By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , /


Whether it’s after a long day hunched over
your computer or a week of stressing out about a big test, you probably have had muscle knots
before. These knots — otherwise known as myofascial
trigger points — are pretty much what they sound like: painful spots in your muscles.
They’re different from the kind of muscle soreness that shows up a day or two after
you exercise. But biologists still aren’t entirely sure
what these trigger points are — or how to fix them. On the one hand, the physical sensation of
a muscle knot seems to be real and measurable, and it’s sometimes linked to severe, ongoing
pain. The evidence for this comes mostly from magnetic
resonance elastography imaging, a form of MRI that allows researchers to examine soft
tissues — like muscles. The images sometimes show V-shaped patterns
in muscles that correspond to the little nodules you can feel at the trigger points. So it’s possible that they come from overactive
nerves, which send too much of the chemical signal that causes muscles to contract — which
shows up as those patterns on scans. Those extra tense muscles would prevent normal
blood flow through the muscle tissue, which would explain why they hurt. If that’s the case, treatments like massage,
physical therapy, and anesthetics might help by relaxing the tissue, restoring normal blood
flow, and reducing pain. But some studies have shown that they don’t
help, which could mean that our understanding is flawed. For example, in most patients, when researchers
injected trigger points with meds that should’ve stopped the muscles from over-contracting,
it didn’t affect pain levels. And in some studies, many of the other recommended
treatments barely helped more than a placebo. It’s just hard to know for sure, because
these muscle knots aren’t well understood. The diagnostic criteria aren’t clear, which
means that studies aren’t all that consistent — what one group of researchers considers
a muscle knot might not count for a second group. So it’s hard to compare results. But there is at least one thing that scientists
can agree on: understanding these trigger points is probably important for understanding
chronic pain disorders, like fibromyalgia, or chronic, widespread muscle pain. Because in order to properly treat pain, especially
chronic pain, doctors need to figure out what’s actually causing it. And maybe, along the way, they will learn
more about where those hard, uncomfortable knots come from — and how to get rid of them. Thanks for asking, and thanks especially to
all of our patrons on Patreon who keep these answers coming. If you would like to submit
questions to be answered, or get these Quick Questions a few days before everyone else,
go to patreon.com/scishow. And don’t forget to go to youtube.com/scishow and subscribe!


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