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Solving Work Related Pain in Dentistry

Should You be Treating Your Trigger Points?

-Dr. Bethany Valachi-

Your Trigger Points Might be Causing Your Pain!

Have you ever experienced a ‘headache’ behind your eye that won’t go away with pain medication?  Or experienced neck pain that feels slightly better with massage, but massage doesn’t resolve the neck pain?  These are typical characteristics of upper trapezius trigger points.  Since the upper trapezius is the most active muscle when practicing dentistry, it makes sense to consider preemptive therapy to work more comfortably and productively.


Pain clinic doctors who treat trigger points state they are the primary cause of pain in about 75% of cases!

Consider the facts:

  • 80% of dental professionals complain of neck & shoulder pain.
  • The upper trapezius muscles are the most active muscles in dentistry.
  • Upper trapezius trigger points are the primary trigger points responsible for neck pain and headaches.
  • The upper traps are the most reactive muscles in your body to emotional stress.
  • To effectively resolve most trigger points, they should be treated multiple times  (3-5 times) per day.
  • Is there any doubt that most dental professionals should be treating their upper trapezius trigger points?  The process is easy and incredibly effective.

Based on a study comparing different methods for patients to self-treat their trigger points (in the Journal of the American Physical Therapy Association), here is an effective sequence for treating the most problematic upper trapezius trigger points–#1 and #2.  I have added the moist heat (step #1), as I’ve found it enhances the treatment!

1) Moist heat

Start with a moist heat pack. The moisture causes the heat to penetrate much more deeply and is more effective than simple hot packs.  Follow instructions for treatment, which is usually 15-20 minutes.

2) Trigger Point Treatment

The upper trapezius muscle

Upper Trapezius Trigger Point #1 is located in the thick roll of muscle between your shoulder & neck and can be treated manually.  Sidebend your head toward the trigger point, and with the opposite hand, grasp the thick roll of muscle between your thumb and index finger.  When you find the trigger point, gently compress it until it ‘hurts so good’ (pain level of 5/10) for 5 seconds.  Then gently roll the TP between the fingers for 5 seconds.  Repeat this sequence for no longer than 1 minute.

Upper Trapezius Trigger Point #2 is located on top of the shoulder and can be treated with the Backnobber tool. With arms relaxed on the tool, fulcrum the tool on your chest so the neck/shoulder muscles stay relaxed and repeat the above sequence on these trigger points.

3) Stretch

Perform the upper trapezius stretch (Find all 20 Chairside Stretches and Trigger Point Treatment in Dr. Valachi’s CE Video Course: Chairside Stretching & Trigger Point Therapy Package).  To stretch the right upper trapezius, place your left hand on left thigh and right arm behind your back. Sidebend your left ear toward your left armpit.  This is a very large muscle, so take time to experiment with sidebending, rotating or flexing the head forward to stretch different parts of this very large muscle.

You can repeat this sequence 3-5 times/day for very problematic trigger points.

Read Dr. Valachi’s feature article:

The 5 Steps to Practicing Dentistry Pain-Free



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Dr. Bethany Valachi

Beat Pain and Extend Your Career

Dr. Bethany Valachi has helped thousands of dental professionals for over 20 years, and is recognized internationally as an expert in dental ergonomics. Let Dr. Valachi help you work pain-free and take back your practice!

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