Jock Doc

Neck, upper back pain can mean tight trapezius muscle

Q. I have had neck and upper back pain for about two months. It bothers me when I work out. It also hurts at night. I had a massage and it felt better for about a day. My primary doctor told me I had a muscle strain and trigger points and gave me a muscle relaxer, which didn’t help. I’m wondering what to do next.

A. A common muscle to injure is the trapezius. This is a large trapazoidal-shaped muscle that extends from the base of the skull down the neck to the back of both shoulder blades. Like any muscle, it can be injured and produce pain, limited motion, tightness and spasms. Localized areas of tenderness that when touched produce sharp pain are called trigger points. Injuries can occur from accidents, working out, poor posture and even sleeping wrong.

Since you are still having symptoms, you may want to see a spine specialist. The usual treatments are anti-inflammatory and muscle-relaxant medications as well as physical therapy. For patients who don’t respond to traditional treatments, Dr. Alan Herskowitz, the Miami Heat neurologist, has found trigger point injections of Botox to be highly successful.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to