Don’t you hate it when a muscle in the middle of your back cramps up, creating a knot of hot pain? You long to rub away the agony, but unless you’re as flexible as an acrobat, the tender spot is impossible to reach.

After suffering for several days from such a knot smack-dab between my shoulder blades, I called Donald O. Miles, PhD, LMT, a licensed massage therapist with Fitness Plus, a service of Saint Francis Medical Center in Cape Girardeau, Missouri, to discuss why this kind of knot forms…and more importantly, how to get rid of it.

Dr. Miles told me that such cramps often are the result of “muscles overreacting to try to protect you from whatever stress you are under”—whether that stress is emotional or physical (for instance, the result of sitting too long in one position). The muscle fibers, which normally are stretchy, temporarily lose their pliability and clench up. This cuts off circulation, depriving the tissue of needed nutrients and oxygen and leading to pain.

Massage techniques and other tactics can help disperse tension from muscle fibers and promote healing by restoring circulation to the affected area. To release a hard-to reach knot in your back, try the following…

Tennis-ball tip: Place a tennis ball inside the toe end of a long sock. Grasping the open end of the sock, toss the ball over one shoulder and stand with your back close to a wall. Lean backward so the ball is pressed between you and the wall, positioned directly against the sore spot. Maintain as much pressure as possible for as long as you can stand it—though that may be only a few seconds to start, Dr. Miles said. Rest for a moment, then repeat several times. Use the technique as needed throughout the day.

Candy-cane cure: For more precise control, Dr. Miles recommended the Thera Cane Deep Pressure Massager (, $39.95), which is shaped like a two-foot-long candy cane with several projections that allow for a firm grip and various self-massaging options. Experiment to determine the specific positions and degrees of pressure that bring the most relief.

Hot-and-cold healing: Between your self-massage sessions, wrap an ice pack in a towel and lie on top of it so that the sore spot is in contact with the ice pack (but don’t let your skin get uncomfortably cold). Or try alternating the ice pack with a warm pack, such as a hot water bottle or heating pad, at intervals of 15 minutes or less. The ice brings relief by numbing the area, while the heat relaxes the contracted muscle and improves circulation. Repeat the sequence three times throughout the day, Dr. Miles suggested.

Get-up-and-go: You probably don’t feel like moving much when your back is causing you pain, but staying stationary may only exacerbate the muscle cramp. So rather than sitting (or lying) around for hours on end, get up at least every hour and walk around…shrug and roll your shoulders…and gently stretch your neck and arms.

If symptoms persist: See a professional massage therapist. Ask your doctor for a referral or check the Web site of the American Massage Therapy Association at