My brother has this annoying habit of coming up behind me and pinching the muscle above my shoulder. He says it’s the “Vulcan death grip.” I can believe that because it is incredibly painful. Brings me to my knees every time. What is he really pinching and what can I do to stay relaxed and unresponsive to this technique?

Star Trek lovers are familiar with the “Vulcan nerve pinch”, a technique used by Dr. Spock to cause someone to lose consciousness. The technique was to pinch a pressure point at the base of the victim’s neck but in fact, it’s likely the pinch was in fact a trigger point (TrP) of the upper trapezius muscle. The upper trapezius muscle is the muscle along the top of the shoulder at the base of the neck (where the neck and shoulder meet).

Trigger points are defined as hyperirritable areas of tenderness in a muscle that when pressed or pinched can cause local and/or distant referred pain (e.g., someplace else down the arm). Trigger points can be active (currently already causing pain) or latent (only painful when pressed or pinched).

Physical therapists often treat this problem using a variety of techniques that may be noninvasive or invasive. Noninvasive approaches include massage, stretching, and ultrasound. Invasive treatments include dry needling and corticosteroid injections. Dry needling refers to using needles to stimulate the trigger point without actually injecting any medication or other substances.

Two other techniques that have been shown to work well include phonophoresis and pressure release. Phonophoresis is a way to use ultrasound to push a topical corticosteroid (antiinflammatory ointment applied over the skin) through the skin into the muscle. Pressure release is the application of sustained pressure to the trigger point until pain is reduced.

Some experts suggest the increase in blood flow to the area from phonophoresis helps clear out substances in the area that cause pain. Pressure release may help by lengthening the muscle fibers themselves. Once the pressure is removed, there is a release of antipain hormones (e.g., endorphins, enkephalins), thus blocking pain and making it possible to move once again.

Whether you are the victim of the Vulcan nerve pinch or simply a neck pain sufferer from trigger points of the upper trapezius muscle, ask a physical therapist to apply either or both of these treatment techniques. Experience the safe and effective relief of painful symptoms without adverse effects that phonophoresis and/or pressure release have to offer.