Written by Kim Grundy, PT | Reviewed by Sanjai Sinha, MD
Published on November 15, 2022
Key takeaways:
Muscle knots are painful, hardened spots that often form on your shoulders, neck, and back.
Overuse, poor posture, and other lifestyle factors may cause muscle knots.
These painful knots often go away with treatment, including massages, stretches, or acupressure.
FG Trade/iStock via Getty Images Plus
If you’ve ever felt a hard, painful spot on your neck or shoulders after sitting at your desk all day, you probably had a muscle knot. These sensitive spots can cause muscle aches and limit your range of motion. And if you’ve had one, you’re not alone. An estimated 85% of the general population will develop a muscle knot at least once.
But, you don’t have to suffer through them. Most muscle knots often go away with treatment and healthy lifestyle modifications.
What are muscle knots?
A muscle knot is exactly what it sounds like: a sensitive, hardened spot on your muscle.
Also called trigger points or myofascial pain, these tense muscle fibers may cause muscle aches. And they can be active or latent. An active trigger point hurts even when you aren’t touching it. But a latent trigger point only hurts when you press it.
Muscle knots can develop anywhere you have muscle or connective tissue called fascia. But they often form in your postural muscles, such as the neck, shoulders, back, and pelvis.
Common symptoms of muscle knots include:
A knot or hardened bundle felt in the muscle, even when it isn’t contracted
Local pain or tenderness when you touch the trigger point
Referred pain that causes soreness in nearby muscles
Less range of motion
Muscle twitching
The tender spots may cause other, less common symptoms such as headaches, tinnitus, and joint pain. It’s important to note that muscle knots do not cause bruising.
If you have a sore spot that is bruised or discolored, has pain with movement, and feels warm to the touch, check in with your healthcare provider. They can rule out other conditions, such as a muscle tear, contusion, or deep vein thrombosis.
What causes muscle knots?
Experts believe overuse or underuse often causes muscle knots to form. But several factors can raise your risk of developing these sensitive trigger points.
Some common causes of muscle knots include:
Muscle overuse or repetitive strain injury from activities like lifting heavy boxes or holding a phone between your ear and shoulder for long periods
Muscle underuse from an inactive lifestyle, prolonged sitting, or bed rest
Poor posture, especially while sitting for long periods without stretching
Stress and anxiety
Inadequate sleep
Dehydration
Poor nutrition and vitamin deficiencies
How do you treat muscle knots?
It can take time for muscle knots to go away. But, the following treatment options may help speed up the process:
Stretching: Gently stretching a knotted muscle can help ease pain. That’s because stretching elongates your muscles and promotes circulation. You can hold stretches for about 15 to 30 seconds and do them several times daily. Try incorporating gentle neck, back, and hip stretches into your routine.
Exercise: Aerobics and strengthening exercises may lessen myofascial pain and trigger points. Exercise boosts blood flow to your muscles. This can help muscle imbalances that contribute to trigger points.
Massage: Massage therapy is proven to help release muscle knots. It promotes circulation and lessens mental and emotional stress. Both of these improvements can help relieve muscle knots. Don’t worry if you can’t book a professional massage treatment. Using a foam roller at home can also be effective in loosening muscle knots.
Heat or cold therapy: A heating pad or ice pack on your muscle knot might be worth a try. Heat boosts circulation to help relax the knot, while ice lowers pain and swelling. You can alternate between the two. Or, use whichever one is most effective for you.
Muscle rubs: An over-the-counter (OTC) muscle rub can ease pain from muscle knots. You can find these topical creams or gels as roll-ons, sprays, or lotions. They contain ingredients like menthol and camphor to give temporary relief. And they may cut down on inflammation to speed up the healing process.
Dry or wet needling: Stubborn muscle knots may benefit from dry needling. A healthcare provider inserts a small needle into the trigger point during this procedure. With wet needling, trigger point injections include an anesthetic. Studies show that needling is very effective. But wet needling may offer better long-term results with less pain during the treatment.
Cold laser or low-level light therapy: Low-level light therapy is a less invasive option for stubborn muscle knots. It involves exposing the knot to near-infrared light. And it’s been shown to ease pain and improve range of motion.
Acupressure: Acupressure is another non-invasive treatment that may decrease myofascial pain. This alternative treatment puts pressure on trigger points (or acupoints) to soothe aches and pains. You can see a professional or try at-home methods like an acupressure mat.
Physical therapy: A physical therapist (PT) can offer many manual techniques to treat muscle knots. This includes trigger point release and spray-and-stretch cooling spray. They might also use techniques like ultrasound and transcutaneous electrical nerve stimulation. Plus, your PT can address muscle imbalances that cause muscle knots.
Medication: OTC pain relievers, like nonsteroidal anti-inflammatory drugs, can help muscle knot soreness. Your healthcare provider may also prescribe medications, including antidepressants or muscle relaxers. They can relax tension, lower pain, and promote sleep.
Can you prevent muscle knots from forming?
Yes. Prevention really is the best medicine. These suggestions can help keep muscle knots from forming:
Exercise regularly. Keep your body moving to prevent muscle imbalances and knots. Your routine should include aerobic and strength training exercises.
Take stretching breaks. Take active stretching breaks throughout the day. Regular stretching keeps your muscles flexible and loose. You can even do some exercises right at your desk
Make sure your workstation is set up properly. An ergonomic workstation helps take the stress off your body. And it’s critical whether you have a desk job or one that requires prolonged standing
Practice stress-relieving techniques. Stress is an inevitable part of life. But there are several ways to help you manage it. Try spending time outside, meditating, and other methods for stress relief.
Eat a healthy diet and stay hydrated. Proper nutrition and adequate hydration help your muscles function. And it could help you avoid muscle knots or cramps.
Rest. Rest is critical for your health and wellness. If your muscle knots result from overtraining, adjust your fitness routine. Practice active recovery with lower-intensity workouts that give your muscles time to adapt.
The bottom line
Muscle knots are common and often form in the neck, shoulders, and back. Overuse or underuse may cause muscle imbalances that can lead to these hard, painful spots. Luckily, massage, stretching, and other treatments can offer relief.
References
Ahmed, S., et al. (2018). Effect of aerobic exercise in the treatment of myofascial pain: A systematic review. Journal of Exercise Rehabilitation.
Alvarez, D. J., e tal. (2002). Trigger points: Diagnosis and management. American Family Physician.
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