Knots and Knots of Pain

Pain has many causes.  One common cause that I would venture to say afflicts every single one of us is muscle pain in the form of “knots.”  What are these knots exactly and why do they commonly end up in our necks, backs and legs?  Most people are unaware that these pesky knots are looming under the surface and causing those common aching pains.  It takes a little bit of knowledge of anatomy—knowing where the muscles are—to find these knots and to begin the process toward getting rid of them.

Knots are also referred to as “trigger points” or “tender points”.    They really are knots, actually.  Our muscles and nerves are entangled in a connective tissue called “fascia.”  You have seen fascia before---it is the white stringy substance you see when you cut up raw chicken.  This connective tissue normally runs smoothly, but after trauma it bunches up in specific areas.  Trauma can take many forms.  It can be from something as serious as a car accident or direct blow to the body, or it can be accumulated trauma from years of less than perfect posture or habitual positions that strain certain muscles more than others.

As the fascia bunches abnormally, the surrounding muscles, nerves and soft tissues react.  The area becomes hardened and we can feel the telltale knot below the surface.  You know you are feeling a true trigger point when pressing on it causes intense shooting pain (professionals know the specific pattern of where the pain may shoot to).  This condition, myofascial pain syndrome, just may be the root cause of your aches and pains.  It can cause varying degrees of pain, tingling, numbness and dysfunction that starts either suddenly or gradually.  It is not up to you to make the diagnosis because it may be something more serious that only a professional can differentiate between.  And, overlooking myofascial pain can lead to mistreatment and misdiagnoses, making the condition worsen with wasted time. 

Oftentimes you may be unaware that latent trigger points are hiding below the surface because you do not feel pain.  However, there are related muscle restrictions and weaknesses that accompany the trigger points and when your body is stressed in one way or another, it will become an active pain syndrome.  I commonly see people in this “pre active” trigger point state.  Identifying and treating the underlying myofascial problems helps them to correct it before it erupts.  When ignored, the muscles associated with the trigger points become tense and fatigued and they lack good blood circulation and oxygen.  This ends up as the aching pain you may be feeling in one or more areas of the body.  When left untreated, these trigger points can multiply and cause a myofascial pain syndrome from head to toe-literally!

Treatments for active trigger points include a variety of manual release techniques (you may have heard of myofascial release or acupressure), postural re-training, muscle stretching and strengthening, trigger point injections, and other symptom-relieving medications and modalities.  Depending on the “age” of the trigger point, relief may be immediate or take several treatments.  The good news is that these knots can be eliminated forever if the initiating factors are corrected and maintained.