From the Guidelines
Muscle knots, also known as myofascial trigger points, are areas of tight muscle fibers that can cause pain and stiffness, and the most effective treatment is manual trigger point therapy, as recommended by the latest clinical practice guideline 1. When considering treatment options for muscle knots, it's essential to prioritize interventions that have been shown to be effective in reducing pain and improving quality of life.
- The guideline panel issued strong recommendations in favour of cognitive behavioural therapy, therapist-assisted mobilisation, manual trigger point therapy, supervised postural exercise, supervised jaw exercise and stretching, and usual care, such as education, home exercises, and stretching 1.
- Manual trigger point therapy, in particular, has been shown to be effective in reducing pain and improving function in patients with myofascial trigger points 1.
- The guideline panel also noted that the interventions recommended were not associated with serious harms, and that the evidence for harms was almost entirely very low certainty 1.
- Therefore, manual trigger point therapy, along with other recommended interventions, should be considered as a first-line treatment for muscle knots, due to its effectiveness and safety profile. Some key points to consider when treating muscle knots include:
- The importance of proper diagnosis and identification of myofascial trigger points
- The use of manual trigger point therapy, along with other recommended interventions, to reduce pain and improve function
- The need for patient education and self-management strategies, such as home exercises and stretching, to prevent recurrence and improve overall quality of life 1.
From the Research
Definition of Muscle Knots
- Muscle knots, also known as trigger points, are taut, band-like nodules located within skeletal muscle that can produce pain and disability 2.
- They are a common cause of myofascial pain syndromes, which involve muscle stiffness, tenderness, and pain that radiates to other areas of the body 3.
Characteristics of Muscle Knots
- Trigger points are capable of producing pain and disability, and are often treated with injections, although the effectiveness of these treatments is still being researched 2, 4.
- They can be identified through manual palpation, and their presence can be confirmed through the use of pressure algometers to measure pressure-pain thresholds (PPT) 5.
Treatment of Muscle Knots
- Various treatment approaches are available for muscle knots, including stretching, physical therapy, dry needling, and injections 3, 2, 4.
- Massage therapy, including deep tissue massage, has been shown to be effective in increasing PPT and reducing pain and disability in individuals with myofascial pain syndrome 5, 6.
- A comprehensive, multimodal, and team-based approach to treatment is recommended, with less invasive treatment strategies such as massage and physical therapy being employed first, and trigger point injections being reserved for patients whose pain has been refractory to other measures 2.