Muscle Knots in Back

Muscle knots (also known as Myofascial Trigger Points) are tense, tender knots that are formed in muscles after strenuous workout due to an inability of fibers to completely relax after sustained contraction. Muscle knots present as stiffening of shoulder or upper back muscles that makes any activity difficult across the inflamed muscles due to intense pain (and sometimes swelling). The size of muscle knots may vary from the size of a resin to about the size of thumb depending upon the number of muscle fibers involved. Poorly managed muscle knots interfere with regular physical activity due to constant nagging pain and discomfort.

The sign and symptoms of muscle knots are also dependent upon the type of muscle knots:

  • Latent muscle knots are generally less painful at rest; however, may be tender to touch or pressure (or activity).
  • Active trigger knots are formed by tense tissues that are painful at rest and may lead to diffuse pain involving larger areas of skin and tissues.

Causes of Muscle Knots in Back

A lot of research has been done to identify what causes muscle knots in the back region. Although, lactic acid build up due to sustained muscle contraction is one of the established reasons, researchers believe that sedentary lifestyle is one of the contributing factors. For example, if your shoulders at rest project forward instead of straight alignment, you may be more likely to develop muscle knots with prolonged contraction of muscle fibers.

Healthcare providers suggest that the risk of developing muscle knots is higher in certain predisposing conditions like:


History of acute muscular injury as a result of trauma, fall or accident may lead to spraining of soft tissues and joints leading to higher risk of developing muscle knots due to inactivity or muscle fiber damage.

Postural Stress

Improper posture or sitting, standing or exercising without support can pose excessive stress on your muscles leading to fiber damage or over-stretching.


Overstimulation refers to prolonged and sustained state of muscular contractility in certain exercises like weight lifting and other forms of isometric activity in which muscle fibers remain contracted for prolonged periods of time.

Remedies for Muscle Knots in Back

Pain Killers

In vast majority of cases, muscle knots are produced as a result of acute inflammation that leads to swelling of muscle fibers. When you try to move your muscle fibers, the activity is limited by pain and stiffness. Over- the-counter, non- steroidal anti- inflammatory drugs are an ideal remedy in all such cases for acute relief of pain and discomfort.

Tennis Ball

Tennis ball technique involves using a tennis ball to perform deep tissue massage without requiring the help and assistance from a professional. Take a tennis ball and support your back with a wall. Now using the wall support, roll your back on the tennis ball across the wall.

Foam Roller

When muscle knots are multiple or are discomforting, you can use foam rollers. The benefit of using foam rollers is stimulation of large muscle groups without any second-hand assistance or help. Moreover you can roll while sitting on a sofa set or while lying flat on the floor.


Massage is helpful in many ways. Superficial massage at and across the inflamed muscle fibers relieves pain by improving blood circulation to the damaged tissue (enhanced blood flow also promotes healing). In addition, massage also helps in releasing endorphins and other soothing chemical mediators that release anxiety, stress and pressure in the region. Deep muscle massage helps in relaxing fibers and releasing muscle knots. Moreover, deep massage also alleviates the release of toxins and chemicals from the system.

Heat Compression

Sometimes heat compresses also plays a very important role in the management of muscle knots. When you apply warmth to your tissues, the muscle fibers may get lose and less tangled. In addition, warmth also relaxes and soothes the aching tissues that make future exercises or activity across tangled muscle fibers much easier due to less pain and swelling.

Stretching Exercises

You can increase the intensity and efficacy of various stretching exercises many folds by applying heat compresses at the site of maximum swelling or tenderness. Although warm compresses are helpful but you can also take warm showers or use warm water bottles to relieve swelling and relieve pain. Once the swelling has reduced to almost 50% of the original, you can perform horizontal and vertical stretches by flexing your limbs in a sitting position and stretching your back muscles against a flat space.

Helpful Tips

You can relieve the symptoms of pain and discomfort by using simple tips as listed below:

  • Instead of using your hands or relying on professional help, you can get benefitted from a number of props or tools.
  • Instead of using static forces or pressure across your muscle knots, make sure to use stroking action to stimulate the muscle fibers (for an easy and quick release).
  • Be slow, gentle and consistent. Make sure to avoid extra pressure or push that may further aggravate pain and also result in tissue injury.

Preventions of Muscle Knots in Back

Muscle knots may occur infrequently in individuals (especially those who perform strenuous physical activity); however, if you are developing very frequent and disabling episodes of muscle knots, you may seek the help of a healthcare provider.

  • Maintain your hydration status by increasing your water intake to up to 2 liters/ day.
  • Get your serum calcium and potassium levels assessed with the help of blood investigations.
  • Take small and frequent breaks from prolonged periods of inactivity to stretch your body.
  • Maintain normal body posture and avoid twisting and hunching your tissues or muscles too much.
  • Do not perform physical activities that are too painful or difficult for your body. Healthcare providers suggest working with your body and not against your body and muscles.