Myofascial pain syndrome (MPS) is a musculoskeletal disorder characterized by trigger points and functional limitations. Massage interventions are used in physiotherapy; however, their effectiveness versus conventional physiotherapy remains unclear. To compare the short-term effects of conventional physiotherapy, therapeutic massage, and a combined treatment approach on pain, pressure pain threshold, muscle activity, functional disability, and quality of life in individuals with chronic MPS. In this randomized controlled trial, 60 participants with upper trapezius MPS (31 females, 29 males; mean age 42.20 years) were allocated to three groups (1:1:1): Conventional physiotherapy (Group A), therapeutic massage (Group B), or combined treatment (Group C). Interventions were applied three times per week for four weeks. Outcomes included pain intensity (VAS), pressure pain threshold (PPT), upper trapezius muscle activity assessed by surface electromyography (sEMG), functional disability (NDI), and health-related quality of life assessed using the SF-12 physical and mental component scores, all assessed at baseline and after the 4-week intervention period. Significant time × group interactions were observed for all outcomes (all p < .001; partial η2 = 0.90-0.99). Post hoc analyses indicated that Groups B and C achieved greater reductions in VAS and NDI scores and greater improvements in the SF-12 physical component score compared with Group A (all p < .001), with no significant differences between Groups B and C. In contrast, Group C showed greater improvements in PPT, EMG-rest, EMG-Abd90, and the SF-12 mental component score than both Groups A and B (all p < .001). Therapeutic massage, applied alone or in combination with conventional physiotherapy, may provide greater short-term improvement in pain and function than conventional physiotherapy alone in individuals with chronic MPS. The combined approach may offer additional short-term benefits for neuromuscular and psychosocial outcomes.

Abdominal wall pain syndromes, including anterior cutaneous nerve entrapment syndrome (ACNES), myofascial pain, and muscle strain, account for up to 30% of chronic abdominal pain cases, yet remain under-recognised, resulting in diagnostic delays and unnecessary investigations. We report a case series of five such patients. Management incorporated core strengthening, progressive muscle relaxation, ergonomic modification, neuropathic agents, and ultrasound-guided nerve blocks where indicated; visual analogue scale scores remained <4 at follow-up. A structured diagnostic algorithm is proposed to facilitate early recognition and appropriate referral by gastroenterologists.

Myofascial pain syndrome (MPS) of the cervicothoracic region is a common cause of chronic neck and upper back pain that often shows limited response to conservative therapies. The recently described serratus posterior superior intercostal plane block (SPSIPB) targets the fascial plane between the serratus posterior superior and intercostal muscles and may provide effective regional analgesia. However, its long-term clinical efficacy in MPS has not been systematically evaluated. This study aimed to investigate the effectiveness and safety of ultrasound-guided SPSIPB in patients with unilateral cervicothoracic MPS. This single-center retrospective cohort study evaluated the effectiveness of ultrasound-guided SPSIPB in patients with unilateral cervicothoracic MPS. A total of 75 patients treated between June 2024 and May 2025 were included. Pain intensity (Numerical Rating Scale [NRS]) was assessed at baseline, 1h, 4 weeks, 12 weeks, and 6 months. Functional disability (Neck Disability Index [NDI]) and quality of life (EQ-5D-5L) were evaluated in a predefined subset. A linear mixed-effects model including all available observations was used for primary analysis, with post-baseline co-interventions incorporated as a time-varying covariate. Sensitivity analyses included per-protocol, complete-case, and conservative missing-not-at-random (MNAR) approaches. NRS scores decreased significantly over time, with the greatest reduction observed at 1h and continued improvement at 6 months (adjusted mean change - 2.73, 95% CI - 3.18 to - 2.28; p < 0.001). Clinically meaningful improvement, defined as ≥ 50% reduction in NRS, was observed in 90.7%, 34.7%, and 28.0% of patients at 1h, 4 weeks, and 6 months, respectively. Functional disability improved significantly, with NDI reductions of - 7.83, - 7.37, and - 6.67 at 4 weeks, 12 weeks, and 6 months, respectively (all p < 0.001). EQ-5D-5L scores also improved significantly across all follow-up time points (all p < 0.001). Sensitivity analyses demonstrated consistent findings across all models, including conservative MNAR assumptions. No major complications were observed. Ultrasound-guided SPSIPB was associated with rapid pain reduction and continued improvements in disability and quality of life up to six months in this retrospective cohort. No major complications were documented. These findings support further prospective controlled evaluation of SPSIPB as a potential interfascial approach for cervicothoracic MPS.

Background: Myofascial pain syndrome involving the upper trapezius is a common musculoskeletal problem in adult males and is frequently associated with active trigger points, increased pain sensitivity, and changes in muscle structure. Objective: To compare the effects of dry needling and inhibitory Kinesio taping on pressure pain threshold and muscle thickness in males with upper trapezius myofascial pain syndrome. Methodology: This single-blinded randomized controlled trial included 60 male participants presenting with active trigger points in the upper trapezius muscle. Participants were randomly assigned to three equal groups. Group 1 underwent dry needling, Group 2 received inhibitory Kinesio taping, and Group 3 acted as the control group without intervention. Pressure pain threshold was measured using a pressure algometer, while ultrasound imaging was used to determine muscle thickness. Participants were excluded if they had a previous cervical spine surgery, neurological disease, systemic inflammatory condition, bleeding disorder, or were using anticoagulant drugs. Outcomes were recorded at baseline, on the 5th day after intervention, and again on the 10th day. Descriptive statistics were used for demographic and baseline data. Repeated-measure ANOVA was used to examine changes within groups and differences between groups over time. Results: Both the dry needling and inhibitory Kinesio taping groups demonstrated statistically significant improvements in pressure pain threshold following intervention (p&lt;0.001) and significant reductions in upper trapezius muscle thickness (p&lt;0.05). Both interventions were superior to the control group, which showed no significant changes in either outcome. No statistically significant difference was observed between the two treatment groups. Conclusion: Dry needling and inhibitory Kinesio taping were both beneficial in decreasing pain sensitivity and reducing muscle thickness in males with active trigger points in the upper trapezius. Despite differences in therapeutic approach, both interventions produced comparable clinical effects.

Diagnostic criteria for equine thoracolumbar myofascial pain syndrome: A foundational study.

Myofascial pain of the masticatory muscles significantly contributes to temporomandibular disorders (TMD) and is often associated with impaired function and depressive symptoms. While trigger point injections like dry needling and local anesthetics are common, direct comparisons in the orofacial region are limited. This randomized trial compared the effectiveness of dry needling, lidocaine, and mepivacaine regarding myofascial pain, self-reported TMD symptoms, and depressive symptoms. In this double-blind trial, 75 patients with bilateral active masseter and temporalis trigger points were randomized to dry needling, lidocaine (20mg/mL), or mepivacaine (30mg/mL) (n = 25 each). Interventions were administered weekly for three sessions. Pain intensity (Visual Analog Scale), depressive symptoms (Beck Depression Inventory), and TMD symptoms (Fonseca Anamnestic Index) were assessed at baseline and at a short-term follow-up (one week post-treatment). Two-way repeated measures ANOVA with Bonferroni post-hoc tests evaluated interactions between time and treatment. All interventions significantly reduced pain, depressive, and TMD scores (p < 0.001). A significant time x group interaction was observed for pain intensity (p < 0.001). Mepivacaine achieved the greatest mean pain reduction (5.36), which was significantly superior to dry needling (p = 0.001), whereas no significant difference was found between lidocaine and dry needling (p = 0.226). No significant between-group differences were observed for changes in depressive or TMD symptom scores (p > 0.05). All three modalities effectively reduced myofascial pain and improved psychological outcomes within the short-term observation period of one week. Mepivacaine demonstrated superior short-term pain reduction compared to dry needling. Both local anesthetics represent viable options for short-term myofascial pain management, though studies with longer follow-up periods are required to evaluate sustained effects and comparative advantages. ClinicalTrials.gov, NCT07079449. Registered on July 14, 2025.

Botulinum toxin type A (BoNT-A) has been increasingly investigated as a therapeutic option for myogenous temporomandibular disorders (TMD), yet uncertainties remain regarding the duration of its clinical effects and the relevance of dosing parameters. To systematically evaluate the clinical effects, duration of action, and dosage parameters of BoNT-A in the management of myogenous temporomandibular disorders. This systematic review followed PRISMA 2020 guidelines and was registered in PROSPERO. Electronic searches were conducted in PubMed/MEDLINE, Embase, Scopus, Web of Science, and LILACS. Randomized clinical trials evaluating BoNT-A for myogenous TMD were included. Study selection, data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2 (RoB-2) tool were performed independently. Due to methodological heterogeneity, a qualitative synthesis was conducted. Ten randomized clinical trials were included. Pain was assessed using validated instruments, including the Visual Analog Scale, Characteristic Pain Intensity, and Numeric Rating Scale. Pain reduction over time was reported in both BoNT-A and control groups, including placebo and conservative therapies. In placebo-controlled trials, BoNT-A did not consistently demonstrate superiority over saline injections. Greater pain reductions were reported in studies involving refractory myofascial pain. Improvements in mandibular function were observed in both intervention and control groups. Clinical effects were generally reported to persist for 8 to 24 weeks. Current evidence is insufficient to determine whether a clinically relevant dose-response relationship exists across the evaluated regimens. Adverse events were mostly mild to moderate and transient. Current evidence does not support the routine use of BoNT-A as a first-line treatment for myogenous temporomandibular disorders. Its use may be considered in selected refractory cases after failure of conservative therapies.

To compare the effectiveness of ultrasound (US)-guided superficial dry needling (SDN) and deep dry needling (DDN) in patients with myofascial pain syndrome (MPS) of the upper trapezius muscle. This prospective, single-blind, randomized study included 80 patients with upper trapezius MPS. Patients were assigned to SDN or DDN groups. Under US guidance, needles were inserted into the subcutaneous deep fascia in the SDN group and directly into muscle trigger points in the DDN group. Both groups received a one-week home exercise program. Outcomes were evaluated before and one week after treatment using the numeric pain rating scale (NPRS), neck Bournemouth questionnaire (NBQ), neck disability index (NDI), pressure pain threshold (PPT), and cervical range of motion (ROM). Both groups showed significant improvements in NPRS, NBQ, NDI, and PPT (p<0.001). Cervical ROM improved in flexion, extension, right/left lateral flexion and rotation in the DDN group (p<0.001), but only in flexion and right rotation in the SDN group (p<0.05). Between-group comparisons showed that the DDN group demonstrated more favorable outcomes across all parameters. Both techniques were safe and effective for upper trapezius MPS. However, DDN demonstrated greater improvements in pain, functional status, daily activities, and biopsychosocial outcomes.

Large language models (LLMs) can generate plausible diagnoses from patient symptom descriptions and convey complex medical information in conversational, empathetic language. Given that LLMs may struggle with the vague symptom descriptions characteristic of less healthy mindsets, discordance between LLM and clinician diagnoses might signal misinterpretation of sensations. Among new musculoskeletal outpatients, we studied factors associated with (1) diagnostic discordance between an LLM and a clinician and (2) patient rating of experience interacting with the LLM. One hundred forty English-speaking patients described their symptoms to an LLM prompted to provide a single most likely diagnosis. Clinician diagnoses were recorded after the visit. Patients completed a survey assessing perceptions of the LLM interaction, demographics, and psychosocial factors-including measures of unhelpful thoughts and distress (eg, catastrophic thinking, misperception of pain as necessarily signifying injury, rumination about pain, and fear of losing cherished roles). Linear regression sought associations between personal factors, diagnostic concordance, and experience with the LLM. Discordance between clinician and LLM diagnoses was common 45% (67 of 140), but was not associated with any factors. Discordance often reflected diagnostic ambiguity (eg, knee osteoarthritis and meniscal tear) or clinician use of specific diagnoses for nonspecific symptoms (eg, myofascial pain syndrome, complex regional pain syndrome, and piriformis syndrome). Hispanic ethnicity, unmarried status, lower educational attainment, and lower annual income were associated with more favorable patient-rated experience with the LLM. Clinician use of speculative and ambiguous diagnostic labels may limit the usefulness of LLM-clinician discordance as a signal of patient unhelpful thinking and distress. LLMs may support personal health agency, particularly in the setting of social disadvantage.

Joint hypermobility is associated with connective tissue disorders, hypermobile Ehlers Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorder (HSD). Affected patients have high rates of myofascial pain and mast cell dysfunction, both of which have been associated with genito-pelvic pain. To characterize diagnoses among patients with hEDS/HSD with genito-pelvic pain.gate thematic evolution and collaboration patterns, network visualisation and clustering analysis were carried out. Gynecology patients were evaluated with the 5-point Hypermobility Questionnaire (5HQ), and positive patients underwent additional diagnostic testing for hEDS and chart review. Patients also completed Female Sexual Function Index (FSFI), and Female Sexual Distress Scale (F-SDS) scales. Diagnoses and survey responses were analyzed with descriptive statistics. Of the 44 total patients with a diagnosis of hEDS, 44 (100%) had provoked vulvodynia confined to the vestibule (vestibulodynia). Similar patterns were noted in patients with hypermobile features not fully meeting hEDS diagnostic criteria. Of patients with provoked vestibulodynia, 31.6% (25/79) had posterior vestibular allodynia, suggesting hypertonic pelvic floor muscle dysfunction as the only cause of their vestibulodynia, and 68.4% (54/79) had diffuse vestibular pain, suggesting an inflammatory, neuroproliferative, or hormonal etiology. Hypermobile features are common among patients presenting for genito-pelvic pain.

Myofascial pain syndrome (MPS) is considered highly prevalent in horses, yet it is frequently underdiagnosed due to limited understanding of its clinical presentation and functional consequences, as well as the inherent challenges associated with its clinical assessment and objective measurement. In equines, the relationship between palpation-based MPS indicators, gait asymmetries, and pain-related behaviours during ridden work remains unclear. The primary aim of this study was to evaluate the association between thoracolumbar palpation pain scores and gait asymmetries measured in-hand and during ridden exercise, as well as behavioural indicators of pain assessed using the ridden horse pain ethogram (RHpE). The secondary aim was to explore the effect of a rider on gait asymmetry using a within-horse comparison between in-hand and ridden conditions. Clinical and behavioural signs and demographic variables were also described. Twenty police working horses from the Special Mounted Unit of the Spanish National Police in Madrid were included. At least one myofascial trigger point, identified by a palpable taut band and a hypersensitive spot, was identified in all horses (100%) in the thoracolumbar region, followed by the jump sign (85%) and restricted range of motion (80%). Local twitch responses were not observed in any horse (0%). Clinical indicators of MPS were not associated with objective gait asymmetries measures in either condition. Forelimb push-off asymmetry (HDmax) increased under ridden conditions (β = 0.196, 95% CI 0.028-0.034, p = 0.022). Training level modified this effect, with higher-level horses exhibiting greater increases in HDmax when ridden. The mean RHpE score was 7.2, with 40% of horses scoring ≥ 8 behaviours. The most frequent behaviours were ears rotated back (95%), mouth opening (95%), and intense stare (80%). No significant associations were found between RHpE scores and either MPS clinical signs or ridden gait asymmetries. This is the first study integrating palpation-based assessment of thoracolumbar MPS with objective gait analysis and the RHpE. The findings suggest the importance of palpation as the primary diagnostic approach for MPS in horses and indicate that a multimodal approach may improve the understanding and management of equine MPS.

Temporomandibular disorders (TMD), particularly the myofascial subtype, are common and impair quality of life. Although conservative treatments are effective, limited access and adherence issues highlight the need for alternative approaches such as telerehabilitation. To evaluate the effects of a supervised telerehabilitation program, comparing its physical and psychosocial outcomes with those of a standard home-based exercise program in individuals with myofascial TMD. In this randomized, single-blind trial, 50 individuals with myofascial TMD were assigned to a telerehabilitation (TeleR, n = 25) or a home-based exercise group (HomeEx, n = 25), both following the same 6-week standardized exercise protocol. Outcomes included pain intensity (NPRS, primary), palpation pain, cervical-mandibular range of motion (ROM), TMD severity (FAI), oral habits (OBC), oral health-related quality of life (OHIP-14) and neck disability (NDI); analyses used non-parametric tests and GEE with FDR correction. Significant improvements were found across all outcomes within both groups (p < 0.05, r = 0.72-0.88). TeleR showed greater reductions in pain intensity (p < 0.001), cervical and mandibular ROM except for lateral excursion, and in TMD severity, OBC, OHIP-14 and NDI scores (p = 0.001-0.004). Palpation pain decreased in all muscles in both groups (p < 0.001), with greater improvements in the masseter muscles in TeleR (OR = 1.69-1.82; p < 0.001). Both telerehabilitation and home-based exercise programs effectively improve physical and psychosocial outcomes in myofascial TMD patients in the short term. Telerehabilitation is more effective in reducing pain scores and increasing maximum mouth opening. Long-term clinical studies are needed to confirm the efficacy of telerehabilitation. Registered at ClinicalTrials.gov under the identification number NCT06526845.

Hematopoietic cell kinase activation in skeletal myocytes contributes to local inflammation and pain sensitization in myofascial trigger points.

To characterize unilateral and bilateral masticatory myofascial pain (MMP) in a clinical cohort. Patients meeting criteria for MMP according to the Research Diagnostic Criteria for Temporomandibular Disorders were recruited over a 2-year period. Demographic and clinical date were recorded. Data for unilateral and bilateral pain were analysed using Mann-Whitney U, Kruskal-Wallis H, and Fisher's Exact tests. Variables showing a p < 0.2 were entered into a binary logistic regression model, with pain laterality as the dependent variable. Patients with unilateral pain exhibited muscle tenderness both ipsilaterally and bilaterally, and patients with bilateral pain likewise demonstrated tenderness bilaterally and unilaterally. Unilateral pain was significantly associated with pain-related awakening (p = 0.03), nausea (p = 0.01), and primary pain (p = 0.01). These associations were confirmed in the regression analysis. Patients with unilateral and bilateral pain were similar in demographic characteristics. Unilateral and bilateral masticatory muscle pain differ in three clinical domains. Unilateral pain is significantly associated with pain-related awakening, primary pain, and nausea. The significance of these findings needs further study in a larger cohort. Additionally, the potential relationship between unilateral/bilateral MMP and headache warrants further investigation.

Multidimensional analysis of the clinical spectrum and symptom burden of unexplained myofascial pain.

Patients seeking information about Myofascial Pain Syndrome (MPS), which affects a large segment of the population, are increasingly turning to AI-based chatbots as an alternative to traditional methods. However, the medical accuracy of the content offered by these digital platforms, as well as its suitability to the “grade 6 reading level” standard, which determines its comprehensibility by patients, is a critical point of uncertainty. This study aims to fill this significant gap in the literature by systematically comparing MPS content generated by different AI models using readability indices, reliability, and quality metrics. The 18 most relevant keywords, derived from 25 keywords identified via Google Trends data, were queried using ChatGPT (GPT-5.2), Gemini 3 Flash, and Perplexity (Sonar-4 Large) models. The readability of the generated responses was analyzed using six different indices (FRES, FKGL, GFOG, CLI, ARI, SMOG), while content quality was assessed using GQS and EQIP scales, and reliability using DISCERN and JAMA scales by two independent observers. The responses generated by all AI models examined were found to be statistically significantly more complex than the suggested 6th-grade reading level (p < 0.001). In inter-model comparisons, ChatGPT exhibited the easiest readability [lowest linguistic difficulty] scores, while Perplexity scored significantly higher than both ChatGPT and Gemini in content quality and reliability metrics (JAMA, DISCERN, GQS, EQIP) (p < 0.05). Correlation analysis revealed a strong and positive relationship between quality and reliability parameters. Artificial intelligence platforms have been observed to exhibit high potential in the production of medical information. However, linguistic barriers exceeding sixth-grade reading comprehension, along with reliability limitations of current models, prevent them from replacing professional medical consultation. Perplexity has been found superior in terms of academic quality, while ChatGPT has been found superior in terms of readability. Nevertheless, positioning these systems as complementary “secondary consultation mechanisms” supporting physician oversight in clinical decision-making processes is critically important for patient safety.

Clostridium botulinum neurotoxin (BoNT) is widely recognized for cosmetic facial applications, yet its therapeutic value spans a range of craniofacial and cervical neuromuscular disorders. Despite multiple US Food and Drug Administration (FDA)-approved indications across 4 commercial preparations, a comprehensive synthesis of off-label craniofacial and cervical applications remains limited. This scoping review synthesizes current evidence on off-label BoNT-A and BoNT-B use in the craniofacial and cervical region. A scoping review was conducted using Arksey and O'Malley's framework. Systematic searches of MEDLINE, SCOPUS, and Google Scholar identified English-language US studies published from 1989 to 2025 involving adults ≥18 years. Six reviewers independently screened and extracted data. Fifty-nine studies met inclusion criteria. Of 103 muscles above the thoracic inlet, 63 were clinically relevant for BoNT treatment, and 61 had at least one documented study. BoNT was used to treat 49 conditions, of which 42 (85.7%) were off-label. Consistent therapeutic benefit was reported for cervical dystonia, myofascial pain, headache disorders, facial synkinesis, oromandibular dystonia, palatal tremor, laryngeal movement disorders, ocular motility conditions, and middle ear myoclonus. Treatment response varied by injection technique and musculature. Adverse events were dose- and region-dependent, with transient dysphagia and neck weakness most associated with cervical injections, while facial and intraoral applications were generally well tolerated. BoNT is a versatile, anatomically targeted therapy with broad off-label utility in craniofacial and cervical neuromuscular disorders. With careful muscle selection and condition-specific dosing, BoNT maintains a predictable and manageable safety profile. Standardized protocols and expanded clinical trials are needed to optimize off-label applications in the head and neck.

PurposeTo characterize a patient group with refractory orofacial pain (OFP) at a tertiary pain clinic with emphasis on subtype distribution, comorbidities, sex differences and psychological factors.Patients and MethodsThis retrospective study reviewed 98 consecutive patients assessed at the National Unit of Orofacial Pain, Haukeland University Hospital, Bergen, Norway (2017–2021). All patients were investigated by an interdisciplinary team that used a structured clinical interview and assessments and patients completed a series of standardized questionnaires that formed the basis for the final diagnosis and treatment plan. The International Classification of Orofacial Pain (ICOP-2020) was launched later and therefore retrospectively used forming the basis for this study. Five primary subtypes were analyzed: primary myofascial orofacial pain (pMOP), post-traumatic trigeminal neuropathic pain (PTTNP), persistent idiopathic facial pain (PIFP), trigeminal neuralgia (TN) and burning mouth syndrome (BMS). Secondary MOP (sMOP) was recorded when myalgia co-occurred with another primary diagnosis. Descriptive statistics, χ2-tests and one-way ANOVA was performed.ResultsThe most frequent diagnosis was pMOP (60.2%), followed by PTTNP (20.4%), PIFP (14.3%), TN (4.1%), and BMS (3.1%). Twenty-five patients had more than one diagnosisa(aPercentages do not sum to 100%. A total of 25 patients with overlapping diagnoses, including 23 patients with secondary MOP and 2 patients with dual primary diagnoses.). Significantly more women (82.6%) had OFP (p<0.05). Patients with pMOP experienced longest mean pain duration (9.9 years) and reported comorbidities such as body pain, headaches and arthritis more frequently than non-MOP groups (p < 0.05). sMOP was present in 75% of PTTNP cases (p = 0.0038). Psychometric and functional measures varied across subtypes: patients with pMOP exhibited the highest scores on HADS (15.3), MFIQ (14.4), and RS (7.0).ConclusionRefractory OFP is dominated by pMOP and female patients. The strong association between PTTNP and sMOP suggests early combined management of neuropathic- and muscle pain which may limit chronification. Together, our findings support a personalized, interdisciplinary approach to OFP that can improve diagnostic precision and optimize long-term patient outcomes.

The occurrence of shoulder or neck pain in overhead sports is nontraumatic because of chronic overuse, biomechanical variability, and repetitive impaired techniques adapted during the performance. Myofascial Pain Syndrome (MPS) is of both acute and chronic types and is caused by repetitive movements, microtrauma to muscle fibres, and faulty postures. MPS can cause pain, decrease the Range of Motion (ROM), and influence the Overhead Athletes' (OA) performance. The present study aimed to estimate the prevalence of MPS among OA with neck and shoulder pain. A prospective, cross-sectional study was conducted on OA. A total of 370 OA aged between 18 and 35years, students at a recognised college practising 4-5days a week and participating in at least a university-level competition were screened. Athletes suffering from neck and shoulder pain were included. OA with recent injuries, fractures, surgeries, and other neck and shoulder pathologies were excluded. MPS was diagnosed with Travel and Simon's criteria. Pain and pressure pain threshold (PPT) were evaluated. Among 345 OA with neck and shoulder pain, 86% of them were diagnosed with MPS. Most people had trigger points (MTrPs) in the Trapezius muscle (73%) and Infraspinatus muscle (42%), followed by Biceps brachii (22%), Deltoid (18%), Pectoralis major (17%), Sternocleidomastoid (16%), and Levator scapulae (14%). The PPT values of the muscles with the MTrPs were significantly lower on the left side compared to the right side. MPS is highly prevalent (86%) among overhead athletes with neck and shoulder pain.

Nociplastic pain, characterised by altered central pain processing, is associated with increased healthcare utilisation. This study investigated the relationship between nociplastic pain, based on clinical diagnoses of fibromyalgia, chronic pain, or myofascial pain, and hospital outcomes in patients. A retrospective cohort study was conducted using hospital records of hospitalised patients. Patients aged ≥18 years with a diagnosis of fibromyalgia, chronic pain, or myofascial pain were classified as the research group, while a comparison group of hospitalised patients without these diagnoses was selected. Outcomes included length of stay (LOS) for the index hospitalisation, recurrent hospitalisations within 6 months, Opioid use disorder (OUD), and 5-year mortality. Statistical analyses included t-tests, Wilcoxon tests, linear and Poisson regressions, adjusting for age and sex. Of 18,393 patients, 3,326 (18.1%) were in the research group. The research group was older (mean age 62.35 vs. 50.57 years, p<0.001) and had a higher proportion of females (72.7% vs. 56.6%). Adjusted analyses showed longer LOS in the research group (mean 6.89 vs. 5.59 days, p=0.002), higher recurrent hospitalisations (p<0.001), and increased OUD (87.5% of cases in the research group, p<0.001). Surprisingly, 5-year mortality risk was lower in the research group (HR 0.523, p<0.001). Nociplastic pain diagnoses are associated with prolonged hospitalisations, increased readmissions, and OUD, but lower long-term mortality. These findings highlight the need for targeted pain management strategies.