What is a muscle knot actually? A pain in the neck, but not a knot.

As humans age, daily work, smartphones, and even pillows can seem to have it out for our necks. Bad posture, repetitive motions, or even just one wrong move involving this part of the body can trigger tenderness, tension, and pain. If you’re experiencing such sensations, you might say you have a knot in your neck. But is anything actually getting knotted up in there?

The short answer is no. “Muscles are never tied into knots,” said Ara Nazarian, who runs the musculoskeletal research lab at Beth Israel Deaconess Medical Center in Boston. Yet, “they can feel that way due to the accumulation of tight muscle fibers within a specific area.” 

Nazarian, also a professor of orthopedic surgery at Harvard Medical School, told Popular Science that when neck knots—or myofascial trigger points—occur, “a specific portion of the muscle contracts similarly.” In other words, what’s commonly called a knot is actually an area of contracted muscle fibers that can’t fully relax. This phenomenon, Nazarian explained, might feel like a bump, lump, or band beneath your skin.

If you’re suffering from a knot in your neck, you’re in good company. Almost everybody experiences sensitive trigger points at one point or another in their life. “Trigger points are present in 97% of individuals with chronic pain, and they are found in 100% of individuals experiencing neck pain,” Nazarian said. For most people, they’re impossible to completely avoid, but muscle knots are treatable and it’s possible to reduce how often they appear. Typically, the trick is in identifying the common causes and making some adjustments.

A variety of behaviors can foster muscle tension and lead to knots, including sitting for a long time, gazing downward at your laptop, tablet, or smartphone habitually, not drinking enough water, and falling asleep “in an awkward position,” said Nazarian. “Physical trauma, such as whiplash or a pulled muscle, heavy lifting, or even using a non-standard pillow, can result in muscle knots as the body tries to protect the injured area by tightening surrounding muscles,” he added.

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Inversely, improving your posture, taking frequent breaks, exercising regularly, taking care when lifting something heavy, and managing stress with yoga or breathing exercises can mitigate knots. Nazarian also cited staying hydrated and making sure “your diet contains a balanced combination of magnesium, potassium, and calcium” as two other prevention techniques.

If you’re suffering from a knot right now, experts often recommend massages, stretches, a warm compress, over-the-counter drugs like ibuprofen, or dry needling. These methods can speed up the recovery process by relaxing muscles and boosting blood flow, which “provides nutrients and oxygen to the damaged tissue, enhancing recovery,” Zachary Gillen, a professor of exercise physiology at Mississippi State University, wrote in a 2022 essay. 

“Usually within a week or two a muscle knot will resolve on its own,” Gillen said.

However, if such techniques don’t help, or if your pain is chronic, Nazarian recommends contacting a healthcare professional. “You should also consult a doctor if the pain is severe, lasts for more than a few days, or is accompanied by symptoms like numbness or dizziness or if any radicular pains radiate to the upper extremities,” he told Popular Science.

While muscle knots aren’t actually knotted, the discomfort is real and the turn of phrase endures. Since the mid-aughts, queries for neck and muscle “knots” on Google have trended upwards, dipping at the height of pandemic lockdowns, before continuing to climb. Sometimes, scientific precision is simply no match for popular language.

This story is part of Popular Science’s Ask Us Anything series, where we answer your most outlandish, mind-burning questions, from the ordinary to the off-the-wall. Have something you’ve always wanted to know? Ask us.