Do you have knots in your shoulders?  Do you have headaches?  Did you know they can definitely be related?

Here’s a question from a reader:

I’ve been suffering with awful headaches for years now.  I have what i call “knots” in my neck, upper back, shoulder blade area, and shoulders.  All of this is on my right side.  I’ve been to many doctors, I’m in physical therapy right now, and nothing has helped.  I’m looking for exercises that I can do to break up these “knots”.  The headaches are becoming unbearable.  They start at the base of my skull and radiate through my head, into the front of my face.  On top of this,  I was just diagnosed with severe thoracic outlet syndrome on my right side.
I can’t wait to feel like myself again.
Please help.

Here’s my answer:

I feel you.  I do not think there is anything that interferes more with life than head pain.  Here are my best long distance thoughts.

The thoracic outlet syndrome (TOS) is related to your headaches.  The muscles that are causing the TOS are the same that are part of the cause of your headaches.  You may need a massage therapist to help you relax the muscles that are causing these headaches and knots in your muscles.  I will also give you self-help ideas.

The reason you have the headaches is because trigger points in your upper shoulders and neck are ‘firing’ pain into your head.  Those muscles are ‘tight’ and complaining due to shortened muscles in your chest or your lower back on your right side.  The shortened muscles pull on your shoulder and back muscles and cause them to complain and develop trigger points.

But the real problem–the real cause–starts in the shortened muscles in the chest and side of your armpit.  (In a nutshell.)

So why did those muscles get short?

Well, the problem is usually posture.  From your symptoms, I KNOW your pain is related to your posture.  Bodies are logical and work in specific ways.  If this happens, then a result will happen.  In your case, the result is pain.

But that’s okay.  Why?  Because this is muscle-related and muscles are treatable!  🙂

If you go to a massage therapist be sure to interview that person first.  Here’s how:  This link will take you to several articles about how and why massage works and what to expect.  One of the older articles will explain how to interview a massage therapist.

And you will find lots of other articles I have written about upper back pain and knots in your back right here at Simple Back Pain Relief.

Here are some self-help ideas for right now:

1.  Use ice massage or cold packs on your upper shoulders and the back and sides of your neck.  A bag of frozen peas or corn works fine.

2.  Lie on your back.  Do this on the floor if you can.  Do you see how your right shoulder is farther from the floor?  That means the muscles in the front of your shoulder are short.  Try to press your shoulders to the floor.  This movement helps strengthen the muscles in your upper back and it also stretches and lengthens the short chest muscles.  Do it only a few times so you don’t get soreness from over-exercising those muscles.  They will get stronger and you can do more and more of these shoulder presses over time.

3.  Look in the mirror.  Is your right shoulder is lower than the left?  If so, that means the muscles next to your armpit in back and along that side of your back are also short.  They need to be lengthened.  Side stretches will help.

4.  There is a blue book on the right hand side of the page at  It is a self-help book for trigger points.  It is easy to read and to do.  I really like it.  You can click on it to order a copy or ask your local librarian to order it for you but it’s a great reference to have at home and you will use it a LOT!

Since you are seeing a physical therapist, if it is difficult to do the side stretches with your arm raised over your head, ask for assistance.  It’s okay to stretch both sides of your body but the short side needs to be stretched 4x as much as the unaffected side.  That is what allows change to occur–stretch the short side 4 times as much.

You used to feel well and I believe you will feel well again.  You have a smart body.  It just needs a little help from you right now.

Everything in your body is attached to everything else.  When you have knots in your back, that is a symptom.  Head pain is another symptom.  Symptoms mean there are muscles, habits or postures that need some care.

You can get rid of the knots in your back and your headaches at the same time.  🙂


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2 Comments on Do Knots In Your Upper Back Also Cause Headaches?

  1. Josh Petersen says:

    Did this ever help you or have you resolved it? My wife seems to be going through the EXACT same thing.. we can’t find relief…

  2. Hi Josh,

    Yes, I sure have had bad headaches caused by muscles knots in my shoulders. Please follow the suggestions in the article.

    I am very biased about the value and benefits of massage. BUT you have to find a therapist who actually can make a difference. Most of them do lovely relaxation massages but that’s not what your wife needs at this time.

    If you can afford a therapist look for one who does Neuromuscular Massage Therapy (NMT.) My favorite instructor of that type of therapy is Paul St. John. He’s in Florida but if you can’t go to him or one of his staff ( ) look for someone who does that work in your area. And interview them! If someone has never had a headache my feeling is they don’t quite understand as well as someone who has had them and has been through this.

    The blue book that I refer to in the article will be a huge help if you have to do it yourself and it doesn’t cost much. There are also trigger point self-help books specifically for migraines and headaches. The key is to get a trigger point book. Otherwise it is just conventional medical advice and conventional medicine usually overlooks the roles of muscles in head pain.

    There are several things that can cause migraines and head pain. They include certain foods and beverages, posture, aspartame (if she eats or drinks anything with aspartame or other artificial sweeteners she should stop right now!) and hormones.

    The only thing that isn’t controllable is the hormones but if you can get rid of the rest of the causes, even the hormonal headaches a couple of times a month will be less severe.

    The muscles in the upper back don’t need to be treated gently. Thoughtfully but not gently. When muscles are tight and knotty they will feel tender. They may feel very tender. That’s how you know you are in the right place. If you just rub nicely it won’t help. If you press, pinch or massage too deeply, it’s too painful and the body won’t respond as well.

    I cannot see what your wife looks like but here are my best long distance thoughts: She needs to correct her posture when standing, walking, sitting, working and sleeping. If she lifts her breastbone and the crown of her head that will help get her head back where it belongs.

    And I KNOW that’s hard when you are hurting! And her tight muscles in front are going to keep trying to pull her forward again.

    A muscle therapist can help release the muscles that are keeping her in a forward head posture. It’s just more dedication and work if you have to do it yourself.

    I used to have horrible migraine headaches. Here’s what helped me most:

    1. Extensive bodywork (massage) to straighten me out. I had a side to side curvature in my spine (scoliosis) and probably had about 10-12 hours of Neuromuscular Massage by Paul St. John. (My curve was caused by a leg length difference which was caused by a flat arch.) The treatment was to work deeply into the structural muscles to let them go back to normal resting lengths. This is not comfortable but you feel such a sense of relief afterward.

    2. Changing my diet to eliminate all of the potential causes: nuts, pork, caffeine (which is in lots of headache medications), chocolate, peanuts and some other trigger foods. Sometimes it’s easy to see the food tie-in but sometimes it’s not. Look online for a list.

    3. Making my leg length even with orthotics in my shoes.

    4. Working on having a strong back side from knees to base of the head. That helps keep my head over my shoulders where it belongs. That takes the strain off the muscles in my upper back.

    I hope this helps you help your wife get rid of her headaches. There are reasons for the knots in her back. Gotta get rid of the reasons for the muscle knots and that will help get rid of the headaches naturally.

    The Pain Relief Coach