Q. I have a painful knot at the back of my neck. Please help.

Answered by
Dr. Atul Prakash
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Aug 27, 2020 and last reviewed on: Apr 28, 2021

Hi doctor,

I am a 40-year-old healthy woman with no prior serious health conditions or taking any medications. I occasionally experience bouts of asthma and have recently started to experience some minor arthritis in my right wrist due to playing professional squash in my younger years. I work at my desk 40 plus hours a week and have been known to sit in my bed (in silly positions) while watching some movies on the laptop and occasionally passing out while doing so and waking up with an aching neck or shoulders afterward. After one of these movie sessions, I woke up with a terrible strain in the right side of my upper neck (at the base of my head) in the small hours of the morning, approximately four to five weeks ago. Initially, the pain was overwhelming for a few days afterward, making it difficult to move my head towards the right. Now weeks later, I have pain and strain when manoeuvering my neck to one side or another. My niece tried massaging it for me and said she feels swelling or a knot there, and it seems to run down the neck somewhat. It feels like there is a hard stone back there since and massaging does not seem to relieve it. It is hard to sleep comfortably at night, being a stomach sleeper, and the injury has shown no sign of progress since it took place. I am health conscious and have seen chiropractors in the past, have heard of horror stories, and do not trust so much going in that direction without a proper referral. I have a history of sports injury in the upper shoulder blade area while playing tennis, received chiropractic help for three years, and have not had flare-ups since. I would appreciate it if you could give me some opinions about what you would suggest as a healing regime. Money and time being out towards diagnosis are of no concern to me, so name the price and plan, and I am all ears. I am very interested to hear back from you at your earliest convenience. Do not hesitate to ask me further questions to help me further assess.



Welcome to

You seem to be having cervical spondylosis with neck strain from an abnormal position. The knot you feel is the myofascial knot or trigger spots. This will need to be released with deep massage. Take anti-inflammatory tablets and apply ice and perhaps some pain gels. Give it a week, and if this does not settle down, you will need to search for a physiotherapist with manual therapy interest or a chiropractor. You can ask your general physician to help out with the decision. Thank you.

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