) creating stress to the mechanoreceptors and nocioceptors(A delta and C fibers)

Lastly there is central sensitization. Which is where the pain is a result of an upregulated nervous systems. Due to someone who has had multiple injuries, or several car accidents, etc. The brain does not understand how to deal with the pain. Then yellow flags such as sadness, anger, stress, depression, fear, fear avoidance, make it worse and the person in a sense bottles up the pain.

This is what I learned while studying abroad in Australia and I truly love helping those with chronic pain. Because there is a nice connection between the nervous system and musculoskeletal system, where we need to figure out as physios, to take a detailed history, clarify severity/irritability of pain, location of pain, and what makes it better, worse with a 24 hr period.

The upper traps when someone is in pain do NOT become lengthened. It is the opposite, they shorten. To protect, to guard and usually trigger points(TrpS) develop in the upper traps, because they are a postural muscle, which tighten over time. An accident or stress with poor posture/ergonomic setup will cause Trps to develop. Which is where the muscle becomes adaptively shortened and in a sense the muscle becomes literally a "tight ball"

Knowing the answers to the prior questions I asked is how we can treat and help you. Or a similar client

The bio-psychosocial model is approaching to help someone holistically. Bio-biology pertaining to the tissues, psycho-is referring to the cognitive state of the individual
social-refers to the coping strategies, social support, family and belief system.
I use this new model and it really does work.

I hope this helps and I look forward to hearing from you..

Chronic pain courses and sessions at IDEA are coming!!!

I am going to take a guess and assume your upper traps are in a very lengthened state (especially the side with more issues) which in usually the case in people experiencing symptoms in this area. The upper trapezius gets in this lengthened state due to your body and in particular shoulders working to resist gravity. With all other body parts you body does a sufficient job to maintain upright erect position but the shoulders do not in turn causing the shoulders to be depressed. Most lose the kinesthetic sense of where their shoulders are and this causes the excessive tension or sometimes called repetitive strain.

I would work on getting the upper trapezius in a neutral physiological resting position (Not lengthened or not shortened). This will alleviate the tension built up in the muscle structure also allowing more fluid scapulohumeral rhythm.

For more information please check out my article about this exact topic.

http://www.npionline.org/articles/2011.1_september.html

Let me know if you have any questions.

Fuel the Movement,
JM

About half a year ago, I started seeing a Rolfer. Rolfing is a technique for Structural Reintegration and mainly addresses connective tissue.

While my issue was nowhere near as severe as yours, it just dissipated at some time during the therapy sessions, and I have become a true advocate for Rolfing now.

Rolfers are few and far between but I hope there is one near you.

On top of what Joanne posted..heat causes inflammation and is counter productive without an ice phase in the therapy..better yet just use ice, it not only brings blood to the area for healing (which is what heat does) but also reduces inflammation (which heat doesn't do). Have you had a medical determination if its nerve related? could be an impinged nerve in the cervical spine, just that possibility takes it outside of a trainers scope of practice.

Hi,Tracy!
According to my datebase diagnosis of shoulder tendinitis must rule out other causes of shoulder pain,such as myocardial infarction,cervical spondylosis,and tendon tear or rupture.
Significantly,in tendinitis,heat aggravates pain;in other painful joint disorders,heat usually provides relief.
Treatment to relieve pain includes resting the joint (by immobilization with a sling,splint,or cast),systemic analgesics,application of cold,ultrasound,or local inj
ection of an anesthetic and corticosteroids to reduce inflammation.
You have to visit orthopedic doctor becouse diagnosis and treatment is outside of trainers scope of practice.
With regards,Miroslava.

Most of us would be out of our scope of practice to make specific recommendations. Heat, although superficial, increases blood flow, perhaps leading to increased distress. My best recommendation is to find a sports orthopaedist who you trust and will give you the best specific recommendation(s) to relieve your upper back pain.

Take care.