Here’s how to get rid of a knot in your lower back

If you’ve ever felt like you had a really tight or hard spot in your lower back, you more than likely had a muscle knot — a tight, sensitive spot that feels like a small bump or nodule. Muscle knots can occur anywhere in your body, but your lower back is especially vulnerable to carrying tension, due to sitting for extended periods and holding stress in this area.   

“When a muscle is overloaded, its fibers can become disorganized, leading to tight spots or lumps,” says Melissa Marek, PT, DPT, a physical therapist at Hinge Health. “Muscle knots can cause tightness and discomfort that affect daily activities, from lifting and bending or gardening to playing sports and even sleeping.”

While muscle knots can be painful, they’re not dangerous. “They often signal that a muscle is overworked, tight, and irritated,” says Dr. Marek. Imagine one family member doing all the household chores alone — it understandably leads to frustration and crankiness. 

“Most muscle knots are easy to treat,” Dr. Marek says. Regularly moving your body, including performing targeted exercises and stretches, can help ease irritation and release muscle knots.

Read on to learn more about how to get rid of a knot in your lower back, including exercises recommended by our Hinge Health physical therapists.

What is a knot in your lower back?

A knot in your lower back can feel like a tight spot or tender area along your spine and just above your sacrum, or the triangular bone that sits at the base of your spine. This can happen when the muscles in that region become overworked and tense, leading to discomfort. Muscle knots, also sometimes called trigger points, are focused areas of tension. This sets them apart from other types of muscle soreness or pain, which might feel more widespread.

“Muscle knots are your body’s way of telling you that it needs more care and attention in this area to get back to feeling its best,” Dr. Marek says.

What causes knots in the lower back?

Knots can develop in the lower back for various reasons. Common causes include:

• Overdoing it. Doing too much lifting, bending, or twisting when your body isn’t ready can overload your lower back muscles, leading to muscle knots. Jumping into an intense workout program can have a similar effect. Even tasks you might be used to, like yardwork or household chores, can overwork muscles when you spend hours doing it.

• Repetitive motions. Tasks that involve repeated motions, such as frequently turning or rounding your back, can lead to muscle imbalances and overuse, resulting in tightness and tension.

• Muscle imbalance. “If your core or glutes are weak, your back muscles have to work harder to pick up the slack while lifting weights, playing sports, or doing chores,” says Dr. Marek. This extra effort can lead to tension and discomfort in the lower back, making those muscles more prone to knots.

• Holding the same position for too long. Staying in one position, whether you’re standing or sitting, can lead to tension and stiffness in your lower back, which can turn into a muscle knot. Regularly switching positions and performing gentle movements throughout your day can help keep your back feeling comfortable and at ease, Dr. Marek says.

• Carrying emotional tension in your upper body. When you’re feeling anxious or overwhelmed, you’re more likely to tense up. While the upper back and neck are often affected, stress-induced tightness can also develop in the lower back.

• Injuries or other conditions. Strains and sprains, or conditions like arthritis, sciatica, and spinal stenosis can increase tension in lower back muscles, setting the stage for knots.

Symptoms of knots in lower back

Muscle knots can be large or small. Some knots only feel tender when you apply pressure while others may constantly ache. Common symptoms of lower back knots include:

• A hard lump in a low back muscle 

• Pain specific to one spot

• Pain that radiates to other areas

• Sensations ranging from sharp pain to a dull ache

• Pain that worsens with certain movements, positions, or activities

• Stiffness or reduced range of motion

• Difficulty performing daily activities like bending, lifting, twisting, or getting comfortable to sleep

These exercises stretch and strengthen key muscles supporting the lower back to reduce tension and improve range of motion in your lower body. When you feel tense in your lower back, try performing all of these moves to help ease pressure and reduce pain. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for knot in lower back

In addition to ‌doing strengthening and stretching movements, getting a massage, using a foam roller, and applying heat to tense muscles can all help relieve a knot in your lower back.

• Try physical therapy and targeted exercises. Targeted exercises like those above, can help break up tension in and around your lower back, which can alleviate pain. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stretch regularly. Engaging in gentle stretches can improve blood flow and relieve tightness, helping muscles relax and ease tension.

• Strengthen your core. A strong core can support lower back muscles that are prone to knots. While strength training won’t provide immediate pain relief, it can help prevent muscle knots (and certain injuries) in the future. 

• Take a walk. Walking boosts blood circulation, warms muscles, and reduces stress, making it a great way to ease back tension and discomfort.

• Apply heat. Heat increases blood flow to sore and tense areas, helping muscles relax and heal. You can apply heat therapy by using a heating pad, or by taking a hot shower or bath, for example. 

• Get a massage.  A trigger point massage specifically targets muscle knots, but deep tissue and sports massages also involve kneading out muscle tension, which may help release knots.

• Use a foam roller. Rolling over tight areas can help release tension. For deeper relief, consider using a tennis or lacrosse ball.

• Add Epsom salts to a bath. In addition to the soothing effects of soaking in a warm bath, Epsom salt contains magnesium sulfate, which may help muscles relax.

• Stay hydrated. Drinking water helps muscles function properly, which can prevent tension and discomfort.

• Take deep breaths. When you feel stressed, consider taking a break to do some deep breathing exercises. Lowering stress levels can help relax ‌all of the muscles in your body.

PT tip: Find a comfortable position

Try these two positions to see which one makes your back feel less tight. You might find that one position feels better than the other. “If you find relief with one, practice it a few times a day or before bed to help relax your back and improve your comfort for sleep,” Dr. Marek says.

Option 1: Lie on your back with your legs elevated so your knees are above your hips and bent at 90 degrees. You can do this by placing your feet on a chair, against the wall, or using pillows to support your legs. Breathe deeply for a few minutes, observing how your pain or discomfort feels. 

Option 2: Flip over and lie comfortably on your belly with your legs straight behind you, with your heels naturally falling out to the sides. You can stack your hands, resting your forehead there. Relax for a few minutes, breathing deeply and paying attention to how your lower back feels.

“See which one helps reduce your pain,” says Dr. Marek. Practice your diaphragmatic breathing while lying in either position to enhance the effect.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Shipton, B., Sagar, S., & Mall, J. K. (2023). Trigger Point Management. American Family Physician, 107(2), 159–164A. https://www.aafp.org/pubs/afp/issues/2023/0200/trigger-point-management.html

2. Guzmán-Pavón, M. J., Cavero-Redondo, I., Martínez-Vizcaíno, V., Fernández-Rodríguez, R., Reina-Gutierrez, S., & Álvarez-Bueno, C. (2020). Effect of Physical Exercise Programs on Myofascial Trigger Points–Related Dysfunctions: A Systematic Review and Meta-analysis. Pain Medicine, 21(11), 2986–2996. doi: 10.1093/pm/pnaa253

3. Sitthipornvorakul, E., Klinsophon, T., Sihawong, R., & Janwantanakul, P. (2018b). The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials. Musculoskeletal Science & Practice, 34, 38–46. doi: 10.1016/j.msksp.2017.12.003

4. Wilke, J., Vogt, L., & Banzer, W. (2018). Immediate effects of self-myofascial release on latent trigger point sensitivity: a randomized, placebo-controlled trial. Biology of Sport, 35(4), 349–354. doi: 10.5114/biolsport.2018.78055