Trigger points, often called “knots” are tight bands of muscle fibers that can be a common and significant source of pain. They can essentially occur in any muscle of the body but are more commonly seen in the neck and upper back. When palpated, a trigger point can refer pain to a larger area than one would expect. For example, a trigger point on the upper portion of the trapezius muscle may refer pain to the neck or into the shoulder. This characteristic differentiates a trigger point from a tender point, which causes pain only at the point of tenderness. Pain from trigger points can be confused with radiating nerve pain, and much be considered in diagnosis. Trigger points are the result of overuse or overloading and can feel like a restriction in range of motion as well. For persistent trigger points, a local injection of a short acting anesthetic can temporarily “calm” down the pain, and this, coupled with deep tissue techniques and stretching, can resolve over time.