Trigger Point Pain Research Articles

Trendelenburg Gait Improved by Trigger Point and Scar Tissue Lidocaine Injections: A Case Report

This case report describes a 74-year-old Caucasian female patient who presented with bilateral gluteus muscle trigger point pain, decreased gluteus medius strength, a substantial transverse abdominal scar, and a history of knee replacement culminating in a Trendelenburg gait and chronic pain. Treatment of the patients' symptoms with lidocaine solution injections, known as neural therapy, into the bilateral gluteus muscle trigger points and along scar tissue facial planes yielded markedly improved gait and immediate resolution of trigger point pain.

EFFECT OF RECIPROCAL INHIBITION WITH ISCHEMIC PRESSURE ON THE TRIGGER POINT OF QUADRATUS LUMBORUM MUSCLE IN LOW BACK PAIN.

BACKGROUND AND AIM Quadratus lumborum trigger points developed in low back pain. The aim of this study was to compare Reciprocal Inhibition with Ischemic Pressure on the Trigger Point of Quadratus Lumborum muscle in Low Back Pain. METHODOLOGY A 6 month randomized controlled trial was conducted. Non probability Convenience sampling was used to select a sample 50 participants having low back pain with Quadratus lamborum trigger points placed into group1 and group 2 by lottery method. Group 1 was treated with reciprocal inhibition and ischemic pressure along with conventional therapy and group 2 was treated with ischemic pressure along with conventional therapy. The data collection tools were Numeric pain rating scale and Goniometer. Data was analyzed by statistical package for social science 21. Independent t-test used for between comparison analysis and Paired t-test was used for within analysis. RESULTS The numeric pain rating scale mean difference in group 1 and group 2 was 4.72±0.12, 5.13±0.13 respectively. The Quadratus lamborum muscle length mean difference in group 1 and group 2 was 8.95±1.67, 5.34±1.25 respectively. CONCLUSION The addition of reciprocal inhibition with ischemic pressure showed significant results. KEY WORDS reciprocal Inhibition, ischemic pressure, quadratus lumborum, Back Pain, Myofascial Trigger Point Pain, Articular Goniometry, range of motion

Physiotherapy in Musculoskeletal and Sports conditions: AB No: 180: Effects of Static versus Dynamic Myofascial Decompression on Gastrosoleus Muscle Power and Latent Trigger Point Pain

Physiotherapy in Musculoskeletal and Sports conditions: AB No: 180: Effects of Static versus Dynamic Myofascial Decompression on Gastrosoleus Muscle Power and Latent Trigger Point Pain

Trigger point injection for post-mastectomy pain: a simple intervention with high rate of long-term relief

Post-mastectomy pain syndrome (PMPS) is a common and often debilitating condition. The syndrome is defined by chest wall pain unresponsive to standard pain medications and the presence of exquisite point tenderness along the inframammary fold at the site of the T4 and T5 cutaneous intercostal nerve branches as they exit from the chest wall. Pressure at the site triggers and reproduces the patient’s spontaneous or motion-evoked pain. The likely pathogenesis is neuroma formation after injury to the T4 and T5 intercostal nerves during breast surgery. We assessed the rate of long-term resolution of post-mastectomy pain after trigger point injections (2 mL of 1:1 mixture of 0.5% bupivacaine and 4 mg/mL dexamethasone) to relieve neuropathic pain in a prospective single-arm cohort study. Fifty-two women (aged 31–92) who underwent partial mastectomy with reduction mammoplasty or mastectomy with or without reconstruction, and who presented with PMPS were enrolled at the University of California San Francisco Breast Care Center from August 2010 through April 2018. The primary outcome was a long-term resolution of pain, defined as significant or complete relief of pain for greater than 3 months. A total of 91 trigger points were treated with mean follow-up 43.9 months with a 91.2% (83/91) success rate. Among those with a long-term resolution of pain, 60 trigger points (72.3%) required a single injection to achieve long-lasting relief. Perineural infiltration with bupivacaine and dexamethasone is a safe, simple, and effective treatment for PMPS presenting as trigger point pain along the inframammary fold.

Investigation of Effectiveness of Two Different Kinesiotaping Techniques in Myofascial Pain Syndrome: An Open-Label Randomized Clinical Trial

Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by trigger points. Although there are widely accepted treatment modalities, there is no gold standard treatment. Kinesiotaping represents an interesting modality in the treatment of musculoskeletal disorders and attracts attention with studies emerging in the recent years, but in spite of the proposed benefits of kinesiotaping, its efficacy is still unclear, thus further studies evaluating the effectiveness of kinesiotaping are needed. We aimed to investigate, not only the effectiveness of kinesiotaping applied with the space correction and muscle inhibition techniques (compared to the home exercise program in reducing pain and improving functional status and quality of life in female patients with myofascial pain syndrome related to active trigger points in the upper trapezius), but also to evaluate the superiority of the 2 techniques over each other. An open-label randomized clinical trial with a parallel assignment intervention model. The physical medicine and rehabilitation clinics in Istanbul University, Istanbul Faculty of Medicine. Seventy-one female patients with the complaint of pain in the upper trapezius region, diagnosed with myofascial pain syndrome, and having at least one active trigger point in the upper trapezius fibers, were randomly assigned by a computer program to 1 of the 3 groups: kinesiotaping with the space correction technique (KSCT, n = 20), kinesiotaping with the muscle inhibition technique (KMIT, n = 24), and the home exercise program alone (control group [CG], n = 27). The patients were evaluated by the numerical rating scale for pain intensity, the neck disability index for functional status, and the 36-Item Short-Form Health Survey for quality of life in the beginning of the study and at the first, second, and sixth weeks (1-month follow-up). Kinesiotaping was associated with lower pain intensity levels (P = 0.019 at the first week and P = 0.026 at the second week) and better functional status (P = 0.011 at the second week) and it was effective in increasing quality of life by improving physical functions and general health (P = 0.033 and P = 0.003 at the second week, respectively) earlier than in the CG. Role limitations due to physical factors improved in the KMIT group earlier than in the other groups (P = 0.022 at the second week). Being performed in a limited number of female patients only, absence of a placebo group, and lack of blinded assessments. Both kinesiotaping methods were associated with lower pain intensity levels and better functional status and were effective in increasing quality of life by improving physical functions and general health earlier than the home exercise program. There was no significant difference between the kinesiotaping methods, except for role limitations due to the physical factors domain of SF-36 which was improved in the KMIT group earlier than in the KSCT group and CGs.

AB0715 THE PREVALENCE OF FIBROMIYALGIA IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER AND THE RELATIONSHIP BETWEEN FATIGUE AND QUALITY OF LIFE

Background:Familial Mediterranean Fever (FMF) can cause various muscle diseases. Because it is a chronic auto inflammatory disease, painful trigger points may be encountered in the examination due to a decrease in the pain threshold (1-3).Objectives:The aim of this study was to determine the prevalence of Fibromiyalgia in patients with FMF, at the same time to identify the relationship between fatigue and quality of life.Methods:Sixtyseven patients (38 female, 29 male) with FMF were enrolled in the study. They were diagnosed with FMF based on the Livneh diagnostic criteria (4). Fibromyalgia involvement of the patients was evaluated according to the Fibromyalgia Impact Questionnaire (FIQ). Patients with diagnose with other chronic disease were excluded. Fatigue Severity Scale (FSS) was used to evaluate fatigue. Quality of life was evaluated with Short Form-36 (SF-36).Results:Respectively, the mean age, disease duration and body mass index were 34.46±12.69 years, 12.66±7.86 years and 24.96±5.42 kg/m2. In addition, 65% of the patients had no rheumatic disease in their family history. The mean of scores of FIQ was 38.66±25.14, the mean of FSS was 38.07±17.56, the mean of SF-36-PCS was 45.55±10.54 and SF36-MCS was 30.93±17.39. Patients were categorized as mild (n=28), moderate (n=24) and severe (n=15) affected according to their FİQ score. The relationships of scores of FIQ, FSS and SF-36 were demonstrated Table 1.Conclusion:Fibromyalgia symptoms can be seen in FMF. According to our results, it has been shown that patients with moderate and severe symptoms have increased fatigue levels and decreased quality of life. In the light of these results, we can say that also the fibromyalgia symptom of patients with FMF should be considered in the treatment.

Effectiveness of blood irradiation by modified intravenous laser (ILIB) on the clinical parameters of fibromyalgia

Pain control remains an urgent task. If the goal is to achieve permanent pain relief and not temporarily mask the pain (masking the pathology), then that goal can only be achieved by treating the pain with physiotherapeutic methods, the most universal and effective of them is low-level laser therapy intensity (LLLT). Treatment methods vary fundamentally in the case of neuropathic pain (nonspecific, primary), which includes pain with trigger point (PT) and nociceptive (specific, secondary) pain, which includes all types of pain resulting from trauma, inflammation, etc. When treating patients with fibromyalgia (FM), which is a chronic condition with high worldwide prevalence, auxiliary therapies have been indicated for the treatment of fibromyalgia including low-level laser. Currently, the low intensity laser has been attached to a bracelet over the radial artery, in order to irradiate blood cells, using a technique called modified ILIB (Intravascular Laser Irradiation of Blood), with improved control of fibromyalgia, of chronic inflammatory processes. This study evaluated the effectiveness of the modified ILIB in improving the clinical parameters of fibromyalgia used to treat a patient who had chronic pain for 20 years, who received conventional treatment associated with two laser applications using the modified ILIB technique.

A pilot study on non-invasive treatment of migraine: The self-myofascial release.

The aims of this paper was to determine the effect of self-myofascial release (SMFR) on postural stability and to analyze if it can influence migraine condition. Twenty-five subjects (age 49.7± 12.5) affected by migraine were enrolled. Assessments included a stabilometric analysis in order to evaluate balance and plantar support, with eyes open (OE) and closed (CE); cervical ROM measurement; evaluation of upper limb strength through handgrip. All the analysis were carried out before and after the administration of a single SMFR protocol, using medium density small balls laid in the three most painful trigger points in migraine patients: trapezius, sternocleidomastoids and suboccipital muscles. Performing a T test for paired samples, there was a significant increase in two ranges of the stabilometric analysis: ellipse surface, both with open and closed eyes (p value EO = 0.05; p value EC = 0.04) and length of the sway path, but just with closed eyes (p value = 0.05). SMFR might have a positive impact on postural stability in subjects with migraine. Further investigation should be conducted to confirm the hypothesis.

A pilot study on non-invasive treatment of migraine: The self-myofascial release

The aims of this paper was to determine the effect of self-myofascial release (SMFR) on postural stability and to analyze if it can influence migraine condition. Twenty-five subjects (age 49.7± 12.5) affected by migraine were enrolled. Assessments included a stabilometric analysis in order to evaluate balance and plantar support, with eyes open (OE) and closed (CE); cervical ROM measurement; evaluation of upper limb strength through handgrip. All the analysis were carried out before and after the administration of a single SMFR protocol, using medium density small balls laid in the three most painful trigger points in migraine patients: trapezius, sternocleidomastoids and suboccipital muscles. Performing a T test for paired samples, there was a significant increase in two ranges of the stabilometric analysis: ellipse surface, both with open and closed eyes (p value EO = 0.05; p value EC = 0.04) and length of the sway path, but just with closed eyes (p value = 0.05). SMFR might have a positive impact on postural stability in subjects with migraine. Further investigation should be conducted to confirm the hypothesis.

The impact of myofascial release and stretching techniques on the clinical outcomes of migraine headache: A randomized controlled trial.

Background:Migraine patients often have painful trigger points, especially in the area of head and neck. Thus, we aimed to investigate the effect of myofascial release and stretching techniques in the management of migraine headache.Materials and Methods:This was a randomized controlled trial study on 40 migraine patients. The subjects in the experimental group received three sessions with a duration of 20 min per session techniques. Databases were analyzed using 2 × 3 repeated-measures analyses of variance (P < 0.05).Results:Experimental group showed a significant reduction in pain intensity (P < 0.001) and the neck disability index score (P < 0.001) and an increase in cervical range of motion (P < 0.001) in all time points after the intervention as compared with baseline and control group (P < 0.001).Conclusion:Myofascial release and stretching techniques were effective in improving symptoms in patients with migraine headache.

Repeated Electrical Point Stimulation (EPS) Treatments for Myofascial Trigger Points in the Upper Trapezius Muscle

Electrical point stimulation (EPS) is suggested to decrease myofascial trigger point (MTrP) pain without influencing pressure pain threshold (PPT) following one treatment. The purpose of this study was to determine if repeated EPS treatments decrease pain perception or PPT. EPS decreased pain immediately following and 10 min following (p &lt; .05) application. For those receiving EPS, pretreatment pain on day 1 was greater than pre- and posttreatments on days 2, 3, 4, 5, and 6 (p &lt; .05). Patients receiving EPS experienced less pain than placebo and control. Pain did not change for placebo or control (p &gt; .05). PPT did not change for treatment, time, or day (p &gt; .07).

Dry Needling Versus Sham Needling for Myofascial Pain Syndrome: A Critically Appraised Topic

Focused Clinical Question: In patients with myofascial trigger point pain, does dry needling result in greater decreases in pain compared to sham needling? Clinical Bottom Line: The evidence supporting dry needling as more effective than sham needling in reducing patients’ pain is mixed.

PENGARUH PEMBERIAN ISCHEMIC COMPRESSION DAN STRETCHING UNTUK MENGURANGI NYERI MYOFASCIAL TRIGGER POINT OTOT UPPER TRAPEZIUS PADA PEGAWAI KLAIM BPJS DI RUMAH SAKIT GRANDMED LUBUK PAKAM TAHUN 2020

Background: Myofascial Trigger point syndrome is a local pain trigger point characterized by irritation, inflammation, and swelling. The main problem is that when the emphasis is made, it creates a hypersensitive pain. Myofacial trigger point occured by adhesions, increase by malnutritions and oxygen to ischemic. The problems are pain on muscle cervical contraction and spasm, tenderness, tightness, stiffness, decrease muscle strength.Physiotherapy modalities that can be used for Myofascial Trigger point syndrome are Ischemic Compression and Stretching exercise. Objectives: The study aims to determine influence of Ischemic Compression and Stretching exercise in patients with the myofascial trigger point syndrome with pain of the Upper Trapezius muscle Trigger Point at the Grandmed Lubuk Pakam Hospital. Research method: uses quasi experiments with one group pre test and post test. Samples for this research are 20 respondents got Ischemic Compression and Stretching exercise intervention. Respondents divided into two variable, dependent variable got stretching and ischemic compression method and independent variable is measure for pain in myofascial trigger point syndrome. Results: Hypotheses test results with the Wilcoxon saigned rank test result obtained by P-value ≤ α (0.000 &lt; 0.05). Mean of pain based on Numeric rating scale before intervention (pre test) is 4,60 and after interventiom (post test) is 2,00. Conclusion:According to experimental decisions, there is an influence Ischemic Compression and Stretching exercise to decrease pain in the Myofascial trigger point syndromeof the upper trapezius muscle trigger point at the Grandmed Lubuk Pakam Hospital.

PENGARUH PEMBERIAN ISCHEMIC COMPRESSION DAN CONTRACTRELAX STRETCHING TERHADAP INTENSITAS NYERI MYOFASCIAL TRIGGER POINT SYNDROME OTOT UPPER TRAPEZIUS

Myofascial trigger point syndrome is a hypersensitive pain point in the tightened area that can cause local pain, if pressed it will give spesific, and the muscle that has the most myofascial trigger point syndrome is the upper trapezius. Purpose: This study is to find aims to determine the effect of ischemic compression and contract relax stretching on the intensity of myofascial trigger point syndrome upper trapezius muscle in Nurse station (Ns) administration employees at Granmed Lubuk Pakam Hospital in 2019. This type of research is a type of pure experimental research using one group pre and post test design research, conducted at Grandmed Lubuk Pakam hospital. The population and sample used in this study were 13 people. The statistical test of the hypothesis with the t test obtained p- value α &lt; (0.001 &gt;0,05). Ther is the effect of fiving ischemic compression and contract relax stretching to the intensity of myofascial pain trigger point syndrome upper trapezius muscle in Nurse station (Ns) administration employees in Granmed Lubuk Pakam Hospital in 2019. The researcher recommends that the next researcher add a longer sample size and research time so that the result of the research obtained are more maximal.

Botulinum toxin infiltrations versus local anaesthetic infiltrations in pelvic floor myofascial pain: Multicentre, randomized, double-blind study

Many studies have demonstrated a link between pelvic floor myofascial syndromes and chronic pelvic pain. Botulinum toxin has been extensively used for several years in the field of pain, especially due to its action on muscle spasm. However, the efficacy of botulinum toxin in the context of chronic pelvic pain remains controversial. This multicentre, randomized, controlled, double-blind study was designed to compare the efficacy of botulinum toxin and local anaesthetic (LA) injection versus LA injection alone for pelvic floor myofascial syndrome and chronic pelvic pain. According to the number of painful trigger points detected on physical examination, patients received from 1 to 4 injections of botulinum toxin with LA (BTX) or LA alone. The primary endpoint was Patient Global Impression of Improvement (PGI-I) score on day 60 after infiltration. Secondary endpoints were pain intensity, number of painful trigger points on palpation, analgesic drug consumption and quality of life. We included 80 patients, 40 in each group. This study failed to demonstrate a significant difference between the 2 groups on day 60 in the primary endpoint or secondary endpoints (PGI-I score≤2=20% [LA] versus 27.5% [BTX], P=0.43). However, both groups showed significant alleviation of global pain. This study does not justify the use of botulinum toxin in the context of chronic pelvic pain with myofascial syndrome but does justify muscle injections with LA alone. ClinicalTrials.gov: NCT01967524.

Effect of Post-Isometric Relaxation and Laser on Upper Trapezius Trigger Point Pain in Patients with Mechanical Neck Pain.

The current study aimed to determine the effectiveness of post-isometric relaxation and LASER treatment in minimizing pain and increasing neck range of motion and function in people with upper Trapezius trigger point pain. A total of 45 participants with upper Trapezius trigger point pain were studied. All the participants were randomly assigned into three equal groups (post-isometric relaxation, LASER, and Control) to receive the respective treatments for 1 week. The pressure threshold meter was used to assess the pain-pressure sensitivity of myofascial trigger point pain. Pain intensity and cervical range of motion were measured using the visual analogue scale and cervical goniometry, respectively. The neck disability index was used to assess neck function. The results of within group analysis indicate significant changes in all the outcomes in three groups (All groups, P = 0.001) except an insignificant improvement of pain pressure threshold in the control group (P = 0.069). Additionally, there were significant differences noted among three groups on pain-pressure threshold and visual analogue scale scores at posttest day 1, day 5, and day 12 (all P = 0.001). However, there was non-significant improvements of neck disability index and side flexion on both sides noted at all timelines except (all P > 0.05), a significant improvement at posttest day 5 (P = 0.015) among three groups. Both PIR and LASER treatment have been effective in reducing pain-pressure threshold and pain intensity in the management of muscle trigger point pain. Long-term studies are warranted to further validate the effectiveness of these modalities in the management of upper Trapezius trigger point pain.

Effectiveness of percutaneous microelectrolysis and ultrasound in the decrease of pain in myofascial trigger points: evaluation through algometry and visual analog scale

IntroductionPercutaneous electrotherapy is a therapeutic alternative in musculoskeletal conditions. Percutaneous micro- electrolysis (MEP) stands out as treatment for tendinopathies and musculoskeletal pain, such as myofascial trigger points (MTrPs), although more studies are needed to support it. The study aimed to investigate MEP effectiveness in reducing pain pressure threshold (PPT) and pain intensity (PI) in MTrPs.MethodsA randomized controlled clinical trial was performed at Physiotherapy Laboratory of Andrés Bello University and in- volved 48 volunteers with MTrPs in upper trapezius muscle, randomly assigned to the experimental or control group. Both groups received baseline ultrasound treatment. In the experimental group, MEP intervention was applied with 3 re-evaluation sessions (on days 1, 3, and 7). Direct current was delivered with an acupuncture needle directly to MTrPs, and PPT and PI were re-evaluated before and after the application. The main outcomes were PPT and PI differences (PPTdiff and PIdiff) between evaluation sessions.ResultsTMEP implied positive changes, increasing PPT (PPTdiff1-1, &lt;i&gt;p&lt;/i&gt; = 0.0000; PPTdiff2-1, &lt;i&gt;p&lt;/i&gt; = 0.0000; PPTdiff3-1, &lt;i&gt;p&lt;/i&gt; = 0.0000) and decreasing PI (PIdiff1-1, &lt;i&gt;p&lt;/i&gt; = 0.0001; PIdiff2-1, &lt;i&gt;p&lt;/i&gt; = 0.0001; PIdiff3-1, &lt;i&gt;p&lt;/i&gt; = 0.0008) in the experimental group. Significant differ- ences were observed in PPT in the second re-evaluation session compared with the control group (PPTdiff2-1, &lt;i&gt;p&lt;/i&gt; = 0.0032).ConclusionsMEP is a good analgesic treatment for MTrPs compared with therapeutic ultrasound, although neither of these therapies seems to be better than the other in a long term. They improve PPT and PI, so MEP can be considered effective alter- native treatment for MTrPs pain.

Association Between Adductor Longus, Iliopsoas and Rectus Abdominis Muscle Trigger Point and Groin Pain in Football Players: A Case Control Study

Objective: To find the presence of trigger point in iliopsoas, adductor longus and rectus abdominis muscle and association between trigger point in these muscles and groin pain Study design: Case control study Method: A case control study was done on 60 football players (30 symptomatic with mean age 23.30 and 30 asymptomatic with mean age 21.76). All the participants were assessed for trigger points in rectus abdominis, iliopsoas and adductor longus muscles with manual palpation technique to check the pain response. Presence of myofascial trigger point were determined according to Simons and Gervin criteria. Results: Phi value for adductor longus muscle (0.484) and iliopsoas muscle (0.304) have shown association between trigger point and groin pain and were statistically significant (p<0.05). There were no association between trigger points in rectus abdominis muscle and groin pain. Discussion: Studies on EMG findings have shown greater activation of Hip flexors, Hip adductors, and abdominal muscles during kicking phase as these muscles act as a pelvic stabilizers. Thomas Mayer has explained the fascial continuity in deep front line between these muscles and trigger points in these muscles give referred pain in groin region. Conclusion:This study concluded strong association between myofascial trigger point in adductor longus and iliopsoas muscle in football athletes. So, football/soccer players can be assessed for trigger point to relieve groin pain and improve their performance.

The Effect of Two Different Types of Physical Exercise Programs on Work Related Neck-Shoulder Pain Intensity, Range of Motion and Muscle Strength in Female Blue-Collar Workers

Research background. During the rapid development of science and technology in the world, number of people suffering from pain in the neck-shoulder complex is increasing. Musculoskeletal disorders are influenced by non-ergonomic adaptation of the workplace, rapid decline in physical activity and other factors. The research aim was to evaluate the effect of stretching and strengthening exercises on work related neck/shoulder pain, muscle strength, range of motion in female blue-collar workers. Methods. The study involved 16 participants with neck-shoulders complex pain. The women were aged between 35–55 years. Participants rated their worst neck-shoulder pain during the previous week on a numerical rating scale from 0 to 10. Participants’ active range of motion of neck and humerus movements were measured with a goniometer, latent trigger point pain thresholds was measured with an algometer and muscle strength of upper trapezius, scalenus and sternocleidomastoideus muscles was evaluated with a dynamometer. The frst group (stretching exercise group) consisted of 9 participants, the second group (strengthening exercise group) – of 7 participants. Results. After 5 weeks stretching and strengthening exercise programs, the changes were statistically signifcant in both groups. Comparing pain intensity and muscle strength between groups, statistically signifcant changes were found in muscle strengthening group. Statistically signifcant latent trigger point pain threshold and range of motion changes were found in both groups (p &lt; 0.05). Before the study, differences were found between the groups that could have had an effect on the results. Conclusion. Muscle strengthening exercises are more effective for blue – collar workers reducing muscular pain, increasing muscle strength and functional ability. Muscle strengthening exercise had a greater influence of pain intensity and muscle strength then stretching exercises.Keywords: neck-shoulder pain, stretching exercise, strengthening exercise.

Comparison of radial shockwave and dry needling therapies in the treatment of myofascial pain syndrome

Background/Aims Myofascial pain syndrome is a frequent problem in the musculoskeletal system. As a method of treatment for myofascial pain syndrome, dry needling therapy is an effective and convenient treatment for patients because they do not need to be treated every day. However, as patients often have post-needle soreness or some patients are afraid of needles, there are limitations to this treatment. The purpose of this study is to compare the effectiveness of radial shockwave therapy with dry needling therapy to treat myofascial pain. Methods A total of 42 patients attending the rehabilitation department with at least one myofascial pain trigger point in their upper back muscles, were randomly assigned to receive radial shockwave therapy or dry needling therapy. Treatment was performed once a week for 3 weeks in both groups. Participants' pain pressure threshold, measured using an algometer, and pain levels, measured using a numeric pain scale, were assessed before the designated treatment was applied each week. Each patient also performed upper trapezius, rhomboid and infraspinatus muscle stretches twice a day throughout the study period. Results There was no difference in pain pressure threshold at the three trigger points before treatment with the different modalities commenced. At the end of the study, the radial shockwave therapy group had a significant improvement in trapezius pain pressure threshold, increasing from 11.7 at baseline to 14.8 at the end of study. There was no significant between-group difference in pain level (P=3.4 vs P=2.6) at the end of the study. Both treatments significantly reduced pain levels: from 7.2 to 3.4 in the radial shockwave group (P&lt;0.001) and from 6.8 to 2.6 in the dry needling therapy group (P&lt;0.001). Conclusions Dry needling and radial shock wave therapies are effective in reducing myofascial pain syndrome originating in the upper back muscles. Participants' pain pressure threshold increased after 3 weeks of treatment with both therapies. Radial shock therapy can be used as an alternative to dry needling in the treatment of myofascial pain syndrome in patients who have trouble attending daily physical therapy or in whom dry needling therapy is contraindicated.