If you have knotted muscles ("muscle knots" or "myofascial trigger points") that cause severe pain, your doctor may already prescribe medications like nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants. Depending on your symptoms, they may also prescribe combination drugs.
Addressing muscle knots without delay is crucial because if left untreated, they could lead to chronic pain, a condition in which the pain lasts or recurs for over three to six months.
Chronic pain is highly prevalent, with data from the U.S. CDC noting that, as of 2023, nearly one in four American adults (24.3%) had chronic pain. Close to one in 10 U.S. adults has even experienced high-impact chronic pain (pain that frequently limits life or work activities).
Learning more about chronic muscle pain caused by knotting can help you better understand what to expect from the common prescription medications used to treat it.
What Do Knotted Muscles Feel Like?
You can usually feel knotted muscles as small, hard, and painful muscle lumps or nodules under the skin within a tight, taut band of muscle. If you touch or press them, they'll likely feel:
- Achy
- Bruised
- "Crunchy" (or as if they're "popping")
The pain you feel from the knotted, tight muscles may also radiate to other parts. When there's severe muscle tension, the affected muscle's range of motion may become restricted, too.
Do Knotted Muscles Go Away on Their Own?
The good news is that, yes, most muscle knots go away on their own without medical intervention. You still need to treat yourself (and the affected muscles) with care and attention, though, ensuring you:
- Get adequate rest
- Hydrate properly
- Give the muscles time to "unknot" and recover (before re-subjecting them to vigorous activity)
- Stretch and massage the affected muscles
Heat therapy (HT) can also be a valuable home remedy for knotted muscles. An article published in the National Library of Medicine says HT can help manage musculoskeletal (MSK) disorders, relieving:
- Pain
- Muscle spasms
- Stiffness
It can also help boost muscle flexibility and range of motion.
What Prescription Medications Can Help With Knotted Muscles?
When your knotted muscles don't improve after one to two weeks, or if their symptoms become too much to bear, consult your primary healthcare provider as soon as possible. Muscle knots that linger often indicate underlying concerns, such as:
- Injury
- Stress
- Poor posture
Depending on the findings of your doctor, they may prescribe one or more of the following medications to help with your muscle knots.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are medications that reduce inflammation (swelling) and pain by blocking certain enzymes responsible for producing prostaglandins.
Prostaglandins are compounds that the body produces at sites of tissue damage (e.g., muscle knots). They regulate various processes like blood flow and inflammation, but in doing so, they can also increase pain sensitivity as a result of swelling.
Since NSAIDs block the prostaglandin-producing enzymes called COX-1 and COX-2, they can also help decrease swelling and pain. They provide temporary relief from soreness and tenderness, which, in some cases, may be enough to help promote better movement and range of motion.
You can buy lower-dose NSAIDs over the counter (e.g., ibuprofen and naproxen). If they're not enough to help with your muscle knots, however, your doctor may prescribe something with a higher dose, such as:
- Celecoxib
- Diclofenac
- Indomethacin
- Ketorolac
- Meloxicam
Muscle Relaxants
Muscle relaxants are prescription medications that work by interacting with the central nervous system (CNS). Its goal is to induce sedation and alter pain signals, which then allow it to treat acute muscle pain, rigidity, and spasms, all of which can arise from myofascial trigger points.
Common examples of prescription muscle relaxants are:
- Carisoprodol
- Cyclobenzaprine
- Methocarbamol
Combination Drugs
Combination drugs for knotted muscles are medications that usually involve a mixture of local analgesics and anti-inflammatory agents. Their goal is to break the pain-spasm-pain cycle that myofascial trigger points can cause.
Let's say you experience pain, inflammation, spasms, and a limited range of motion due to your severe muscle knots. In this case, your doctor may prescribe Intagesic MR pain relief tablets. They're potent pain relievers that contain three active ingredients, primarily:
- Chlorzoxazone (muscle relaxant)
- Diclofenac (NSAID)
- Paracetamol (analgesic)
Another example of a combination drug that your doctor may prescribe for severe knotted muscles is Norgesic Forte. It contains orphenadrine citrate (muscle relaxant) and aspirin (anti-inflammatory/analgesic). It also features caffeine, an adjuvant that helps boost the medication's pain relief effects.
Frequently Asked Questions
Can You Develop Muscle Knots Due to Overuse?
Yes.
You can develop muscle knots as a result of overuse or repetitive strain injuries. They can occur when you use the same muscle group over and over again (e.g., when performing manual labor or playing sports). In this case, your muscles can become overworked and be unable to rest.
Is It True That Poor Posture Can Lead to Knotted Muscles?
Yes. Poor posture and a lack of adequate ergonomics can also result in knotted muscles.
A perfect example is your desk/computer posture. If you often slouch or hunch over, you place your muscles, particularly those in the neck and shoulders, under constant tension, making them more likely to develop knots.
What Are Other Possible Causes of Muscle Knots?
Mental and emotional distress can cause tensed muscles, too. When your muscles are under involuntary and prolonged tension, they can "lock" up into knots.
Direct physical trauma and injury, from muscle strains to tears and twists, can also result in myofascial trigger points. Your muscles turning and tightening into knots is like a defense mechanism.
What Happens If You Leave Muscle Knots Untreated?
If left unaddressed, muscle knots that don't go away on their own can lead to chronic pain by causing "referred" or radiating pain to other parts of the body. They can, for instance, trigger:
- Chronic headaches
- Recurring muscle spasms
- Myofascial pain syndrome
Don't Let Knotted Muscles Get in Your Way
Knotted muscles can lead to severe, even long-term pain, particularly if not addressed right away. If resting, hydration, stretching, and massages don't help, and you still feel tight knots, visit your doctor without delay so they can prescribe medications like NSAIDs or combination drugs to help.
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