1000 Section - Comparative Efficacy of Focused Extracorporeal Shockwave Therapy and Dry Needling in Myofascial Pain Syndrome of the Upper Trapezius: A Randomized Controlled Trial

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

PS

Punpetch Siriratna, MD

Assistant professor
Mahidol University
Bangkok, Krung Thep, Thailand

Co-Author/Coautor(s)

TP

Thitiporn Phakdepiboon, MD

Assistant professor
Mahidol University
Bangkok, Krung Thep, Thailand
CW

Chattaporn Wittayadumrongchai, MD

Physician
Thatphanom Crown Prince Hospital
Nakhon Phanom, Nakhon Phanom, Thailand

Objectives : Myofascial pain syndrome (MPS) of the upper trapezius muscle is a worldwide musculoskeletal disorder. Various treatment modalities have been proposed, including Focused Extracorporeal Shockwave Therapy (F-ESWT) and Dry Needling (DN). Although previous studies found no significant difference between radial shockwave therapy and DN in pain relief, evidence directly comparing F-ESWT and DN remains limited. Therefore, the objective of this study was to compare the effectiveness of F-ESWT and DN in reducing pain and improving function in patients with MPS of the upper trapezius muscle.

Design:

This study was a single-blind randomized controlled trial. Fifty-eight patients with MPS of the upper trapezius were randomized equally into F-ESWT and DN groups. The first group received moderate-energy F-ESWT (0.20–0.25 mJ/mm², 4 Hz, 1,000 shocks/session) once weekly for three sessions. The second received a single DN session targeting the upper trapezius. Both groups received education, behavioural modification, and a home exercise program. Visual Analogue Scale (VAS) and Pressure Pain Threshold (PPT) were measured at baseline, 1 week, and 3 weeks post-treatment. The Thai version of the Neck Disability Index (Thai-NDI) was assessed at baseline and 3 weeks post-intervention.

Results:

Both groups demonstrated significant improvements in VAS, PPT, and Thai-NDI from baseline (p < 0.05). However, there was no significance between the two groups in any outcome at any follow-up time point (p > 0.05).

Conclusion: Three sessions of moderate-energy F-ESWT are non-inferior to a single DN session for improving pain and functional disability in Thai patients with upper trapezius MPS. F-ESWT may serve as an effective, non-invasive alternative to DN, although cost-effectiveness should be considered in clinical application.