Normal anatomy: This is a very frequent question and for most patients, the "knot" at the base of the neck is normal anatomy - the spinous processes of C7 and t1 are larger than the adjacent spinous processes, which gives the illusion of a knot. Patients never notice that until they start having pain and reach back there. Your smaller knot may very well be a spinous process also. See an md if symptoms persist.
Answered 2/13/2015
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