What Causes Painful Muscle Knots
Dr Hannah Row Breaks downs the science into understandable English

Chronic stress Research also suggest that stress influences the nervous system, by closely interacting with the immune system. Just as hypersensitive nerves trigger inflammation in the area of myofascial trigger points, stress can activate this process, leading to a cycle of heightened nerve sensitivity and inflammation. Chronic pain conditions often arises from ongoing stress, which perpetually activates the “fight-or-flight” response of the sympathetic nervous system. This continuous activation lowers the brain and spinal cord’s pain response threshold, making us more sensitive to pain and more reactive to areas signaling muscle injury. On the brighter side, leveraging the power of the vagus nerve, a key component of the parasympathetic nervous system, has shown promise in reducing inflammation and managing chronic pain conditions such as fibromyalgia, chronic pelvic pain and headache. Studies using non-invasive vagal nerve stimulators have showed decreased inflammation and pain sensitivity in various chronic pain conditions. This supports the idea that these conditions are related to a constant “fight or flight” state. While our understanding of myofascial trigger points continues to evolve, it's evident that a complex interplay of physical and nerve-related factors contributes to myofascial pain. In future blogs, we'll explore how our knowledge of hypersensitive nerves can aid in pain management. Meanwhile, prioritize your sleep and minimize stressors for a healthier, pain-free life.   References: Smith M. Sex differences in measures of central sensitization and pain sensitivity to experimental sleep disruption: implications for sex differences in chronic pain Sleep. 2019, 42 (2):209. https://doi.org/10.1093/sleep/zsy209. Meade, E.; Garvey, M. The Role of Neuro-Immune Interaction in Chronic Pain Conditions; Functional Somatic Syndrome, Neurogenic Inflammation, and Peripheral Neuropathy. Int. J. Mol. Sci. 2022, 23 (15):8574. https://doi.org/10.3390/ijms23158574. Chakravarthy, K. Chaudhry, H. Review of the Uses of Vagal Nerve Stimulation in Chronic Pain Management Curr Pain Headache Rep 2015.19:54. DOI 10.1007/s11916-015-0528-6