The effectiveness of deep tissue massage on pain, trigger point, disability, range of motion and quality of life in individuals with myofascial pain syndrome.

PURPOSE: This study aims to examine the effect of deep tissue massage (DTM) on the myofascial trigger point (MTrP) number, neck range of motion (ROM), pain, disability and quality of life in patients with Myofacial pain syndrome (MPS). METHODS: The study involved patients with MPS between the ages of 20-57. The patients were randomly divided into two groups: the control group (n = 40) and the study group (n = 40). Transcutaneous Electrical Neuromuscular Stimulation (TENS), hotpack and ultrasound were applied to 40 patients in the control group. The study group was also administered DTM for 12 sessions in addition to TENS, hotpack and ultrasound applications. Neck pain and disability scale (NPDS) for a neck disability, universal goniometer for neck ROM, MTrP count using manual palpation, Short Form 36 (SF-36) for quality of life and severity of neck pain were evaluated using a visual analog scale (VAS). All patients were evaluated before and after treatment. RESULTS: It was found that the DTM group has statistically more improvement than the control group for VAS, NPDS and SF-36. Moreover, although there was a significant improvement in favour of the study group for extension, lateral flexion, right rotation and left rotation in the neck ROM, there was no significant difference in flexion measurements between the study and control group. CONCLUSION: In addition to the traditional rehabilitation program, DTM is effective on neck ROM, pain, disability and quality of life. Therefore, DTM treatment is a safe and inexpensive treatment method that can be applied in patients with MPS.

Dry needling, trigger point electroacupuncture and motor point electroacupuncture for the treatment of myofascial pain syndrome involving the trapezius: a randomised clinical trial.

OBJECTIVE: The objective of this study was to compare trigger point (TrP) dry needling, TrP electroacupuncture and motor point electroacupuncture of the trapezius muscle for the treatment of myofascial pain syndrome (MPS). METHODS: This randomised clinical trial included 90 patients divided into three groups. Group 1 was treated with dry needling of TrPs, group 2 with intramuscular electrical stimulation of TrPs, and group 3 with electroacupuncture of motor points and/or the spinal accessory nerve. Each group received seven treatment sessions. The outcomes were the pain score measured by visual analogue scale (VAS) and quality of life evaluated by the 12-item short form (SF-12) health questionnaire. We compared the pain outcome over serial time points using growth curve analysis methods. RESULTS: Participants in the three groups experienced significant improvements in pain scores over time. The average pain level of participants in group 3 across the repeated assessments was 0.98 units lower than in group 1 (mean difference (95% confidence interval (CI) = 1.74-0.23)), p = 0.012). There were no significant differences in pain scores between participants in groups 1 and 2, and there were no significant differences in quality of life across the three groups at the end of the treatment period. CONCLUSION: Our results provide evidence that electrical stimulation of motor points and/or of the spinal accessory nerve may be superior in terms of pain relief (but not quality of life) to dry needling and possibly electrical stimulation of trigger points for the management of MPS involving the trapezius. TRIAL REGISTRATION NUMBER: TRIAL-RBR-43R7RF (Brazilian Clinical Trials Registry).

Comparative effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome.

BACKGROUND: Thoracic myofascial pain syndrome is a clinical problem arising from the muscles and soft tissues of thoracic region, which include the mid and upper back area. Risk factors associated with myofascial pain syndrome are muscle overuse and repetitive strain, poor posture, trauma or injury, emotional and psychological stresses. The management of myofascial pain syndrome (MPS) typically involves a multidimensional approach that focuses on relieving pain, reducing muscle tension, and improving muscle function. Bowen therapy and tennis ball technique are also recommended for treating myofascial pain syndrome. OBJECTIVE: The objective of this study was to compare the effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome. METHODS: It was a randomized clinical trial conducted on thirty patients. It was carried out in physiotherapy outpatient department of D.H.Q Hospital, Kasur. Non-probability convenience sampling technique was used. Data collection was done from the patients of thoracic myofascial pain syndrome by using Numeric Pain Rating Scale (NPRS) for pain and Pain Disability Questionnaire (PDQ) for functional disability. Participants were randomly allocated into two groups using computer generated random number method. Group A received Bowen therapy, and group B received tennis ball technique. Outcome measures were measured at baseline, after second week treatment session and after fourth week with three sessions in a week on alternate days. Data analysis was done by using Statistical Package for the Social Sciences (SPSS) version 26. RESULTS: There was significant difference between the mean values of NPRS and PDQ in both groups at baseline, second week and fourth week with p value < 0.05. The results indicated that both treatments were significant but Bowen therapy is more effective treatment than tennis ball technique. Within-group difference calculated with repeated-measure ANOVA indicated that there was significant difference from pre- to post-values of both groups. CONCLUSION: This study concluded that Bowen therapy produced statistically significant and clinically relavant results for all the outcome measures. TRIAL REGISTRATION: (IRCT20190717044238N7).

Evaluation of Radial Extracorporeal Shock Wave Therapy on Treatment-Resistant Trigger Points Using Sonographic Shear Wave Elastography.

OBJECTIVE: To assess the effectiveness of radial extracorporeal shock wave therapy (rESWT) on treatment-resistant myofascial trigger points (MTrPs) in the upper trapezius and evaluation of treatment efficacy by Sonographic Shear Wave Elastography (SWE) objectively. STUDY DESIGN: An experimental study. Place and Duration of the Study: Department of Physical and Rehabilitation Medicine and Department of Radiology of Acibadem University Atakent Hospital, from August 2020 to June 2021. METHODOLOGY: Forty-one patients with 70 active treatment-resistant trigger points in their upper trapezius muscles were included. The treatment involved rESWT with 1500 pulses, administered at 8 Hz and 1.5 bar pressure. Of the 1500 pulses, 1000 impulses targeted MTrPs, while 500 impulses were applied to the surrounding taut band. The treatment sessions were conducted at 1-week interval until the Visual Analog Score (VAS) reached below 2 or a maximum of 5 sessions. Baseline assessments of VAS, Neck Disability Index (NDI), and shear modulus of the upper trapezius MTrPs were performed and reevaluated after the last treatment sessions. Furthermore, a follow-up assessment of the VAS was conducted after a period of 3 months for long-term effects. RESULTS: There was a significant improvement in both NDI scores and pain relief between the pretreatment and posttreatment periods. Moreover, the shear modulus of the upper trapezius MTrPs showed a significant decrease from 41.5 kPa to 30 kPa after the treatment. CONCLUSION: The treatment effectively alleviated pain, improved neck function, and reduced the shear modulus of the affected areas. SWE offered a reliable real-time measurement of soft tissue stiffness, providing valuable insights into the treatment's efficacy. KEY WORDS: Shock wave therapy, Trigger points, Elastography, Neck pain, Myofascial pain.

Role of Rehabilitation Exercise on Myofascial Pain Syndrome Causing Upper Back Pain.

Upper back pain is as painful or troublesome as the pain in the lower back or the neck. Myofascial pain syndrome which is most common cause of upper back pain is characterized by localized musculoskeletal pain and tenderness in association with trigger points. The aim of the study was to correlate the improvement of myofascial pain syndrome patients with proper and timely physical therapy. This quasi experimental study was conducted in the department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from 1st January 2008 to 31st August 2008 to see the role of rehabilitation exercise on myofascial pain syndrome causing upper back pain. Sixty (60) patients of myofascial pain syndrome causing upper back pain were randomly assigned for treatment; out of which 23(38.33%) were male and 37(61.66%) were female. The male and female ratio was 1:1.6. The patients selected for the trial were divided into two groups: Group A and Group B. In group A (n=28) the patients were treated with thermotherapy- Microwave diathermy, non-steroidal anti inflammatory drugs and activities of daily living instructions and in Group B (n=32) with same interventions in addition to rehabilitation exercises. Treatment duration was 6 weeks. The difference of treatment improvement was statistically significant (p<0.05) from 1st week up to 6th week. After complete course of treatment 67.86% patients in Group A and 78.13% patients in group B reported improvement. So rehabilitation exercises can be a valuable adjunct to other modalities of treatment of myofascial pain syndrome causing upper back pain.

An overview of myofascial pain syndrome with a focus on trigger point injection.

ABSTRACT: Myofascial pain syndrome (MPS) is a very common condition, with an estimated lifetime prevalence of 85% in the general population. MPS is commonly underdiagnosed or misdiagnosed due to the lack of standardized diagnostic criteria and the symptoms' overlap with those of other musculoskeletal pain conditions. The most notable and bothersome feature of MPS is the presence of myofascial trigger points (MTrPs), hypersensitive areas of muscle commonly characterized as knots, nodules, or bumps that cause strain and pain with and oftentimes without stimulation. A low-risk, low-cost procedure, trigger point injection (TPI) is the gold standard for MPS treatment, and NPs can perform the procedure in an outpatient practice setting. Through administration of TPIs and use of other treatment modalities, primary care NPs can significantly impact the quality of life for those patients affected by acute and chronic MPS. This article aims to educate primary care NPs on MPS diagnosis and provide an overview of treatment options, with a focus on TPI use and administration for MPS relief.

Chronic Pain Syndromes: Myofascial Pain Syndrome.

Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder characterized by trigger points within the muscle or fascia. There are no universally accepted diagnostic criteria. Diagnosis currently is based on a physical examination finding of at least one localized trigger point that, when palpated, recreates the pain at the site or produces pain away from the site in a referral pattern. MPS is thought to be related to sustained muscle contraction from under- or overuse. This syndrome commonly coexists with other chronic pain conditions, including fibromyalgia. The difference between MPS and fibromyalgia is that MPS involves localized pain with discrete areas of tenderness, whereas fibromyalgia symptoms are more diffuse and widespread. Most management recommendations for MPS are based on low-quality clinical trials or expert opinion. A multimodal approach is recommended, involving patient education, exercise, behavior modification, pharmacotherapy, and procedural interventions. Commonly used drugs include topical analgesics, nonsteroidal anti-inflammatory drugs, and muscle relaxants. Procedural interventions include manual therapy (eg, deep tissue massage, spray and stretch technique, myofascial release), dry needling, trigger point injections, onabotulinumtoxinA injections, acupuncture, kinesiology tape, transcutaneous electrical nerve stimulation, extracorporeal shockwave therapy, and low-level laser therapy. Symptoms often resolve with these interventions if they are used early in the course of the condition. As MPS enters the chronic stage, it becomes increasingly refractory to treatment.

Comparison of kinesio taping, trigger point injection, and neural therapy in the treatment of acute myofascial pain syndrome: A randomized controlled study.

OBJECTIVES: Myofascial pain syndrome (MPS) is a regional painful soft-tissue disorder, characterized by trigger points (TrPs) and taut bands in the muscles. In this study, we aimed to compare the effectiveness of kinesio taping (KT), TrPs injection, and neural therapy (NT) on pain and disability in acute MPS. METHODS: 104 patients with MPS in the cervical region were allocated into three groups. Group 1 (n=35) were treated with KT, Group 2 (n=35) received local anesthetic (LA) (lidocaine of 0.5%) TrPs injection, and Group 3 (n=34) received NT with the same LA solution. Patients were assessed by means of pain, pressure pain threshold (PPT), and disability. Pain severity was measured by Visual Analog Scale. The neck pain disability scale was used for assessing disability. PPT was measured by using an algometer. Measurements were taken before and after treatment of 3rd and 7th days. RESULTS: There were improvements on pain and disability in all groups at the end of treatments at 3rd day and during follow-up period (p<0.001) and no differences were found between the groups. There was significant difference in PPT values in TrPs injection and NT groups in comparisons between all time periods, however, the change, depending on time in the KT group, was not statistically significant. CONCLUSION: The results of this study show that all these three treatment methods found to be effective on pain relief and disability in acute MPS. In terms of PPT, injection treatments seem to be superior than KT.

Buccal acupuncture combined with ultrasound-guided dry needle-evoked inactivation of trigger points to treat cervical and shoulder girdle myofascial pain syndrome.

BACKGROUND: Myofascial pain syndrome (MPS) is a common disease with easy persistence and recurrence. In clinical practice, although many methods have been adopted to prevent and treat MPS, the control of MPS is still not satisfactory. OBJECTIVE: To compare the safety and effectiveness of buccal acupuncture, inactivation of trigger points (MTrPs), and their combination in the treatment of MPS. METHODS: Two hundred MPS patients in the pain clinic were randomly divided into four groups (n= 50) to receive oral drugs (Group A), oral drugs + buccal needle (Group B), oral drugs + MTrP inactivation (Group C), or oral drugs + buccal needle + MTrP inactivation (Group D). RESULTS: The visual analogue scale (VAS) and cervical range of motion (ROM) of Group D were significantly lower than those of the other three groups, and the pressure pain threshold (PPT) value of labelled MTrPs was significantly higher than those of the other three groups (P< 0.05). The excellent rate and total effective rate of Group D were significantly higher than those of the other three groups. Group C had the highest pain score and the lowest acceptance score. The results showed that buccal acupuncture combined with ultrasound-guided dry needle-evoked inactivation of MTrPs can significantly reduce the VAS score of MPS patients, improve the range of motion of the cervical spine, and improve patient satisfaction. CONCLUSIONS: This study provides a highly accepted and satisfactory treatment for MPS, which is worthy of clinical promotion.

The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: a systematic review.

BACKGROUND: Myofascial pain syndrome (MPS) is a common musculoskeletal pain and dysfunction, which is characterised by myofascial trigger points. Therapeutic physical modalities, as potentially effective treatment options, are commonly used in the clinical setting for the patients with MPS. OBJECTIVE: This systematic review aimed to evaluate the safety and effectiveness of therapeutic physical modalities in the treatment of MPS, investigate its therapeutic mechanisms and provide a scientific evidence-based decision. METHODS: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, Cochrane Central Library, Embase, and CINAHL databases were searched for randomized controlled clinical studies published from database inception to October 30, 2022. A total of 25 articles met the study inclusion criteria. Data were extracted from these studies and a qualitative analysis was performed. RESULTS: Transcutaneous electrical nerve stimulation therapy, extracorporeal shock wave therapy, laser therapy, and other therapeutic physical modalities have been demonstrated to improve the pain symptoms, joint mobility, psychological state, and quality of life in the patients with MPS and no side effects have been reported. The curative effect of therapeutic physical modalities was found to be possibly associated with increased blood perfusion and oxygen supply in ischaemic tissues, reduced hyperalgesia in the peripheral and central nerves, and decreased involuntary muscle contractions. CONCLUSION: The systematic review has shown that therapeutic physical modalities could provide a safe and effective therapeutic option for MPS. However, the consensus is currently lacking regarding the optimal treatment paradigm, therapeutic parameters, and mutual combination of therapeutic physical modalities. The clinical trials with robust quality are required to further promote the evidence-based application of therapeutic physical modalities for MPS.

A New Unified Theory of Trigger Point Formation: Failure of Pre- and Post-Synaptic Feedback Control Mechanisms.

The origin of the myofascial trigger point (TrP), an anomalous locus in muscle, has never been well-described. A new trigger point hypothesis (the new hypothesis) presented here addresses this lack. The new hypothesis is based on the concept that existing myoprotective feedback mechanisms that respond to muscle overactivity, low levels of adenosine triphosphate, (ATP) or a low pH, fail to protect muscle in certain circumstances, such as intense muscle activity, resulting in an abnormal accumulation of intracellular Ca2+, persistent actin-myosin cross bridging, and then activation of the nociceptive system, resulting in the formation of a trigger point. The relevant protective feedback mechanisms include pre- and postsynaptic sympathetic nervous system modulation, modulators of acetylcholine release at the neuromuscular junction, and mutations/variants or post-translational functional alterations in either of two ion channelopathies, the ryanodine receptor and the potassium-ATP ion channel, both of which exist in multiple mutation states that up- or downregulate ion channel function. The concepts that are central to the origin of at least some TrPs are the failure of protective feedback mechanisms and/or of certain ion channelopathies that are new concepts in relation to myofascial trigger points.

Kinesio Taping as a Therapeutic Tool for Masticatory Myofascial Pain Syndrome-An Insight View.

Myofascial pain syndrome (MPS) is thought to stem from masticatory muscle hypersensitivity. Masticatory myofascial pain syndrome (MMPS) is characterized by multiple trigger points (MTrPs), also known as hyperirritable points, in taut bands of affected muscles, regional muscle pain, or referred pain to nearby maxillofacial areas like teeth, masticatory muscles or the temporomandibular joint (TMJ). Muscle stiffness, reduced range of motion, muscle weakening without atrophy, and autonomic symptoms may accompany regional discomfort. Multiple treatments have been utilized to reduce trigger points and mandibular function restrictions. As a result of these incapacitating symptoms, MMPS can significantly impair many elements of quality of life. The application of Kinesio tape (KT) is a non-invasive method of treating dormant myofascial trigger points. Utilizing the body's innate capacity for self-repair, this technique entails taping specific regions of the skin. KT alleviates discomfort, decreases swelling and inflammation, enhances or suppresses motor function in the muscles, stimulates proprioception, promotes lymphatic drainage, stimulates blood flow, and expedites tissue recovery. However, studies conducted to assess its effects have frequently yielded contradictory results. To the best of our knowledge, just a few research has looked into the therapeutic effects of KT on MMPS. The purpose of this review is to determine the efficacy of KT as a therapeutic tool for regular treatment or as an adjunct to existing therapy for MMPS based on the evidence presented in this review. To establish KT as a reliable independent treatment option, additional research is necessary to confirm the efficacy of KT techniques and applications, specifically randomized clinical trials.

The importance of myofascial trigger points in chronic neck pain: An ultrasonography preliminary study.

BACKGROUND: Ultrasonographic evaluation of trigger points detected by physical examination in patients with myofascial pain syndrome is being used more frequently in clinical care. However, the sonographic appearance of trigger points, in association with pain and disability, has not been adequately described. OBJECTIVE: To reveal the presence of trigger points with ultrasonography in those with myofascial pain syndrome and to determine if ultrasound images can help discriminate between demographic and disease characteristics. METHODS: Fifty-two participants with chronic neck pain (NP) were in this cross-sectional study. The pain intensity was evaluated using a 0-10 cm visual analog scale (VAS). The neck disability index measured the NP-induced disability status of the participants. Ultrasonography was used to measure the thicknesses of the paraspinal muscles and the presence of hypoechoic areas within these muscles. RESULTS: There was a positive correlation between the VAS scores of the participants and the ultrasonographic detection of myofascial trigger points (MTPs) in the multifidus and middle trapezius muscles (right/left r = .30, p = .027; r = .29, p = .029; r = .32, p = .009, r = .30, p = .011, respectively). These features correlated with the disability levels of the participants and the MTPs on both the right and left sides of the splenius, multifidus, upper trapezius, and middle trapezius (r = .32, p = .028; r = .38, p = .013, r = .25, p = .027; r = .33, p = .016; r = .25, p = .025, r = .32, p = .018, r = .28, p = .013, r = .29, p = .016, respectively). A significant correlation was present between the detection of MTP at ultrasonography and decreased muscle thickness in the relevant muscles (between p = .001 and p = .034). CONCLUSION: The detection of MTPs with ultrasonography is associated with the severity of pain and disability in those with chronic NP. Features on ultrasound include hypoechoic changes within muscle and reduced muscle thickness associated with MTPs.

Abdominal Wall Pain and Primary Dysmenorrhea: The Importance of Myofascial Trigger Points.

Myofascial trigger points are among the often-overlooked causes of anterior abdominal wall pain and primer dysmenorrhea. It is crucial to evaluate patients with a myofascial perspective in addition to a good history and a detailed physical examination. Myofascial trigger points of the abdominal oblique muscles and rectus abdominis muscle should be considered for patients with abdominal wall pain and primer dysmenorrhea. It should also be kept in mind that myofascial pain syndrome may be the primary pathology responsible for the pain, or it may be an entity accompanying another underlying pathology.

Ultrasound-Guided Trigger Point Injections for the Treatment of Neck and Back Pain in the Emergency Department: A Randomized Trial.

OBJECTIVES: Patients frequently present to the emergency department (ED) with neck or back pain, which can be difficult to treat. We sought to compare ultrasound-guided trigger point injection (TPI) to standard medications for patients with neck or back pain. METHODS: We performed a single-center, open label, randomized controlled trial on ED patients with neck or back pain from myofascial pain syndrome comparing ultrasound-guided TPIs to those who received the combination of a nonsteroidal anti-inflammatory drug (NSAID) and a muscle relaxant (MR). The primary outcome of this study was the reduction in mean pain score at the time of ED disposition. RESULTS: In total, we analyzed 196 patients. At the time of ED disposition, patients in the TPI group had a mean reduction in their pain scores of 45.0 mm as compared to 49.9 mm in the NSAID plus MR group (difference: 4.9 [95% confidence interval (CI) -3.0 to 12.7], P = .22). At the first reassessment, patients in the TPI group had greater pain reduction by 10.7 mm (95% CI 3.1 to 18.4). The rate of rescue therapy use was higher in the NSAID plus MR group (difference: 17.5% [95% CI 4.4 to 36.2]). CONCLUSIONS: We found no difference in pain reduction at the time of ED disposition between patients randomized to the ultrasound-guided TPI group as compared to those who received an NSAID plus a MR. However, patients in the TPI group had greater pain reduction at the time of first reassessment and lower rates of rescue therapy use.

A comparison between effectiveness of gluteal trigger point and epidural steroid injection in lumbosacral canal stenosis patients: a randomized clinical trial.

BACKGROUND: Lumbosacral Spinal Stenosis (LSS) is a degenerative spine disease and a major cause of pain and disability, especially in geriatrics. Primary symptom control in patients with LSS includes conservative treatment and non-surgical methods. In this study, we aimed to compare the effect of steroid injection via epidural and gluteal trigger point techniques. METHODS: Patients aged 40-75 years old who had pain and other clinical signs of spinal stenosis in the last 6 months were included in our study and divided into two groups of gluteal trigger point (TP) or epidural steroid injection (ESI). The patients were evaluated based on the visual analog scale (VAS), Roland-Morris Disability Questionnaire (RDQ), Oswestry Disability Index (ODI), and the Quebec back pain disability scales during their pre-injection period and 2 weeks after follow-ups till 8 weeks. A P value of less than 0.05 was considered significant. RESULTS: A total of 44 patients were included in our study. The TP group had a significant decrease in comparison with their follow-ups; however, in the epidural group, the significant decrease was only observed compared to the pre-injection period and the scores did not have any significant decreases after the second week regarding the ODI, RQM, and VAS scales. The TP group demonstrated significantly higher scores of decreases of ODI and Quebec score compared to the epidural group at weeks 4 and 8. Regarding RQM, the TP groups demonstrated significantly higher scores of decreases compared to the epidural group at weeks 2, 4 and 8. (p < 0.001 p = 0.008, and p < 0.001, respectively). CONCLUSION: Both epidural and TP steroid injection significantly reduced the patients' pain and improved their QoL and function; however, more satisfactory results were observed in the TP group during the patients' follow-ups, while the epidural group demonstrated only statistically significant improvement during the short-term follow-up.

From Histoanatomy to Sonography in Myofascial Pain Syndrome: A EURO-MUSCULUS/USPRM Approach.

ABSTRACT: Myofascial pain is a common clinical condition, whereby accurate physical examination is usually considered as the cornerstone to identify/diagnose the "trigger point complex," that is, the characteristic finding of this syndrome. Considering the emerging role of ultrasound examination as the natural extension of physical assessment for musculoskeletal disorders, we briefly revise the histological/anatomical features of trigger points and propose a standardized, multistep sonographic approach to myofascial pain. We also imply that the integrated clinical-ultrasound evaluation could be considered as a potential tool to discriminate different phases/subsets of this challenging pathology.

Clinical efficacy of magnesium sulfate injection in the treatment of masseter muscle trigger points: a randomized clinical study.

OBJECTIVE: Myofascial pain syndrome with trigger points is the most common cause of nonodontogenic pain. Although injection of the trigger points is the most effective pain reduction treatment, many patients exhibit recurrence after a short period. Therefore, the aim of the current study was to evaluate the clinical efficacy of magnesium sulfate injections in the treatment of the masseter muscle trigger points when compared to saline injections. MATERIAL AND METHOD: This study randomly (1:1) assigned 180 patients to one of two treatment groups based on whether their trigger points were injected with 2 ml of saline or magnesium sulfate. Pain scores, maximum mouth opening (MMO), and quality of life were measured at the pre-injection and 1, 3, and 6 months post-injection. RESULTS: The pain scores were significantly higher in the saline group during all follow-up assessments, whereas the MMO was significantly higher in the magnesium sulfate group up to 3 months of follow-up (p < 0.001). However, the difference in MMO ceased to be statistically significant after 6 months of follow-up (p = 0.121). Additionally, the patient's quality of life score was significantly higher in the magnesium sulfate group compared to the saline group (p < 0.001). CONCLUSION: Injection of magnesium sulfate is an effective treatment measure for myofascial trigger points. However, further studies with a proper design addressing the limitations of the current study are necessary. CLINICALTRIALS: org (ID: NCT04742140) 5/2/2021.