One of the knots in my upper arm has been there, non stop for several years. It came on almost instantly when my RSD moved into my upper arm and shoulder. I have even had botox injections into it to try to get it to loosen up. All the massage, meds etc, and it is still there. I usually use a lidoderm patch on that area, depending if I have one to spare. What I mean by that is, I do a body check in the morning and decide which areas hurt the worse that day, and those are what get the patch. Also if I need to go out that day, and wear a bra, I have to use one under my bra strap on one side. So I have to pick and choose. It does not relieve all the pain, but helps some after a few hours.