Knot helping

December 5, 2013 10:42 AM

Muscle pain in my back and chest is making day-to-day activities painful. Help me get rid of it.

I have a nasty knot in my back that’s been around for the past four or five days. It feels like it’s right between my left shoulder blade and spine. The pain has now extended to my chest. It hurts to take a deep breath and I’ve ruled out the possibility of sneezing or laughing because it makes the pain unbearable.

Hot showers, medicine and massage do help but only for a bit. I sit at a computer all day and I’m trying my best to maintain correct posture and keep my back relaxed.

I don’t think I seriously injured anything – we slept over at my parents house last weekend and I think the bed destroyed my back. I’m fairly sure this knot will go away on its own in a few days but I’m looking for specific stretches, exercises, or techniques to get me to that point.

posted by Diskeater to Health & Fitness (20 answers total)

It sounds like you should go see a doctor--that sounds intense.

I am not a doctor and this is not medical advice, just personal experience. I get a similar knot in my back under my right shoulder blade, by the spine. It's very painful, though yours sounds significantly worse than mine (the pain for me is always localized). When I feel this pain coming on, I lie on the floor with one of these wooden things under the knot. That gives some immediate temporary relief, and seems to speed recovery when combined with heat (or muscle relaxants!).

You may be beyond the point where such a thing would help--but that's what I do.

Again, I'm not a doctor and I can't advise you on medical matters. See a doc! Good luck!
posted by Admiral Haddock at 10:47 AM on December 5, 2013

I'll be watching this thread as I've had issues with recurring left shoulder pain of the same sort for a long time.

I recommend a professional massage, by someone who deals with pain, and a lot of time with a heating pad. Yoga helps a lot too.
posted by bearwife at 10:48 AM on December 5, 2013 [1 favorite]

I immediately thought heart attack. Please go see a doctor.
posted by agregoli at 10:52 AM on December 5, 2013

I get bad knots in that place and have for years. Yours may be worse, but what has always helped me is this: get your partner to press with their knuckes (or any hard, giant-marble-sized object) very hard on the knot and hold it for about 20 seconds, wait, massage, repeat from a slightly different angle. This will hurt while it's going on - they should be pressing exactly on the sore spot. Once they've done this a few times, they will be able to find the knot by how it feels to the touch.

A friend with some kind of hippie massage background told me about this in college. I surmise that the pressure somehow interrupts the muscle spasm, although she told me it was about getting the toxins (lactic acid?) in the muscle to get cleared out by the bloodstream.

IANAD!
posted by Frowner at 10:56 AM on December 5, 2013

You too, huh? I've just started seeing a physical therapist. She's given me a pile of exercises to do for homework to strengthen my back and stretch out my chest, which she says will help get everything back on an even keel. So far everything she's said has been right on the money.

From my experience: first step, get thee to a doctor, and pronto, to get more serious things ruled out. If it's musculoskeletal, get thee to PT to get yourself fixed.

Good luck!
posted by phunniemee at 10:56 AM on December 5, 2013 [2 favorites]

Also, mine have produced some shoulder and chest pain, but it has always been very musculoskeletal pain - not unlike costochondritis pain. I have read a bit about this online and it seems like back pain can radiate to the chest without it having anything to do with the heart. Use your judgment, of course - I have gotten so many knots and so much costo pain that I feel pretty sure of what my normal is.
posted by Frowner at 10:58 AM on December 5, 2013

I'm not a doctor, this is not medical advice - but I went to a doctor for a similarly bad knot when it really was getting painful to the point that raising my arm hurt. My doctor asked me a couple of questions about painkillers - I was taking ibuprofen, and it wasn't helping.

Then my doctor asked "and you're taking the recommended dosage? One every 4 hours?"

"....No, I'm just taking like one a day."

My doctor gave me a look. "uh....it's the recommended dosage for a reason."

What the doctor realized was - I had a knot that was bad and needed stretching, but I wasn't taking enough painkillers to dull it so I wasn't stretching it, and it was just getting worse, and hurting more, and I wasn't stretching it, and....and it was a vicious circle.

So yeah, go to your doctor to be safe, but it's very possible - if you are trying to tough it out without OTC painkillers - that that could be the problem as opposed to this being a heart attack. (My doctor actually wrote a jokey prescription for me so I'd take the proper dosage of OTC advil or whatever.)
posted by EmpressCallipygos at 10:59 AM on December 5, 2013

Take a tennis ball, put the tennis ball between the knotted area and a wall. Brace your knees and press into the ball. Move the ball around on your back as you can in that spot.

It hurts like a bitch when it's happening, but afterwards is sweet, sweet relief. This is my go-to when I can't get a professional massage.

I also recommend a professional massage.
posted by zizzle at 11:01 AM on December 5, 2013 [6 favorites]

I went through something similar not too long ago, and what helped A LOT to work out the knot was a Body Back Buddy (alternatively, a Theracane works well too). Emphasis on the "helped", though -- if poor posture or weird ergonomics are causing your knot, you've gotta fix those if you want to make it go away, but it sounds like you're already aware of that.
posted by un petit cadeau at 11:11 AM on December 5, 2013 [1 favorite]

Yeah, what medicine are you taking/have you taken? You should be taking an OTC anti-inflammatory like ibuprofen or naproxen, and you should take the recommended dose.

I was in a similar position as you a couple months ago for knots/strained muscle, and I went to the doctor (which you definitely should just to rule out something more serious like a heart issue), who did some poking around on the knots to try to release them and gave me a prescription for more heavy duty naproxen and muscle relaxants. Then I went and got a massage. All of those combined gave me enough relief to sleep through the night, though it still took a week for the actual strain to get better. If you just have some knotted muscles, muscle relaxant + massage may be enough to give you relief.
posted by yasaman at 11:26 AM on December 5, 2013

This has happened to me too. Seconding the tennis ball idea, though I say put it in the longest tube sock you can find (as you may have better control over it that way). As far as OTC painkillers, if you haven't tried Aleve (or any variation with naproxen sodium) I would suggest that. My doctor said it's the closest thing you'll get to a muscle relaxant without a RX, and I've found it works a little better than Advil (ibuprofen) or Tylenol (acetaminophen) for this kind of back pain. And sitting at a computer could very well be aggravating it--if you can really take it easy this weekend and not do anything strenuous, that may help for a quicker recovery.
posted by lovableiago at 11:29 AM on December 5, 2013

Thirding the tennis ball--it's a godsend for a friend of mine who developed a long-lasting knot in reaction to a cracked vertebra she sustained in a car accident (her physical therapist had her do it).

If it's a knot and not an injury, warmth should help it relax a bit--get a heating pad and lie on it for a while.

If it's an injury, like you pulled a ligament or something, cold should help the inflammation, and you should really see a doctor to make sure it's not going to get worse. (Don't be me: I didn't have insurance, so didn't go to a doctor until almost a year later, when I was finally employed, and it took about five years for my back to get back to normal.)
posted by telophase at 11:32 AM on December 5, 2013

hi, I'm not saying you shouldn't consult a doctor, but I really suspect you have a big old whopping trigger point (or maybe 2 or 3) in / around your trapezius / infraspinatus area.

Those colors in that chart link are super, super helpful because they show common trigger points and the areas they can "refer" to. Referral pain is a bitch, let me tell you, because you tend to massage the area where it hurts, and it doesn't actually solve the problem. You need to find the source and sometimes working along the muscle fiber will help, but this is where charts like this can help, and it's also a good job for a trained massage therapist. My personal preference is to find a CMT who has these books and knows how to use them.

As far as referral pain being misleading? I frequently get knots in my calves from running that refer to the balls of my feet and cause "plantar fasciitis" pain. It's not PF, though, it's just that stupid gastrocnemius knot acting up again. Massaging and stretching my calves helps 100% kill it. However, it took me YEARS to make the connection between my PF pain (I was considering getting foot surgery for it) and my tight calves. YEARS. Similarly, I've completely killed a chronic case of "carpal tunnel" by having the knots worked out of my delts and latissimus dorsi - because those muscles impinge on the nerve that runs down the arm to your wrist, and the referral pain ends up VERY far from the source.

Accordingly, my lovely, lovely desk job contributes to all sorts of pain from my traps and infraspinatus - sitting forward / slouching stretches these muscles and tightens the ones in front and causes all kinds of referral pain. One thing that chart does not touch on is scalines - the skinny neck muscles in front that attach to the tops of your collarbones. Scaline pain can indeed refer through from front to back, and I suspect that, like many modern desk jockeys, you probably have knots in your infraspinatus, scalines AND traps (and probably a half dozen other common upper back areas) that are all getting pissed off and having a big old bar brawl with each other, and your back and shoulders are taking the fallout.

Full disclosure: you DO NOT have to buy those things in that first link, they are kind of expensive and silly. You can totally make do with the tennis-ball-and-tube-sock hack, and honestly things like Kong dog toys (use a clean one plz) and other DIY tools for cheapsies.
posted by lonefrontranger at 11:57 AM on December 5, 2013 [6 favorites]

I have recurrent chest pain and my doctor's recommendation was to get up from my computer and stretch every 20 minutes. I also got a prescription for Tramadol, which helped immensely and doesn't make me tired and barfy like other opiates.
posted by pony707 at 1:25 PM on December 5, 2013

Also, nothing against tennis balls, but I've done my share of rolling against them without relief. When I can't get in for a massage, an electric massager like this one is a surprisingly effective gadget.
posted by bearwife at 2:15 PM on December 5, 2013

I had it similarly to you almost a decade ago, and my doctor gave me an injection. No idea what it was. I instantly recovered.

Last month, something similar but not so painful happened, and this time went to the pharmacy to ask for their best backpain medicine. Took the recommended dosages for about 3 days and it went away.
posted by TrinsicWS at 3:10 PM on December 5, 2013

I would definitely see a doctor, if only to rule out heart problems. It's unlikely but far from impossible that your pain is due to an ischemic cardiac event -- some part of your heart may not be getting quite enough oxygen, and you may be getting deferred pain from that. This is not a heart attack exactly, but it's one small step down the ladder of severity and can certainly damage your heart. It's also a sign that the sufferer is at very high risk for a real heart attack in the near future.

Your symptoms are pretty classic for this kind of problem. Yes, they can go on like this for days at a time, and yes the pain can start in the middle of your back (especially on the left side) and spread to the chest. No, it's not the most likely cause of your pain (it's probably just muscular, and if that's the case a doctor can probably help you there too) but if this is what's happening then it's life threatening and your prognosis for recovery without damage will be much better the sooner you have it treated.

Don't panic, but go to a doctor as soon as you can. Consider this urgent.
posted by Scientist at 3:43 PM on December 5, 2013

And yeah, I know you're only 28 but sometimes young people have heart problems too. It makes it less likely, but I would still consider ruling out heart trouble an urgent matter if I were you.
posted by Scientist at 3:45 PM on December 5, 2013

1. Yeah, you should seek medical attention to rule out a cardiac event. Get someone to drive you to the E.R. If nobody is available, call 911 and tell them you have multiple days of back pain radiating around to the front of the chest, and have recently started to experience difficulty breathing. An ambulance will come get you. Depending on how trigger-happy the local EMTs are, it may even run lights and sirens.

2. In the likely case that you're not having a heart attack, cross both your arms in front of your chest like you're hugging yourself and really pull your shoulders forward and center so your shoulder blades move away from your spine. Get someone else to dig his fingertips, knuckles, or elbow into the tender area between your shoulder blade and spine, while you slowly move your shoulders and elbows up and down a bit to expose different parts of the musculature. If you can't find an assistant, trap a lacrosse ball between your back and a wall and lean back to produce a similar sort of pressure.

But seriously, go get checked out for a possible cardiac event.
posted by d. z. wang at 10:06 PM on December 5, 2013

Really, I think that the ER would be overkill. Call your GP and see what he thinks. IANAD, but this sounds like your typical muscle pull. Seconding what lonefrontranger said.
posted by computech_apolloniajames at 12:08 PM on December 6, 2013