Pain in the muscles can be caused by muscle knots, also known as trigger points. When the muscles reach a stage of dysfunction where they risk permanent damage, the body sends out signals that reach the brain - these are interpreted as pain. The pain is thus a sign that something is wrong, and that changes must be made to avoid further damage or degradation. Maybe you yourself have noticed that the neck muscles are getting tighter and tighter? And that the back muscles are just waiting for the next chance to give you a proper cut in the lower back when you least expect it?
In this article we are going to talk about muscle pain, why you get them and what happens physically in the muscles when you do not take good care of them.
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Scroll below to see two good exercise videos that will help you keep your muscles in check.
VIDEO: 5 Tensile Exercises for Muscle Pain in the Neck
The neck is a place on the body that is often affected by muscle pain. These five stretching exercises can help you relieve tense muscles and normalize normal neck movement on a regular basis. Click below to see the training program.
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VIDEO: 5 Movement Exercises for Those with Fibromyalgia
Fibromyalgia is a chronic pain diagnosis characterized by widespread muscle pain and fatigue. This exercise program is particularly suitable for contributing to more back and hip mobility in this patient group - but is otherwise also very suitable for anyone who struggles with stiffness and pain in the body.
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- What is a trigger point?
In short, trigger point is just another concise word for dysfunctional and painful muscle fibers - but a trigger point, or muscle knot, occurs when muscle fibers have moved away from their normal structure / orientation and literally contract into a more knot-like formation. You may think of it as if you have several strands lying in a row next to each other, nicely assorted, but when placed crosswise you are closer to a visual image of a muscle knot. We will illustrate this via a picture later in the article. Such muscle dysfunction may be due to a sudden overload, but most normally it is due to a gradual overload over a long period of time - for example, a too static everyday life with a lot of one-sided, repetitive load. A muscle becomes sore, or symptomatic, when the dysfunction becomes so severe that it turns into pain. In other words, time to do something about it.
Trigger points and muscle knots can refer pain to other relevant places in the body. Among other things, tight muscles in the upper back, neck and shoulder areas can cause headaches, dizziness and other symptoms. Jantos et al (2007) found via biopsy tests that these trigger points were hyperirritable and electrically active.
Biopsy tests found that trigger points were hyperirritable and electrically active muscle spindles in general muscle tissue. (Jantos et al, 2007)
Muscle node = Malfunction and increased pain sensitivity in muscle fibers
Muscles consist of muscle fibers - these can be in good condition (resilient, mobile and without damage tissue) or in poor condition (less moving, with reduced healing ability and accumulation of damage tissue). When we have muscles that become defective over time, this can gradually lead to the build up of dysfunctional damage tissue in the muscular structures. By this we mean that they physically change the structure as shown in the picture below:
- Normal tissue: Normal blood circulation. Normal sensitivity in the pain fibers.
- Damage tissue: which involves reduced function, altered structure and increased pain sensitivity.
- Scar tissue: Unhealed soft tissue has a significantly reduced function, severely altered tissue structure and an increased risk of recurring problems. In phase 3, the structures and structure can be so weak that there is a higher chance of recurring problems.
Image and description - source: Råholt Chiropractor Center
Using illustrations as shown above, it will often be easier to understand why muscles and tendons are aching. The picture shows how not taking care of one's own muscles and functionality causes physical changes in the muscle structure and pain as a direct consequence of this.
Conservative treatment at a publicly authorized clinician therefore aims to remodel the soft tissue structure and improve the function of given muscle fibers. The examination and the clinical examination can reveal everything from reduced joint mobility in the neck and back (which thus leads to less blood circulation, reduced range of motion and incorrect use of the muscles) to insufficient stability muscles. We can hint that often (read: almost always) there is a mixture of several factors that cause you to have muscle pain and that you experience that it comes back again and again.
What can I do even with muscle pain?
More mobility in everyday life is always a good start. Movement leads to increased circulation to pain-sensitive and dysfunctional muscle fibers - which in turn leads to enhanced repair processes in the damaged muscle fibers and hence less pain. Other good measures may include active treatment by a publicly authorized clinician (physiotherapist, chiropractor or manual therapist) or passive measures such as regular use of trigger point ball / massage ball on their own.
1. General movement and activity is recommended, but stay within the pain limit. Two walks a day of 20-40 minutes make good for the body and aching muscles.
2. Trigger point / massage balls we strongly recommend - they come in different sizes so you can hit well even on all parts of the body. There is no better self help than this! We recommend the following (click the image below) - which is a complete set of 5 trigger point / massage balls in different sizes:
3. Training: Specific training with training tricks of various opponents (such as this complete set of 6 knits of different resistance) can help you train strength and function. Knit training often involves more specific training, which in turn can lead to more effective injury prevention and pain reduction.
4. Pain Relief - Cooling: Biofreeze is a natural product that can relieve pain by cooling the area gently. Cooling is especially recommended when the pain is very severe. When they have calmed down then heat treatment is recommended - it is therefore advisable to have both cooling and heating available.
5. Pain Relief - Heating: Warming up tight muscles can increase blood circulation and reduce pain. We recommend the following reusable hot / cold gasket (click here to read more about it) - which can be used both for cooling (can be frozen) and for heating (can be heated in the microwave).
Recommended products for pain relief in muscle pain
Biofreeze (Cold / cryotherapy)
Treatment of Sore Muscles and Muscle Nodes
Effective treatment of muscle pain and muscle knots includes a thorough examination in which the clinician examines your overall biomechanical functionality. For example, it is often the case that the problem is more complex than "there is a tight muscle here", and that the treatment should therefore often include both muscle and joint treatment in combination.
Treatment modalities that are often used against tight muscles and muscle pain are muscular techniques (stretching, massage and trigger point treatment), intramuscular needle treatment - and then often in combination with joint mobilization. In long-term, more severe cases of long-term muscle pain, it may also be relevant to use a pressure wave machine on the chronic muscle knots to overcome the problem.
What can I expect from a clinician when I visit them with muscle pain?
We recommend that you seek out publicly licensed professions when seeking treatment and treatment for muscle, tendon, joint and nerve pain. These occupational groups (doctor, chiropractor, physiotherapist and manual therapist) are protected titles and approved by Norwegian health authorities. This gives you as a patient a security and safety that you will only have if you go to these professions. As mentioned, these titles are protected and this means that it is illegal to call a doctor or chiropractor without you being authorized with the long education these professions hold. In contrast, titles such as acupuncturist and naprapat are not protected titles - and this means that you as a patient do not know what you are going for.
A publicly licensed clinician has a long and thorough education that is rewarded through public health authorities with public title protection. This education is comprehensive and means that the aforementioned professions have very good expertise in investigation and diagnosis, as well as treatment and eventual training. Thus, a clinician will first diagnose your problem and then set up a treatment scheme depending on the given diagnosis. The chiropractor, physician and manual therapist have the right of referral for imaging diagnostic examination if clinically indicated.
Exercises, training and ergonomic considerations
An expert in muscle and skeletal disorders can, based on your diagnosis, inform you of the ergonomic considerations you need to take to prevent further damage, thus ensuring the fastest possible healing time. After the acute part of the pain is over, in most cases you will also be assigned home exercises that also help to reduce the chance of relapse. In the case of chronic ailments, it is necessary to go through the motor movements you do in everyday life, so as to be able to weed out the cause of your pain occurring time and again. It is important that the individual exercises are adapted to you and your ailments.
Here you will find an overview and list of exercises we have published in connection with the prevention, prevention and relief of pain in the muscles, muscle pain, tight muscles and other relevant diagnoses.
Overview - Exercises and Exercises for Muscle Pain and Muscle Pain:
Are you plagued with long-term and chronic pain?
We recommend to anyone who is suffering from chronic pain in everyday life to join the Facebook group “Rheumatism and Chronic Pain - Norway: Research and News". Here you can get good advice and ask questions to like-minded and those with expertise in the area. You can also follow and like our Facebook page (Vondt.net) for daily updates, exercises and new knowledge in muscle and skeletal disorders.
NEXT PAGE: - What is Pressure Wave Treatment?
Click on the image above to move on to the next article.
Jantos M (June 2007). «Understanding chronic pelvic pain». Pelviperineology 26 (2). ISSN 1973-4913.OCLC 263367710
Frequently Asked Questions:
I am on sick leave with muscle knot pain. What should I do to be good?
Answer: The public health-authorized clinician who reported you sick should also be able to give you a prognosis and various measures, in the form of active and passive forms of treatment. You should use the time as a sick person to get away from the bad habits you have - maybe you sit too much in everyday life? Are you moving enough? Is your training varied enough? Maybe you should work on posture muscles (also read: 'How to get a better posture')?
Can you get muscle knots in the leg? And how should they be treated?
Answer: The calf, like other areas, can get muscle knots - it often occurs in the back of the calf against the gastrocnemius and soleus muscles. Muscle knots occur, theoretically, due to muscular imbalance and dysfunctions. Manual treatment is beneficial to get help to loosen the worst muscle knots, and then you should address the reason why you get muscle knots (overload, misload or the like).
Some of the most common muscles in the leg involve the tibialis anterior, extensor digitorum longus, extensor hallucis longus, peroneus longus, peroneus brevis, peroneus tertius, gastrocnemius, soleus, flexor hallucis longus, flexor digitorum longus and tibialis posterior.
The chiropractor says I have gluteal allergy, what does that really mean?
Answer: Myalgia simply means muscle pain, or muscle symptoms / muscle tension. Gluteal is simply the seat region (buttocks). So that simply means tension in the muscles of the seat muscles. Myalgia is often seen in gluteus medius, gluteus maximus and gluteus minimus.
Treatment for back muscles?
Answer: Treatment for back muscles may involve chiropractic treatment, which will focus on improving both muscle function and joint movement. Often, the muscles will calm down a bit as the joints move in a more functional way.
- Related questions with the same answer: "Can you get a muscle knot in the lower back?"
Pain in the muscles. How does it feel?
Answer: The pain presentation for muscle knots varies, but terms such as tightness, numbness, immobility and a feeling of being constantly tired in the muscles, are often used by people who have muscle knots. Trigger points and muscle knots are also referred to in certain cases as active or passive - when a muscle knot is active, it will refer to pain in a known reference pattern belonging to the specific muscle. It was the doctors Travell and Simons who mapped this (read: complete overview of muscle knots). Among other things, muscle knots in the neck can cause cervicogenic headaches, which can be felt in the back of the head, against the temple and sometimes in the forehead and behind the eyes.
- Related questions with the same answer: "Can you get knots in the muscles after training?"
Muscle knot in the neck. What should I do?
Answer: Muscles can tighten due to prolonged failure overload or sudden overload. The muscles will feel tight and sore when touched. Tight muscles in the neck can also lead to cervicogenic headaches and cervicogenic dizziness. It can be helpful to identify any muscular dysfunctions you have, with a musculoskeletal expert, who can then tell you exactly what exercises you should do. They can naturally help you with those tight muscles as well. But general movement is advised for almost everyone, often walking on rough terrain (for example in the forest). Other general, good movements can be achieved on the rowing machine and ellipse machine. The latter two may be worth buying online if you want to save a good deal of money (Read: Buying a Roman Machine Online?)
Common neck muscles involve upper trapezius, sternocleidomastoid (both sternal and clavicular part), splenius capitis, splenius cervicis, semispinalis capitis, semispinalis cervicis and suboccipital muscles.
- Related questions with the same answer: 'What are the symptoms of muscle knots in the neck?'
What could be the cause of acute pain in the triceps?
Answer: The most likely cause is overload or trauma. Try to slow down your workload / workload and use icing on the triceps to calm down the overactivity in that area.
Got a muscle knot in the thigh after running… which muscle is it?
Answer: It depends on whether you are familiar with it on the front or back of the thigh. On the front we find the quadriceps muscle which consists of 4 muscles (hence quad-); vastus medialis, vastus lateralis, vastus intermedius and rectus femoris. All four of these can have muscular dysfunctions in the form of muscle nodules or trigger points. These are known, among other things, for referring pain to the knee when they are at their worst. (Read also: Complete overview of muscle knots) On the back we find hamstrings (squats), there are 3 muscles and these are biceps femoris, semitendinosus and semimembranosus.
Could there be a link between muscle knots and dizziness?
Answer: Yes, muscle dysfunction or facet joint locks in the neck and cervicothoracic junction (where the thoracic spine meets the neck) can cause cervicogenic dizziness. The word 'cervicogen' indicates that the dizziness comes from structures related to the neck. It is especially the upper neck and the base of the neck that most often contribute to such dizziness. Remember otherwise that dizziness is often multifactorial, ie that it can have several causes at the same time (muscle knots, dehydration, blood sugar imbalance and the like).
Where can muscle knots in the chest / trigger points in the chest be located?
Answer: All muscles can become overactive and constitute what we call trigger points or muscle knots. Some of those who may become overactive in the chest are pectoralis major, pectoralis minor, sternalis, subclavius and, to some extent, serratus anterior. Other muscles that can refer trigger point pain to the chest region are serratus posterior superior which may have a mild reference to the chest on the involved side.
Where can neck muscles / trigger points in the neck sit?
Answer: All muscles can become overactive and form what we call trigger points. Some of the most common that become overactive in the neck are the suboccipital (those that attach to the back of the head), the longus colli and the paraspinal muscles - as well as the attachments from the levator scapulae, upper trapezius and sternocleidomastoid. Other neck muscles that can cause trigger point pain in the neck include semispinalis capitis, semispinalis cervicis, splenius capitis and splenius cervicis.
Where can muscle knots in the foot / trigger points in the foot sit?
Answer: All muscles can become overactive and constitute what we call trigger points. Some of the most common ones that become overactive in the foot are flexor digitorum brevis, adductor hallucis, flexor hallucis brevis, 1st dorsal interossi, extensor hallucis brevis, extensor digitorum brevis, abductor hallucis, abductor digiti minimi and quadratus plantae.
Where can the jaw muscles / trigger points in the jaw be located?
Answer: All muscles can become overactive and constitute what we call trigger points or muscle knots. Some of the most common ones that become overactive in the jaw are masseter, digastric, medial pterygoid and lateral pterygoid. Temporalis can also refer trigger point pain to the jaw area.
Where can the muscle knots in the groin / trigger points in the groin sit?
Answer: All muscles can become overactive and constitute what we call trigger points or muscle knots. Some of the most common ones that become overactive in the groin are iliopsoas, gracilis, adductor brevis, adductor longus, adductor magnus and pectineus. Other muscles that can refer trigger point pain to the groin region are the quadratus lumborum and the external abdominal oblique.
Where can the muscle knots in the thigh / trigger points in the thigh be located?
Answer: All muscles can become overactive and constitute what we call trigger points or muscle knots. Some of the most common ones that become overactive in the thigh are tensor fasciae latae (TFL), sartorius, rectus femoris, vastus medialis, vastus intermedius, vastus lateralis, gracilis, adductor brevis, adductor longus, hamstrings, semitendinosus, semimembranosus, biceps femoris and pectine. Other muscles that can refer trigger point pain to the thigh region are the obturator internus, gluteus minimus, piriformis, iliopsoas, external abdominal obliqus and multifidi.
Where can muscle nodes in the seat / butt sit?
Answer: All muscles can become overactive and constitute what we call trigger points or muscle knots. Some of those who may become overactive in the seat / butt are obturator internus, sphincter ani, levator ani, coccygeus, gluteus minimus, gluteus medius, gluteus maximus and piriformis. Other muscles that can refer trigger point pain to the seat / gluteal / butt region are quadratus lumborum, iliocostalis lumborum, longissimus thoracis and sacral multifidi.
Where can muscle knots in the shoulder blade / trigger points in the shoulder blade sit?
Answer: All muscles can become overactive and constitute what we call trigger points or muscle knots. Some of those who may become overactive in the shoulder blade are upper trapezius, levator scapulae, serratus posterior superior, latissimus dorsi, supraspinatus, infraspinatus, teres minor, teres major, subscapularis, rhomboideus as well as deltoid. Other muscles that can refer trigger point pain to the shoulder blade are the middle trapezius, lower trapezius, serratus anterior, anterior scalenius, middle scalenius and posterior scalenius (also known as the scaleni muscle).
Where can muscle nodules in the forearm / trigger points in the forearm sit?
Answer: All muscles can become overactive, and sore muscles in the forearm can form what we call trigger points or muscle knots. Some of those that can become overactive in the lower extremity are the anconeus, extensor carpi ulnaris, extensor carpi radialis longus, extensor carpi radialis brevis, brachioradialis, digitorum extensor, supinator, flexor carpi radialis, flexor carpi ulnaris, flexor digitorum superficialis, pronator teres and longus. Other muscles that can refer trigger point pain to the forearm are the triceps brachii, scalenii, pectoralis major, pectoralis minor, subclavius, serratus anterior, serratus posterior superior, latissimus dorsi, supraspinatus, infraspinatus, subscapularis, coracobrachialis and brachialis.
Muscle pain between ribs - what helps?
Pain in the muscles between the ribs, also called the intercostal muscles, can cause relatively sharp and obvious pain - these are often aggravated when the upper body is twisted towards the side where the pain is and sometimes also during deep inhalation. Myalgias and muscle ailments in this muscle often occur in combination with joint locks and joint stiffness - also called rib locks. Joint treatment performed by, for example, a chiropractor or manual therapist, in combination with muscular treatment is among the treatments that work well.