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Myofascial pain patterns of the upper Trapezius muscle (TP-1)

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Trigger points in the upper trapezius cause essential (solid red) and spillover (stippled red) referred pain unilaterally along the posterolateral aspect of the neck to the mastoid process, temple, and back of the orbit, and is a major source of tension headache. Postural dizziness associated with these trigger points has been ascribed to synergistic activation of sternocleidomastoid muscle trigger points. Entrapment of the greater occipital nerve as it emerges just below the occiput through the trapezius and underlying semispinalis capitis muscle is commonly seen in myofascial pain syndrome, with the trapezius contributing a shearing stress. (From Travell JG, Simons DG. Myofascial pain and dysfunction, trapezius muscle, the trigger point manual. Volume 1. Baltimore: Williams & Wilkins, 1983:184, with permission.)