Efficacy of Focused ESWT and Dry Needling Among Patients With Myofascial Pain Syndrome of the Upper Trapezius Muscle

NCT07397039 | Completed

• 1 other identifier: MURA2022/525
• Study Type: interventional
• Target: 53
• Locations: 1 country
• Sites: 1

Brief Summary

Myofascial pain syndrome (MPS) is one of the most common causes of musculoskeletal pain. Among patients with MPS, the upper trapezius muscle appears to be the common muscle that generates pain in the area of upper extremity. The main target treatment for MPS is to eradicate the painful trigger points by using treatment options, such as ultrasound, laser, and dry needling (DN). In the past decade, focused extracorporeal shockwave therapy (fESWT) has become the well-known treatment for pain relief in various musculoskeletal pain conditions. The main advantages of this non-invasive treatment modality are reducing pain, inflammation and promoting tissue healing. However, there were no previous studies compared effects of fESWT to dry needling. Therefore, the present study aims to compare the efficacy of the two treatments in terms of pain reduction and functional improvement.

Conditions

Myofascial Pain Syndrome

Keywords

Extracorporeal shockwave therapy, Myofascial Pain Syndrome

Outcome Measures

Primary Outcomes (1)

• Visual Analogue Scale (VAS)

  VAS is a subjective tool that is used to measure pain scores. In this study, the 100-numerical scale will be used, in which 0 means "no pain," whereas 100 means "the worst pain." Patients mark the scale to rate the pain score based on their pain perception.

  Changes in VAS were assessed at baseline, and at 4 and 6 weeks following baseline.

Secondary Outcomes (2)

• Pain pressure threshold (PPT)

  Changes in PPT were assessed at baseline, and at 4 and 6 weeks following baseline.

• The Neck Disability Index (NDI)

  Changes in NDI were assessed at baseline and 6 weeks following baseline.

Study Arms (2)

Focused Extracorporeal Shockwave Therapy (fESWT)

EXPERIMENTAL

The participant will be treated by fESWT plus conservative treatment. fESWT will be applied once a week, for a total of 3 sessions.

Device: Focused Extracorporeal Shockwave Therapy (fESWT)

Dry needling (DN)

ACTIVE COMPARATOR

The participant will be treated by DN plus conservative treatment. DN will be done as a single session.

Other: Dry needling (DN)

Interventions

Focused Extracorporeal Shockwave Therapy (fESWT) DEVICE

fESWT will be done using an energy flux density of 0.20 - 0.25 millijoule (mJ)/mm2, a frequency of 4 Hz, and 1000 shocks per session which will be done one session per week, for a total of 3 sessions, consecutively.

Focused Extracorporeal Shockwave Therapy (fESWT)

Dry needling (DN) OTHER

DN will be done by using a sterile technique with a sterile acupuncture needle, a diameter of 0.25 mm, and a length of 30-40 mm. The needle will be applied to the painful active trigger point using fan-shaped movements and the fast-in and fast-out technique until the twitching response disappears.

Dry needling (DN)

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• The participant who is diagnosed with myofascial pain syndrome based on the criteria listed below:
• The trigger point must be in a taut band of the upper trapezius muscle. The trigger point in the muscle is hypersensitivity to pain. Pain radiates to the specific pattern of the upper trapezius muscle. When pressure is applied to the trigger point, the participant perceives the same pain sensation as their pain complaint.
• The participant who has a VAS score of \> or = 5 points
• The participant who has had myofascial pain for \> or = 3 months

You may not qualify if:

• Unresolved neurological or musculoskeletal problems, such as fibromyalgia, cervical radiculopathy, and cervical spine fracture.
• History of cervical spine or shoulder surgery
• Uncontrolled underlying diseases, such as psychological problems, cancer, or acute renal or hepatic failure
• Received treatment by other physical modalities or steroid injection into the trigger point within 3 months, or was treated by analgesic drugs within 2 weeks.
• Contraindicated to ESWT or DN
• Refuse to attend the study

Sponsors & Collaborators

• Mahidol University: lead

Study Sites (1)

Ramathibodi Hospital

Bangkok, 10400, Thailand

Location

Related Publications (6)

• Desai MJ, Saini V, Saini S. Myofascial pain syndrome: a treatment review. Pain Ther. 2013 Jun;2(1):21-36. doi: 10.1007/s40122-013-0006-y. Epub 2013 Feb 12.

  PMID: 25135034 BACKGROUND

• Simplicio CL, Purita J, Murrell W, Santos GS, Dos Santos RG, Lana JFSD. Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. J Clin Orthop Trauma. 2020 May;11(Suppl 3):S309-S318. doi: 10.1016/j.jcot.2020.02.004. Epub 2020 Feb 12.

  PMID: 32523286 BACKGROUND

• Jun JH, Park GY, Chae CS, Suh DC. The Effect of Extracorporeal Shock Wave Therapy on Pain Intensity and Neck Disability for Patients With Myofascial Pain Syndrome in the Neck and Shoulder: A Meta-Analysis of Randomized Controlled Trials. Am J Phys Med Rehabil. 2021 Feb 1;100(2):120-129. doi: 10.1097/PHM.0000000000001493.

  PMID: 32520797 BACKGROUND

• Park KD, Lee WY, Park MH, Ahn JK, Park Y. High- versus low-energy extracorporeal shock-wave therapy for myofascial pain syndrome of upper trapezius: A prospective randomized single blinded pilot study. Medicine (Baltimore). 2018 Jul;97(28):e11432. doi: 10.1097/MD.0000000000011432.

  PMID: 29995794 BACKGROUND

• Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991 Sep;14(7):409-15.

  PMID: 1834753 BACKGROUND

• Kinser AM, Sands WA, Stone MH. Reliability and validity of a pressure algometer. J Strength Cond Res. 2009 Jan;23(1):312-4. doi: 10.1519/jsc.0b013e31818f051c.

  PMID: 19130648 BACKGROUND

MeSH Terms

Conditions

Myofascial Pain Syndromes

Interventions

Dry Needling

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Physical Therapy Modalities

Study Officials

• Thitiporn Phakdepiboon, MD

  Ramathibodi Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 7, 2022
• First Posted: February 9, 2026
• Study Start: December 1, 2022
• Primary Completion: May 31, 2023
• Study Completion: May 31, 2023
• Last Updated: February 9, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TH (1)