In my upper back, on the left side, halfway between my neck and shoulder, I have a muscle knot that feels like a small potato. It’s hard, thick, and unmistakable. And it causes me pain. When it acts up, it gets tight and achy and can be ground zero for migraines that can take me down for a day or two.

So what exactly is a muscle knot, and why can they be so miserable?

At the most basic level, your muscles are made of fibers, and they are also layered on top of each other. Most muscles run in different directions from those above or below. To do the work of moving your skeletal structure, your muscles need to be flexible and stay pliant. However, when you continuously use the same position, injure a muscle, or even become chronically dehydrated, your normally elastic muscle layers and fibers start to adhere to each other. This adhesion can feel hard, lumpy, and uneven—a muscle knot.

Beyond just feeling like a lump, muscle knots tend to have a personality in Chinese medicine. Some feel better when you apply ice, and others respond better to heat. Some are painful to the touch, but others feel immensely better being worked with a lot of pressure.

The good news is that Chinese medicine has a number of tools to deal with muscle knots. One of the most important is acupuncture. A particularly effective technique to resolve knots involves gently twisting a needle that has been inserted into the knot to affect the adhered muscle fibers. A series of these treatments can noticeably shrink a knot and relieve pain.

Another technique available through Chinese medicine is called gua sha and involves scraping the skin in the area above the knot. This causes a light bruise-like abrasion that can help soften the knot, stimulate circulation, and promote healing. While gua sha sounds scary and painful, in reality, it’s not; some patients would tell you that it feels good, especially on a particularly difficult knot.

Another method, tui na, is an Eastern form of bodywork that can be helpful in moving the muscle fibers and increasing circulation. Tui na involves various massage-like techniques that manipulate acupuncture points and pathways.

Beyond acupuncture and Chinese medicine, there are some other things you can do if you have stubborn and painful muscle knots.

As for the knot in my upper back, it persists because I get too busy or complacent to take care of it the way I should. I only do something about it when it’s really acting up. Then, when I get a little acupuncture, a couple of massages, and quit hunching over my computer, it calms down considerably.