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Neck Pain


You may have been told that your neck pain is being caused by a pinched nerve, a compressed disk, arthritis, or a displaced cervical vertebra. In reality, your pain may be due solely to referral from myofascial trigger points (tiny contraction knots) in overworked or traumatized muscles of your upper back and shoulders.

This is the view expressed by Doctors Janet Travell and David Simons in their widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual. Travell and Simons demonstrated that trigger points in the trapezius and levator scapulae muscles of the upper back and shoulders are the main cause of neck pain and stiffness.

trapezius points

Shown here are trapezius trigger points and their referred pain at the base of the skull.

Interestingly, trigger points in the larger neck muscles, such as the splenius and semispinalis, are a major cause of headaches but play a minor role in neck pain.

Referred Pain

Trigger points typically refer pain; that is, they usually send their pain to some other site. This is why neck pain can be so frustrating and hard to get rid of. You may never find the real cause of your neck pain if you look for it only in the neck.

multifidi points

Throughout the body, conventional treatments for pain so often fail because they focus on the site of the pain while overlooking and failing to treat the cause, the myofascial trigger points that may be some distance away.

The small mulitifidi and rotatores muscles that interconnect the neck vertebrae are the only neck muscles whose pain is felt solely in the neck.

These tiny muscles can pull individual vertebrae out of place when shortened and tightened by trigger points.

Scientific Misdiagnosis

X-ray evidence of arthritis or compressed disks is often used to justify surgery for neck pain, although such surgery is only occasionally successful in resolving the pain.

Surprisingly, arthritic spurs that appear on X-ray can actually be quite painless. Trigger points are by the far the more likely cause of pain in your neck.

Travell and Simons believe that muscles affected by trigger points can be the root cause of compressed nerves and disks because of the abnormal tension they can maintain on the vertebrae.

The Dangers in Stretching

Even though you may be lucky enough to escape the surgeon’s knife, you may fall victim to “conservative” therapy that can be just as ill-conceived and misdirected.

Many people have discovered to their great regret that physical therapy’s obsession with stretching exercises can make neck pain worse, not infrequently resulting in an excruciating crisis.

This is because stretching can irritate trigger points, causing muscles to be very resistant to any attempt to lengthen them.

The Wrong-headedness of Drugs

Worse yet is the pharmaceutical treatment of the whole body for what is clearly a specific local problem.

Treating neck pain with painkillers, muscle relaxants, and anti-inflammatories suggests that the practitioner has little understanding of trigger points and referred myofascial pain. The medical community employs far too many of these convenient shotgun type remedies, with their too often dangerous side effects.

Painkilling drugs for neck pain are particularly unwise, because they give you the illusion that something good is happening, when in reality they only reduce your awareness of the problem.

Painkillers may actually make a myofascial problem worse by allowing you to continue abusing muscles that are already in trouble. Pain is a message. It’s not good medicine to kill the messenger and ignore the message.


Trigger points should be at the top of the list during any examination for neck pain and stiffness. When healthcare practitioners have had adequate training and experience, trigger points are easy to locate and treat. In fact, there are ways to treat them yourself quite effectively.

trigger points workbook

In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies simplifies Travell and Simons’s extensive research into myofascial pain and makes it accessible to the layman. When trigger points are the cause of your neck pain and stiffness, you can gain significant relief using safe, precise methods of self-applied trigger point massage.

To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.

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