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Answer Wiki. Some knots can come out within a couple minutes. Others never come out. I've had extreme back and neck pain for the past year and a half, most of it just tension in my muscles. I've had numerous massages, taken other treatment, all to no avail.
In many cases the knot in the muscle is caused by an abnormal nerve message being sent to the muscle. The abnormal nerve message is, in turn, caused by a misaligned bone in the spine that irritates the nerve. To keep it simple.