The Best Way to Help Shoulder Tension and Neck Pain May Just Be…Botox?

By Jordan Galloway, GQ

When you spend your days sitting at a desk hunched over a keyboard, it’s probably not a huge surprise if the occasional massage isn’t enough to unwind the muscle tension in your neck and shoulders. To truly tackle chronic tension requires lifestyle changes (which are hard when you live in a flexion-based society like we do and you can’t exactly chuck your work computer no matter how much you may want to at times). But the next-best solution is finding an equally constant treatment, which could explain why so many people are curious about trapezius Botox, better known as traptox, right now.

Searches for “What is traptox?” have grown by over 5,000% nationwide in the past three months alone, according to Google Trends. And doctors who administer the treatment say they’ve been seeing more interest from clients looking for relief from tight traps, from the Hamptons to the heartland.

Botox in the trapezius—the large, triangular muscle located on your upper back and neck—initially became popular in Asia and has started to gain popularity in the United States over the past few years, according to Faiyaaz Kalimullah, MD, FAAD, assistant professor in the department of dermatology at Rush University Medical Center and a board-certified medical and cosmetic dermatologist at the Center for Dermatology and Aesthetic Medicine in Chicago.

What is traptox?

According to Dr. Kennis, in a nutshell, it’s getting Botox injected into your trapezius muscles, a very broad group of muscles that cover the upper portion of the back, starting in the middle and working their way up and out to the shoulders. “It’s a large group of muscles that can account for a lot of strain, chronic tension, stress, and even lead to headaches,” he says.

There are lots of brand names for the type of neuromodulator, produced by the bacterium Clostridium botulinum, used in the treatment. Botox is one, but Jeuveau, Dysport, Xeomin, and Daxxify are others. They all work the same way: by interrupting the signal from a nerve that allows a muscle to contract.

“When the trapezius is injected with a neuromodulator,” Dr. Carqueville says, “the number of muscle fibers contracting is reduced, and as a result, the shoulder and neck muscles relax.” This helps to alleviate the tension you may feel in this area.

As a result, not only can traptox relax your upper back, shoulders, and neck, but Dr. Kalimullah says it can also increase mobility in this area, since overly active traps can lead to muscle imbalances that can reduce your range of motion. “Patients with hypertrophy, or overgrowth of the trapezius, have also often told me that they feel they can work out their back muscles more effectively after traptox,” he adds.

What’s more, those who are prone to tension headaches or migraines may find that traptox offers relief for these conditions. “Many patients request traptox to reduce migraines or headaches,” Dr. Carqueville says. “I will often combine treating the trapezius muscle with treating the masseters or temporalis muscles, which also may be responsible for causing tension headaches or migraines.”

What causes tight traps in the first place?

Imbalanced workout routines, muscle strain, psychological stress, and trigger points, among many other factors, can lead to chronic tension in the trapezius muscle and subsequent neck and shoulder pain, according to Dr. Kalimullah.

So can poor posture and everyday habits that cause your upper traps to engage, like hoisting a heavy bag on your shoulder or lifting bulky items overhead. The chronic tension is typically caused by repetitive movements, meaning the things you’re doing over and over again are likely the cause of the tightness in your upper back. Hence why this area can benefit from Botox: The treatment can effectively work to alleviate tension over extended periods.

What are the potential side effects of traptox?

While most people associate Botox with its FDA-approved cosmetic uses—treating “11 lines” between the eyebrows, forehead lines, and crow’s feet around the eyes—it can be safely used all over the body, Dr. Kalimullah says, adding that “by relaxing and weakening the trapezius with Botox, we can, in many cases, reduce or relieve chronic pain with relatively few side effects.”

Botox and its like are safe for most people. One major exception being people with a history of neuromuscular disease, says Dr. Kennis, who adds that “if you’ve already had issues with your nerves, you don’t want to potentiate that” further by introducing neuromodulators.

Common initial side effects include temporary pain or discomfort, as well as bruising or redness, at the injection site within 24 to 48 hours of treatment.

“In the first two weeks while the Botox is kind of settling in, there is a bit of a time where [chronic pain or tension] may get slightly more painful because the balance between the traps and the other back muscles is changing,” Dr. Kennis explains. “So sometimes that’s a little uncomfortable, but once the other muscles compensate and say, Okay, this is my new tension, the pain melts away and you find a new kind of homeostasis.”

With Botox treatment, “the trap muscles will become weaker due to reduced use and contraction,” Dr. Carqueville says. This is a potential adverse side effect active clients looking to get traptox need to keep in mind and consult their doctors about before getting treatment.

“I have a lot of clients ask me, ‘Is this going to affect my tennis game?’ ‘Is it going to affect my golf game?’” Dr. Kennis says.

The truth is that it could, but Dr. Kennis says being selective about injection sites and the amount of Botox being administered can address this potential issue. “I started to scale it down a little bit because some people reported a little bit of weakness in their lifting capacity,” he says, “so I want to avoid that and make it the best treatment with respect to function and also getting the relief that the person wants.”

At Pain Spa, Dr Krishna is highly experienced in treating patients with myofascial pain including pain in the trapezius muscle (Traps). Dr. Krishna is a pioneer in the use of Botox for pain management in the UK, with over 15 years of experience in the field. For further information please contact us at clinic@painspa.co.uk.