Tied up in Knots

March 4, 2008 4:42 PM

My husband has a huge knot in the muscles at the small of his back (right where his spine meets his pelvis, very close to the spine). He's clearly in a great deal of discomfort, and wants me to massage the area (which I'm happy to do), but what else can he try? (He's already refused to go to the doctor or use a stick-on heat pack, and we don't own a heating pad.) Suggestions as to stretches, massage techniques, and other things we haven't thought of are welcome.
posted by anastasiav to health & fitness (31 comments total)

IANAD but I have back problems. When first started getting knots (I call them "baseballs" because that's what they seem like, under the skin), a doctor suggested that I have someone "knuckle" the knot, that is, really work their knuckles into the knot, not at all gently. I think of it as bullying the knot into submission and it works to an extent for me.
posted by Morrigan at 4:50 PM on March 4, 2008

chiropractor?
posted by matteo at 4:50 PM on March 4, 2008

See if you can get your hands on a foam roller.
posted by exit at 4:50 PM on March 4, 2008

why won't he use a stick on heat thing? if it's not heat he has a problem with (which will totally help) microwave a wet towel for 2-3 minutes. let it cool for a minute or so, then put that where it hurts.
posted by misanthropicsarah at 4:51 PM on March 4, 2008

2 pounds of rice tied into a (clean, large) tube sock and microwaved for 2 minutes makes a darn good heating pad...and it has the bonus that if you fall asleep using it, you can't get burned by it.
posted by leahwrenn at 4:54 PM on March 4, 2008 [1 favorite]

One thing suggested to me by a trainer that has worked wonders is to simulate a deep massage by lying on a small, relatively hard object like a tennis ball. If a tennis ball is too hard, you can wrap a few socks around it to make it a bit softer. Have your husband lie with the ball immediately under the "knot" for about 30 seconds, and then move around a bit to stimulate the tissues surrounding the knot. He can vary the pressure by varying the amount of weight he puts on it. I used to do this while lying in front of the TV and it made a big difference. Also: drink a lot of water while doing this, since it releases some toxins that have built up in the muscles into your system.
posted by googly at 4:58 PM on March 4, 2008

A tennis ball. Put it on the ground and lower the knot onto it. Push down until you feel the knot release (it hurts!). Keep going.
posted by unSane at 4:58 PM on March 4, 2008

(He's already refused to go to the doctor or use a stick-on heat pack, and we don't own a heating pad.)

I'm not sure if the objection is to heat in general, but if not you can get an old school hot water bottle at a drug store for like $5.
posted by advil at 5:04 PM on March 4, 2008

With all due respect, your husband is crazy for not seeing a doctor. My father had the same symptom, but it was a tumor, pressing on his spine. He was paralyzed from the waist down for the last two years of his life.
posted by Wet Spot at 5:04 PM on March 4, 2008

He sounds like he really needs to go to a doctor, especially if this has gone on for more than a day. Lower back problems ain't nothin' to with with.

Temporarily, though, a hot bath, with epsom salts, will probably help.
posted by ignignokt at 5:09 PM on March 4, 2008

Um, yes, doctor for him. Also, stretching and progressive relaxation.
posted by number9dream at 5:16 PM on March 4, 2008

IANAD but I've known several people who have gotten cysts on their tailbones lately and it sounds pretty similar to what you are describing. I would go to a Dr to have it checked out.
posted by whoaali at 5:18 PM on March 4, 2008

why won't he use a stick on heat thing?

Well. He's used it before and found the removal ... painful ... when the pad removed hair.
posted by anastasiav at 5:24 PM on March 4, 2008

IANAD or generally a scaremonger but I'm seconding the lump-on-back-oh-it's-really-a-tumor- story.
posted by ArcAm at 5:53 PM on March 4, 2008

this one doesn't stick, it wraps around and velcros.
posted by Green Eyed Monster at 6:06 PM on March 4, 2008

but he should probably go to a doctor anyway. if nothing else, so he can get some muscle relaxers if it is just a knot.
posted by Green Eyed Monster at 6:07 PM on March 4, 2008

What everyone else said. I find the tennis ball approach to be painful, but a physical therapist recommended it long ago.

Ben Gay and its generic equivalents help my back, but they stink a lot.

The heating pad is very soothing. Y'all should get one. Much more economical, in the long run, than repeatedly buying patches.

And as for the painful removal -- it's his back. You are probably the only one who sees it on a regular basis, no? Shave off a swath of his back where the patch should go. They're still kinda hurty to remove -- just like band-aids are -- but so what? He's a grown man.

Alternative approach: You say, "Dear, you have two choices: Excruciating back pain that lasts for days, or the sting of removing that oh-so-soothing patch, which lasts for 30 seconds. It's your choice, but you're a big baby if you choose the former over the latter."
posted by mudpuppie at 6:36 PM on March 4, 2008

Ice! This was recommended by my doctor when I had knots in my back and shoulders and it worked wonders. The cold causes bloodflow to increase to the area, which helps the spasm relax faster. The doctor recommended 15 minutes of ice, followed by a good long stretch, then more ice.
posted by selfmedicating at 6:36 PM on March 4, 2008 [1 favorite]

Hot bath, and/or over the counter muscle relaxants?
posted by rokusan at 6:36 PM on March 4, 2008

acupuncture is very common in Asia for back pain.
posted by gen at 7:49 PM on March 4, 2008

I use the tennis ball method, but instead of laying on it, I put it against a wall and use my body to roll it. It is easier to control the amount of pressure. Also try putting the tennis ball in a sock, hang it over your shoulder by the sore spot, then rub against the wall.
posted by JujuB at 7:53 PM on March 4, 2008

Had an Uncle that died from a "knot" on his back. He left it there unattended, finally it bugged him so much that he saw the doctor, it was cancer of some sort. He died a year or so afterwards.

On the other hand, it could be a trigger point in his lower back- good reading here and here. The second link is a wiki article, the first is some guy selling a book but has some info.

As I see it, you can keep rubbing on it till hell freezes over, or he kicks the bucket, but if i was you I would some how convince him that having a doctor rub it for a bit might prove much more beneficial than you rubbing it night after night with a tennis ball.
posted by bkeene12 at 8:22 PM on March 4, 2008

Why don't you buy a heating pad? They're pretty cheap.
posted by The Light Fantastic at 10:44 PM on March 4, 2008

Only apply ice if this is recent and an injury; if this is something he just woke up with (sleeping in a bad position, for example), without doing some specific action to injure himself, he's better off with heat.

The tennis ball works. Deep tissue massage works (the knuckles, elbows too). Also, take an anti-inflammatory like ibuprofen.
posted by sic at 12:33 AM on March 5, 2008

Why exactly is seeing a doctor not an option? If he's uninsured, ok, maybe it's $75 and that's not peanuts. But unless he's about to get insured, and is trying to avoid knowledge of a pre-existing condition, it's a poor choice. Really, now that you've been properly scared by tales of cancerous backlumps and paralysis and cysts and whatnot, there's nothing to do for it but make sure that's not the case. 'Cos really, if it is a cancerous paralyzing life-ending tumor, you want to know about it.

But, if you're sure it's really just a knot, then seconding the very first answer: knuckling the damned thing can work wonders over the course of a few days.
posted by mumkin at 12:47 AM on March 5, 2008

Stick the sticky heat pad onto his tshirt, not his skin.
posted by happyturtle at 1:17 AM on March 5, 2008

IANAD, nor am I a CMT, but I have worked at a sports massage clinic for > 1 year.

I second the idea of ice. It is much more helpful than heat. Ice increases blood flow and circulation. Heat can sometimes relax / loosen muscles to the point that the lose their ability to provide support of the spine, which can lead to greater problems.

If you're going to do some massage for him, "think" of lengthening the muscles, providing slow and focused movement, rather than just digging in there as hard as hell. Take your time. Slow, sustained and patient pressure applied to muscles in trauma / spasm, sometimes does amazing things.

Your husband really ought to see a specialist ASAP. If for some reason he can't or won't see a Medical Doctor (not necessarily my first recommendation mind you; many will just prescribe treatments for the symptoms, rather than address the cause), then he could see a Certified Massage Therapist, who should be able at the very least to reduce tension, relieve spasming, increase circulation, and reduce pain. They also may be able to observe whether something "more serious" is going on (i.e. the should be able to feel if it's indeed a muscle issue, or Something Else outside of their scope of practice), in which case your husband should get some imaging done (i.e. the trip to the MD).
posted by armoir from antproof case at 1:22 AM on March 5, 2008

ibuprofen gel, and go see the doctor.
posted by crocomancer at 4:23 AM on March 5, 2008

What everybody else said. I used to be famous for massage, almost made a career out of it living in hippy-land. You stroke and smooth and feel a knot and dig into it for a few seconds, go somewhere else, stroke and smooth and come back to the knot again and dig into it.

The thing is to keep everything else nice and relaxed so you can go back and dig into the knot.

An old 750ml liquor bottle (preferably square so it doesn't roll around), fill with hot water from the sink, wait 20 seconds or so, pour out and refill. Cap, dry off, slip into an old sock. Instant hot watter bottle, 4 or 5 hours of warmth.

See a pro to determine whether it's just a knot or something worse... I also had a friend who went from back pain to cancer to brain cancer to dead... It's worth getting looked at.
posted by zengargoyle at 5:33 AM on March 5, 2008

Someone recommended this self-massager cane on Kevin Kelly's Cool Tools.
posted by averyoldworld at 8:25 AM on March 5, 2008

To contradict what two posters said earlier, ice decreases blood flow. Alternating heat and ice is good for promoting blood flow overall. Moist heat is far better than dry heat for soft-tissue in spasm (assuming it's a muscular issue). Epsom salts and baking soda in a hot bath are tremendous. If a tub isn't available, hot towels heated in the microwave are the next best thing.

FWIW, I'm an LMT.
posted by computech_apolloniajames at 6:06 PM on March 5, 2008