These tender bumps in your neck or back can be a pain, but a few research-backed strategies can help to relieve discomfort.

If you’ve ever had a shoulder massage or used a foam roller, you have probably found a few small painful bumps deep in a muscle. Once you’re aware of these bulges — called myofascial trigger points, or muscle knots — they can be tough to ignore.

But what exactly are muscle knots, and how do they form? Can they cause any long-term issues? And what are the best ways to get rid of them?

Muscle knots tend to form when a muscle is overloaded, either through exercise or poor posture. They are most commonly found in the neck, upper trapezius and upper shoulder muscles, as well as the mid-back, forearms and calves.

For instance, leaning over a computer for hours a day may not feel like a workout, but it can fatigue your neck, shoulder, back and forearm muscles, said Dr. Josh Goldman, associate director of the Center for Sports Medicine at UCLA Health. “Your neck is bent down staring at a computer screen for eight hours,” he said. “That’s a pretty aggressive load on the body.”

When muscles are overtaxed, they can become damaged, causing certain points to shorten or tighten — and stay that way. Some researchers believe the surrounding tissue (or fascia) thickens and becomes less elastic, creating a dense ball. They theorize this may lead to decreased blood flow and fluid in the area, as well as inflammation.

Scientists aren’t entirely sure why some knots hurt and others don’t, or why some hurt only when pressed while others ache all the time, said Christopher DaPrato, a physical therapist at the University of California, San Francisco, who studies chronic pain in athletes.

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