Pain and tension in back muscles is one of the main complaints I hear from clients who come to see me in my clinical massage therapy practice.
If you are suffering from tight back muscles, I have some good news and bad news for you about muscle pain and tension.
The bad news: it’s incredibly common, widespread, and will keep coming back for most people, no matter what you do.
But the good news is that for most people, the primary cause of muscle pain and tension are trigger points. These are fairly easy to treat and keep at bay without expensive or risky interventions.
And although a massage therapist or other pain specialist with trigger point therapy experience can help you pinpoint where your problem trigger points are, you don’t usually need to pay me or any other practitioner to effectively treat many of them. In fact, the best approach is usually very short, but daily doses of massage, which is not really practical to get from a massage therapist.
What are Trigger Points?
Trigger points are small knots in muscles. There are several theories about what they are exactly, but the most accepted idea is that a trigger point is a very small contracted area of muscle. It’s basically a tiny cramp that only affects a small part of the muscle instead of the whole muscle. This cramp can possibly restrict blood flow, increasing irritation and inflammation.
Most of the time, this causes no symptoms at all and therefore, is not really a problem. These are called latent trigger points.
Muscle knots and tightness by itself is often just a healthy adaptation to your posture and the way you carry your body. So there is no reason to try to eliminate this if it isn’t causing pain or restricting movement.
When trigger points become active, however, they can cause a host of issues including tenderness, stiffness, a weak and heavy feeling, or a dull, aching pain in the area of the trigger point. Or they can refer pain to other areas of the body.
Trigger points can become active when muscles are overused or due to illness or stress. Another cause is an injury. As your injury heals, you may notice muscle pains that linger. This is often from active trigger points that became aggravated during the injury or afterward when you were using your body differently due to the injury.
Trigger Point Self-Care Instructions
Now that you know what trigger points are, here’s how to massage knots out of back muscles.
Tools:
One of the cheapest and easiest tools to use is a tennis ball or lacrosse ball against a wall, the floor, or a chair. Some people put these in a sock and use the sock as a type of handle. You can also cut a small slit in the ball and insert a wooden paint stirrer to use as a handle.
Smaller rubber bouncy balls are useful for smaller spots. You can also buy products online for self-massage, including the theracane.
Other options include your fingers, hands, or elbow. Just be careful to not overuse these as you may create new trigger points in your arms or a repetitive strain injury.
Technique:
Simply put your tool on the trigger point, apply pressure, and hold. Or, if it feels better, slowly rub across the trigger point with short, “milking” strokes that move the blood in one direction.
For back muscles, this is incredibly easy. I suggest starting with a tennis ball and lying on a firm but soft surface such as a carpeted floor. Put the ball under your back and hold on the trigger point.
Or you can stand against a wall and rub the your back with the ball by moving your body up and down.
Pressure:
You should use a pressure that is at a medium intensity. It shouldn’t be really uncomfortable or make you grit your teeth, but you should feel some tenderness. You should be able to feel relaxed while you do it. Generally, when massaging a trigger point at the ideal pressure, you will feel a satisfying “good pain,” like you are relieving an itch.
Use less pressure at first. It’s better to use too little than too much.
Length of Each Treatment:
Massage each trigger point for about 30-60 seconds. If you feel the wish to, you can massage for up to about five minutes at a time. It’s better to caution on the side of too little than too much at first. Over-treating a trigger point can make it worse.
Frequency:
If you aren’t too sore or having negative reactions, treat each trigger point at least once a day, up to about six times per day max.
Continue this routine until your trigger points are no longer tender to the touch. This can take one day to several weeks, depending on the severity of the trigger point.
If any of your symptoms become worse or you continue to not see improvement, stop and talk with a healthcare provider before continuing your self-treatment.
Other tips:
Using heat from a bath, shower, heating pad, or flax pillow before and after massage can help reduce pain and make the treatment more effective. Gently stretching the muscle after the massage or throughout the day can sometimes help too.
My Trigger Points Are Gone! Now What?
The best way to prevent trigger points from coming back is movement. Muscles hate stagnation. Stretch and move your whole body daily, but especially the muscles affected by trigger points.
And of course, all general wellness advice you’ve already heard applies here too: get enough rest, drink enough fluids, eat a balanced diet, develop healthy relationships, and keep your stress at manageable levels.
Most likely, your trigger points will return, sooner or later. However, you can nip them in the bud before they become too problematic by staying aware of your body and starting your massage routine as soon as you feel symptoms popping up again.
Beyond Trigger Points
So what’s the point of getting a professional massage if people can just massage themselves? If self-massage solves all your issues completely, then you don’t necessarily need to get massage, especially if money is tight.
However, even though you now know how to massage knots out of back muscles and help correct some local problems in muscles, the most profound benefits of massage from a professional are on the nervous system.
And the nervous system is in control of your whole body and mind: how tense you are overall, how well you deal with stress, how much pain you experience, how much joy you experience, how well you sleep, how much self-control you have, how well you regulate your emotions, etc, etc, etc.
Have you noticed that your daily life makes you feel stress? Have you noticed that stress can cause you to feel tired, experience more pain symptoms, and even cause you to gain weight?
This is because you are living in a sympathetic state of fight, flight, or freeze, and it is so habitual that you aren’t able to get out of it easily.
What your body needs to heal, be healthy, and thrive is time in a parasympathetic state of rest and digest. Massage does this for you.
Research has shown that a single session of Swedish relaxation massage reduces physical signs of stress, lowers anxiety levels, boosts mood, reduces pain levels, and improves sleep quality.
Regular massage sessions, however, produce cumulative and sustained effects. This means that the benefits of each new massage are likely to be better and last longer than the previous massage.
Regular massage therapy sessions can also lower trait (chronic) anxiety, improve symptoms of depression, and make your nervous system more resilient to all forms of stress which will positively impact every other aspect of your health.
Essentially, getting regular massage makes trigger points less likely. And when they do occur, the level of pain experienced is generally lower, regardless of what is going on in the actual muscle.
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