How to fix knot in neck

Reviewed by Poonam Sachdev on June 22, 2021

A muscle knot is a painful or tender spot in a muscle. It feels tight and sore, and it often happens in the upper back or legs. They're not usually harmful, but they can certainly be uncomfortable. In rare cases, muscle knots are a sign of a long-term (or chronic) pain condition. 

If you've ever had pain in your back, in your neck, or under your shoulder blade, you've probably had a muscle knot. The name makes it sound like the muscle is twisted or kinked, but that's not the case. Knots are usually a type of spasm that causes a small portion of a muscle to tense up. This tension can often be painful.  

‌Muscle knots usually happen because a muscle has been irritated by a repetitive motion. Athletes will notice muscle knots after training one group of muscles for a long period of time. A muscle might also knot up when it’s in an awkward position for too long. Sitting at a desk or driving a car for a long time, especially without breaks, can irritate a muscle to the point of it "knotting up".

‌Researchers have found that muscle knots don't show up on scans, so they aren't entirely sure what the muscle is doing to cause pain. Some doctors think the muscle spasms may affect blood flow, and that's what makes the knotted area hurt. Other doctors say the pain could be caused by nerves that are triggered by the spasms. 

No matter what causes it, a muscle knot is painful, and this pain can linger for days or weeks. The discomfort might affect your work or make it hard to do things you enjoy. 

With some time and patience, you can often manage a muscle knot at home. Here are some simple tricks for getting your muscle to relax and stop hurting:

Stretch. Sometimes, getting up and moving or doing gentle stretching exercises can relieve a muscle that's knotted from being in an uncomfortable position for too long. Stretching can also prevent knots. If you notice certain areas knotting up often, ask your doctor about stretches to loosen those muscles and lower the chances of more knots.

Ice and heat. Most muscle pain responds well to alternating ice and heat. Use an ice pack on the spot for a short while, and then switch to a warm compress or heating pad. If you notice that one seems to help more than the other, stick with what one feels best.  

Trigger point massage. Sometimes, firm pressure encourages your muscle to release. You can use your hands or a foam roller to apply pressure. Simply find the knot and press on it as hard as you can tolerate. Do this several times a day until the muscle feels better.  

Professional massage. A massage with a professional massage therapist might be helpful. Tell them where the knot is and what may have caused it. Your therapist can work on that muscle and identify any areas around it that might be adding to the pain.‌‌

It can take some time to ease pain from a knotted muscle. You may need to repeat treatments, such as massage, to resolve the problem fully. In the meantime, try to avoid the thing that irritated your muscle in the first place.

‌Time and home care will usually loosen up a knotted muscle. Some people have a tendency for muscle knots, known as myofascial pain syndrome. Signs that you may have myofascial pain syndrome include: 

  • Pain that lingers or worsens
  • Pain that keeps you awake
  • A persistent sore spot in a muscle
  • Deep muscle pain

If you notice any of these symptoms or have constant issues with muscle knots, talk to your doctor about treatment. They may suggest: 

  • Physical therapy to build muscle strength and endurance
  • Myofascial release therapy to apply gentle sustained pressure into the myofascial connective tissue restrictions to ease pain and restore motion.
  • Injecting a numbing medicine into the spot where the pain is
  • Dry needling, in which the doctor inserts thin needles into the trigger point to reduce pain
  • Acupuncture, a traditional practice that uses needles for pain relief
  • Ultrasound waves to penetrate muscles
  • Transcutaneous electrical nerve stimulation, or TENS therapy, which uses low levels of electricity to relax the muscle.

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We tend to use the expression “a pain in the neck” to refer to difficult and unpleasant situations; in some cases, we may even use this expression to describe a person who is rather difficult to deal with. This allusion to an anatomical condition makes sense insofar as the deeply uncomfortable sensation of overly tense muscles in our necks, also known as knots or trigger points. Muscle knots can occur in various parts of our bodies, but they can be particularly uncomfortable when they emerge in areas of the back, shoulder, or necks.

What Exactly is a Muscle Knot?

Trigger points feel like a bundle of nerves have become tangled up into knots; they can often develop in the back of your neck below the skull, behind the clavicle, or somewhere between the shoulder blades. This is a musculoskeletal condition affecting the upper trapezius, a rather large muscle that becomes active during the extension of the head and neck. When we tilt our heads back, the upper trapezius springs into action. In reality, there is no tangling or knotting happening when a trigger point develops; what actually occurs is a painful tightening and swelling of muscle fibers.

Understanding Muscle Knots

As previously mentioned, muscle knots are overly taut fibers that result in spasms and tender spots. The pain that emanates from these trigger points can follow the network of muscle fibers and nerves until they are felt elsewhere, which means that a muscle knot could create a ripple effect that may include headaches. These trigger points are quite common; according to longitudinal research conducted in 2013, muscle knots are bound to be felt by all people at least once in their lives.

Knotted muscles will feel hard to the touch; they can be as small as a grain of rice or as large as a pebble, but they are invariably uncomfortable and tender to the touch. When you press on muscle knots, you may feel pain radiating up towards your head and down towards your scapular region and shoulders. These rigid spots may develop on just one side of the neck, but they can also be bilateral. They may come and go, and in some cases they may limit range of motion, thus making your neck feel stiff.

What Causes Muscle Fibers to Feel Like Knots

With muscle knots, it all comes down to tension, and it can be related to physical or emotional stress. The worst kind of muscle knots are the kind that feels as if they are actively pulsating; this is because of the continuous contraction caused by spasms; when these happen, the tenderness to the touch will not be felt until the contractions stop. Following are the most common causes of tensions resulting in muscle knots:

  • Repetitive motion such as turning your neck in the same direction
  • Stress
  • Dehydration
  • Very long periods of inactivity
  • Prolonged inadequate posture

In essence, a reduction in the blood flow to muscle fibers causes muscle fibers to become deprived of oxygen, which in turn results in a loss of nutrients; what is left behind is a mess of toxins while the muscle fibers are still fulfilling their functionality. Depending on how quickly this process can be reversed, and also depending on the fitness of the muscle fibers themselves, this painful condition may last for a while.

How Stress Factors Exacerbate Muscle Knots

A few decades ago, trigger points in the neck were described as being a 20th-century malady, and this assertion was based on the rise of desk jobs and cubicle farms. Let’s think about a call center where agents take calls from irate callers; we are talking about employees who slouch over a keyboard and deal with the stress of handling difficult customers, thus creating both physical and emotional tension during shifts that may extend beyond eight hours when agents are working overtime.

Let’s say a customer service agent working for the local cable company has had a long and stressful day dealing with subscribers who have been cut off from internet access for hours; if her workstation lacks ergonomics, she will very likely develop muscle knots not just because of inadequate posture but also because her job is literally a pain in the neck. If this agent decides to unwind by heading over to the golf driving range and hitting a couple of buckets of balls, she may end up making matters worse because of the repetitive neck movements involved in this activity.

Preventing Muscle Knots

Before we get into how to fix a knot in your neck, let’s go over what you can do to prevent this from happening:

* Stay hydrated, which not only means drinking plenty of water but also keeping your caffeine, liquor, and tobacco intake as low as possible.

* Avoid situations in which you will be exposed to poor posture. If you work a desk job, insist on ergonomics for your workstation, and try to stretch your shoulders and neck muscles whenever possible. Slouching may feel more comfortable than sitting straight, but you could end up paying the price with muscle knots.

* Take up yoga or physical exercise. Any activity that involves stretching and a gentle transition from one movement to the next will greatly reduce neck pain. With yoga asanas such as Surya Namaskar, also known as sun salutations, you will not only improve flexibility but also posture.

Self-Treatment for Muscle Knots

You will want to start with massage therapy. If you are not able to schedule a therapeutic session, look into getting a foam roller that you can use right over the trigger point; as long as you start with gentle pressure, you will not radiate pain. As for cold therapy, you can apply ice packs as soon as the muscle knots are felt, but you will want to apply warm compresses to relax the fibers and improve circulation if the trigger point has been bothering you for more than a few days.

In the aforementioned sun salutation yoga asana, the cobra pose requires a neck rotation stretch, which happens to be excellent for alleviating muscular pain in the neck. You don’t have to go through this entire pose; instead, sit up with your shoulders straight and practice shrugging and rolling them around before transitioning to cervical rotations. Slowly turn your head to the left as far as it will go, hold it for a couple of seconds and then push your chin with your right hand for a full stretch. Switch to the other side and repeat until your neck no longer feels stiff.

Should you fail to get relief with hot and cold therapy, massage, or neck stretching, you may want to schedule a chiropractic consultation. In some cases, what feels like muscle knots may actually be a different issue related to your spine. You can also try taking anti-inflammatory medication sold over the counter, but this will only bring temporary relief; it is always better to treat yourself with stretching, massage, ice packs, and warm compresses.