Your muscles sustain your elegance, even as you sit still. Many of us spend hours a day sitting still, save for our fingers clacking away at the keyboard. Those fingers also use muscles, but other muscles are used and abused without conscious thought. The muscles of your back and neck are especially improperly positioned during long hours staring at the screen. If you have taken the time to invest in ergonomic feng shui, you are ahead of me in alleviating needless muscle pain. If you, like me, have ignored your frailty, only to be disturbed by a knot wrecking your back, then it is time to make some changes.

What is this “knot in your back?”

Knots are hard, sensitive areas of muscle that contract even when at rest, giving its familiar bumpy texture. Also known as myofascial trigger points, these knots appear to result from muscle overuse or repeated muscle tensing. This can happen during extended sitting hours or using awkward sleeping positions.

One theory for why pain and inflammation happens is an abnormal abundance of calcium in the muscle area. Calcium is normally required for proper muscle contraction, but if high levels persist beyond what is ‘normal,’ muscle stiffness can follow.

Poor posture, exercise techniques, stress and overuse all contribute to myofascial pain. Other less obvious factors are unbalanced limb proportions, such as having one leg that is longer than the other, which will irregularly tense muscles. Depression, anxiety and other forms of mental distress also result in chronic muscle tension, triggering knots.

How do you know if it’s a knot?

Myofascial pain is not neuropathic pain, but both may feel similar. Myofascial pain is due to injury in the muscle. Neuropathic pain is due to injury in the central nervous system (brain and spinal cord) or peripheral nervous system (nerves connecting the body and are not the brain or spinal cord). Many chronic pain disorders are neuropathic disorders and should be assessed differently.

There are two broad categories of trigger points: active and latent. Active knots are always sore, causing fatigue and limited mobility. Latent knots are sore on touch and can worsen pain when a muscle is injured or strained. Depending on the type, different symptoms will appear first, with consistent pain for an active knot and reactive pain for a latent one. Knots may also spread pain over a general area outside the knot, rather than the specific area the knot is located (this is also known as referred pain). Visiting the doctor, however, is a good step to take to ensure it is a knot and not another concern, like swollen lymph nodes.

There are no set tests used to diagnose knots. Trigger points may be identified on an ultrasound scan, though some experts dispute its efficacy. Often, physicians will need to rule out other causes that may explain your symptoms before confirming knots. Even as resources reveal our poor understanding of this common ailment, what we do know will inform our treatment options.

How to untie the knots

Treating knots can range from doing nothing to surgery. Sometimes all you need is some rest. Gentle stretching, exercising and massaging can relieve pain and ease tension. More severe and chronic cases may need intense therapy, like physical therapy and rehabilitation or medications.

There is no need to have so much pain when not moving. Instead of inducing the problem, quash your bad habits and take a preventative approach to your pain. This is good for your overall health, and more specifically, can prevent many knots. Improving posture, learning stress management techniques and exercising regularly are all good things to do.

Simply put, we must move.   I knew that, but I had to sit on it for a while.



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