Muscle Knots: Symptoms, Causes, And Treatments

Home » What Muscle Knots Look Like » Muscle Knots: Symptoms, Causes, And Treatments

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SubscribeHow to treat muscle knotsMedically reviewed by Alana Biggers, M.D., MPH — Written by Rachel Nall, MSN, CRNA — Updated on January 29, 2024
  • What are they?
  • Symptoms
  • Causes
  • Risk factors
  • Home remedies
  • Treatments
  • Prevention
  • Outlook

Muscle knots, or myofascial trigger points, are small, bump-like areas of muscle that can be painful. Treatment often includes home remedies, like applying warm or cold pads. But, professional therapies are also available.

Myofascial trigger points can cause chronic pain and affect a person’s range of motion. This can have a large impact on quality of life, mood, physical ability, and health. For this reason, individuals should always aim to identify and treat them early.

Keep reading to learn more about treating and preventing muscle knots.

What are muscle knots?

Mam using a roller to help with treating muscle knotsShare on Pinterest
South_agency/Getty Images

Myofascial trigger points are defined as “hyperirritable” nodules of muscle that can cause chronic pain, a decreased range of motion, referred pain, and autonomic dysfunction.

Doctors classify trigger points as either active or latent. With active trigger points, a person does not have to touch the trigger point itself for it to be painful. Latent trigger points are usually asymptomatic but become painful when touched.

Muscle knots can develop almost anywhere on the body where muscle or fascia is present.

Places where muscle knots commonly occur include:

  • calf muscles
  • lower back
  • mid back
  • neck
  • shins
  • shoulders

Symptoms

Muscle knots feel like small, tender lumps or nodules. They are palpable and can be felt when touched. However, knots can be discreet and exist deep in the muscle, and a person may have to press hard into the connective tissue to feel the knots or trigger points.

Symptoms of myofascial trigger points include:

  • deep pain
  • general numbness or tingling
  • feelings of nerve pain
  • a decreased range of motion

Trigger points often cause what doctors call referred pain. When a person presses on the trigger point, the pain spreads from the trigger point to nearby muscles.

This symptom helps differentiate a trigger point from a tender point. A tender point is an area that hurts only when touched and only in the specific area pressed.

Unlike trigger points, the pain from tender points does not radiate to other muscles.

One of the most common sources of muscle knots is the trapezius muscle. This muscle makes a triangle-like shape from the neck to the middle of the back and the shoulder.

Tension and knots in the trapezius muscles often occur due to stress and poor posture.

Muscle knots can also cause additional symptoms, including:

  • jaw pain
  • lower back pain
  • ringing in the ears (tinnitus)
  • tension headaches

Causes

Common causes of muscle knots include:

  • stress and tension
  • physical trauma
  • muscle injury
  • emotional stress
  • poor posture
  • prolonged bed rest or sitting without stretching

A person who spends a significant amount of time sitting at work may develop muscle knots due to staying in the same position for prolonged periods.

Risk factors

Doctors have identified several risk factors for people more likely to experience trigger points. These include:

  • history of joint problems and injuries
  • biomechanical imbalance
  • being overweight or having obesity
  • difficulty sleeping or insomnia
  • poor posture
  • abnormal breathing mechanics
  • sedentary lifestyle

Additionally, poor postural alignment due to cell phone use and improper sleeping and sitting positions may contribute to the development of muscle knots.

Home remedies

Treating myofascial trigger points often requires a multimodal approach.

Evaluating why muscle knots might have occurred can help determine the best course of treatment.

For example, if muscle knots are due to prolonged sitting or a prior muscle injury, engaging in regular stretching breaks may help reduce muscle tension.

If muscle knots are due to poor posture, partaking in posture-correction exercises may improve symptoms.

People can also try:

  • applying a cloth-covered heat pad or ice pack to the affected area
  • gentle exercise therapy, such as swimming, walking, and cycling to loosen tight muscles
  • taking anti-inflammatory medications, such as ibuprofen or NSAIDs to reduce muscle pain
  • muscle stretching and deep breathing (yoga)
  • getting more sleep at night
  • dietary changes to reduce inflammation
  • behavior modifications, like spending at least 15 to 30 minutes a day on relaxation techniques, such as meditation or gentle yoga

Self-massage

Applying sustained pressure to muscle knots leads to an increase in blood flow, which in turn causes the release of muscle fiber tension. This is called myofascial release.

For this reason, self-massage techniques that apply pressure to myofascial trigger points may help increase a person’s range of motion and reduce pain.

A 2018 study found that using a foam roller and applying static compression to myofascial trigger points might help resolve impairments in muscle function and optimize performance.

To perform a self-massage, a person can place a tennis ball or foam roller between their back and the wall or floor, using the pressure from the ball to massage the trigger point.

Treatments

If home remedies do not reduce the symptoms of muscle knots, professional treatments are available. The goal of these treatments is to release the tight nodules of muscle to relax the muscle and restore proper function.

Typically, a variety of treatments are used together in order to restore functionality and provide lasting relief.

Examples include:

  • cold laser: also called low level light therapy, in which the trigger point is exposed to near-infrared light
  • dry needling: in which a doctor inserts a thin needle into and around the trigger point to release the muscle knot
  • electrical stimulation: in which an electrode is placed across the affected muscle to cause rapid contractions and release the knot
  • manual therapy: in which a therapist assesses an individual’s posture and provides exercises and manipulations to realign and correct it
  • therapeutic massage: including trigger point pressure release, passive rhythmic, and active rhythmic massage
  • transcutaneous electrical nerve stimulation (TENS): in which low voltage electrical signals from a small device are applied to the skin
  • pulsed ultrasound: in which sound waves are used to penetrate muscles
  • therapeutic massage
  • trigger point injections: in which a numbing agent or steroid is injected into the muscle knot

Prevention

Muscle knots are often caused by poor posture and inactivity. Practicing good posture and engaging in regular physical activity may help prevent muscle knots.

Many knots develop from repeated muscle trauma, so a person may wish to engage in different activity types to prevent overuse of the same muscles. Activities might include swimming one day and walking the next, based on ability.

Additionally, myofascial trigger points are more common under conditions of psychological stress.

For this reason, taking steps to reduce stress — like practicing meditation, mindfulness, deep breathing techniques, yoga, and regular exercise — may help prevent their development.

A doctor or physical therapist can help ensure a person is practicing the right postures when exercising or working. Evaluating ways to practice better posture and form can help a person prevent muscle injuries and muscle knots.

Outlook

Muscle knots or myofascial trigger points can often be treated with simple home remedies, self-massage, and stretching. However, some knots can cause chronic pain and disability, and interfere with a person’s everyday life and activities.

When this is the case, a person should see a doctor or physical therapist for treatment. Often, a multimodal approach using various techniques is most effective.

 

  • Body Aches
  • Rehabilitation / Physical Therapy
  • Sports Medicine / Fitness

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
  • Bron, C., et al. (2012). Etiology of myofascial trigger points.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440564/
  • Coleman, C. (2017). Triggers points and physical therapy: Striking a nerve in a polarized profession.https://newgradphysicaltherapy.com/trigger-points-physical-therapy-striking/
  • Coping with stress. (2022).https://www.cdc.gov/mentalhealth/stress-coping/cope-with-stress/index.html
  • Gerber, L. H., et al. (2015). Dry needling alters trigger points in the upper trapezius muscle and reduces pain in subjects with chronic myofascial pain.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508220/
  • Hall, B. H. (2020). Chronic myofascial pain, fibromyalgia, and myofascial trigger points.https://link.springer.com/chapter/10.1007/978-3-030-47117-0_18
  • Jafri, M. S. (2014). Mechanisms of myofascial pain.https://pubmed.ncbi.nlm.nih.gov/25574501/
  • Martín-Sacristán, L., et al. (2022). Dry needling in active or latent trigger point in patients with neck pain: A randomized clinical trial.https://www.nature.com/articles/s41598-022-07063-0
  • Motaqi, M., et al. (2020). Trigger and tender points (definitions, similarities, differences, treatments).https://ijmpp.modares.ac.ir/article-32-48195-en.pdf
  • Myofascial pain syndrome. (n.d.)https://www.asahq.org/madeforthismoment/pain-management/types-of-pain/myofascial-pain-syndrome/
  • Myofascial trigger point therapy — what is it? (n.d.).https://namtpt.wildapricot.org/MTPT_What_is_it
  • Parthasarathy, S., et al. (2019). Assessment of predisposing factors in myofascial pain syndrome and the analgesic effect of trigger point injections: A primary therapeutic interventional clinical trial.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460974/
  • Shah, J. P., et al. (2016). Myofascial trigger points then and now: A historical and scientific perspective.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508225/
  • Wilke, J., et al. (2018). Immediate effects of self-myofascial release on latent trigger point sensitivity: A randomized, placebo-controlled trial.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358529/

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Medically reviewed by Alana Biggers, M.D., MPH — Written by Rachel Nall, MSN, CRNA — Updated on January 29, 2024

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