Massage Therapy Trigger Points for Knots in the Neck and Back

Trigger points are small, painful, tight nodules of muscle fibers buried in muscles. They contribute to chronic muscular pain, which in turn leads to joint pain and stiffness. Trigger points keep muscles tense and weak at the same time. Because muscles with trigger points are tense, there is stress on each end of the muscle, spreading the pain out over a larger area. Fortunately, trigger point massage can provide relief.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.


First walk your fingers or thumbs over the painful muscle, searching for the most painful spots. Often you will feel a tight little band of muscle cells about the size of a pea. When you find a trigger point, press into it with moderate pressure and hold the point while you slowly breathe three or four times. You should feel the pain and tightness dissipating. Then search for satellites -- other trigger points clustered near the first one. Hold each one for three breaths or until it starts to dissipate. Once you have found and pressed on all the trigger points, finish with gentle stretching exercises.


Trigger points in the neck are typically found along the base of the skull. Press your finger tips into the center of the base of your skull, over the spine. Then move sideways toward your ears in 1/2-inch increments. When you find a sore spot, press into it and hold it while you rock your head forward and backward over the tip of your finger. Continue until the pain in the point reduces and then search for satellites near that point. Pressing trigger points while moving your muscles helps to relax the muscle. After you work along the base of the skull, work your way down the back of your neck.

Upper Back

Look for a large trigger point on the top of your shoulder near your neck. Press into the trigger point with your fingers and hold it while you turn your head from side to side. When you find a movement that really stretches the trigger point and "hurts good," repeat the stretch several times while you continue to hold the point. Trigger points on the upper back are also typically found across the top of your scapula -- shoulder blade -- and along the middle edge near the spine.

Lower Back

Trigger points on your lower back are typically found along the waist. Search for trigger points along the waist with fingers, thumbs or knuckles. When you find a trigger point, press into it and hold it while you stretch and relax your low back. As you work from the middle out to your sides, twist your low back from side to side as if you are looking over your shoulder.


While it is all right to look for trigger points on the back and sides of your neck, don't press hard on the front of your neck where more delicate structures such as your carotid arteries, thyroid and cervical cartilage are found. It is safe however, to work trigger points under your chin along the jaw line.