For what feels like an eternity, a pesky muscle knot has plagued my upper back, residing just above my shoulder blade and to the left of my neck. The discomfort it causes is both dull and irritating, making me feel tense and restless. I usually try to relieve it by massaging or pulling on the tender spot until I feel some semblance of relief or forget about it altogether.


Recently, while dealing with the persistent pain of a muscle knot, I realized that I didn't really understand what they were or how they develop. So, I turned to Curtis Wu PT, DPT, OCS, SCS, CSCS, clinical specialist in rehab at HSS Paramus, for some insight.


According to Wu, muscle knots, trigger points, and myofascial pain syndrome are terms used to describe the sensitive spots in soft tissue that are often associated with injury or persistent neck/back pain. The Mayo Clinic also notes that repetitive motions, poor posture, and overuse can increase the risk of developing these trigger points.


While muscle knots can appear anywhere in the body, they are most commonly found in the upper back/neck, shoulder, low back, and hip areas. Although they are associated with genuine symptoms, Wu explains that there is no consistent explanation for how they form. In fact, there are numerous theories surrounding these tender spots that can cause significant discomfort.


Some theories suggest that micro-spasms or cramps within the muscle can cause muscle knots due to direct injury or overworking/underworking the muscle. Wu explains that these micro-cramps may lead to the accumulation of "waste" products, which may cause pain. However, he also notes that the challenge in identifying the underlying cause of muscle knots lies in the fact that pain is multifactorial in nature.


"Pain can be influenced by any combination of physical, health, lifestyle, affective, cognitive, and environmental factors. As a result, it may be more important to understand trigger points as a symptom and not the cause of a person's pain experience. The need to identify some of the contributing factors to a person's pain and to address those factors is the most important for long-term benefit," Wu explains.


Although the effectiveness of muscle knot relief can vary from person to person, Wu says there are many ways to reduce the pain of a trigger point. These include massage, acupuncture, ice or heat therapy, and physical activity or exercise. The Mayo Clinic also suggests physical therapy, stretching, and posture training as other common treatments. Personally, I find that using a heating pad and receiving a gentle massage can bring some relief when my muscle knots flare up.


However, Wu cautions that most treatments may only provide short-term benefits. "This further highlights the importance of identifying and addressing the factors that may be relevant to that individual's pain experience, rather than just their symptoms," he emphasizes.


If you are dealing with persistent trigger points, it's important to consult with your doctor to find the best solution for your pain.