Trapezius Myalgia: A review of clinical diagnosis, risk factors, and evidence-based management

Background: Trapezius myalgia (TM) is a prevalent condition characterized by upper back and neck pain, commonly affecting those engaged in prolonged desk work, repetitive overhead activity, or manual labour. The condition is often misdiagnosed due to its overlap with other musculoskeletal disorders such as myofascial pain syndrome or cervical radiculopathy. It is primarily attributed to sustained low-level muscle contraction, leading to local hypoxia, metabolic disturbances, and the formation of trigger points. This review synthesizes literature on the anatomical, physiological, and occupational contributors to TM. Methods: A literature search was performed using PubMed database and ScienceDirect in June 2025. Relevant studies concerning the diagnosis, clinical features, pathophysiology and risk factors of TM were selected and synthesised. Results: Tailored interventions including physical therapy, dry needling, ergonomic adjustments, and stress management demonstrate efficacy in symptom relief and recurrence prevention. Adjunctive pharmacological therapy offers limited benefit and is best reserved for acute symptom control. Conclusion: Trapezius myalgia requires a comprehensive, multidisciplinary approach to manage its complex etiology and symptomatology effectively. Combining ergonomics, physical therapy, and psychosocial interventions offers the best outcomes for symptom relief and long-term prevention.