This study aimed to compare interfascial block therapy with commonly used exercise therapy and conventional invasive dry needling therapy, and to evaluate its effectiveness and superiority. Another objective of this study was to evaluate and compare the short-term and long-term effectiveness of interfascial block, dry needling, and exercise therapies on pain, disability, and quality of life in patients with myofascial pain syndrome. In this respect, our study is important in terms of its contribution to the literature.
Myofascial pain in the upper trapezius muscle that has lasted for at least 3 months
VAS score of 4 or higher for the current pain
Clinically diagnosed with myofascial pain in the trapezius muscle
Ages 18 to 55
Having received interventional injections in the neck and shoulder area within the last 3 months
Having received physical therapy within the last 3 months
Having received regular nonsteroidal anti-inflammatory and myorelaxant treatment within the last month
History of surgery on the affected side (neck or shoulder)
Parallel
Exercise
Other interventionCervical range of motion and trapezius fascial stretching exercises
Dry Needling + Exercise
Other interventionCervical ROM, fascial stretching exercises for the trapezius muscles, and dry needling of the relevant fascia with Hua Long brand 0.25x25 mm disposable sterile steel acupuncture needles under ultrasound guidance.
Exercise + interfascial block
Other interventionCervical range of motion (ROM) and trapezius muscles are treated with fascial stretching exercises and ultrasound-guided interfascial injection of 1 cc of 2% lidocaine + 4 cc of 0.9% saline solution.
Visual Analog Scale
0-10 scale. Higher scores represent more severe pain.
Cervical Range of Motion
Will measure flexion/extension, lateral bending, rotation, protraction/retraction in degrees.
Neck Disability Index (NDI)
The Neck Disability Index (NDI) is a widely used self-report questionnaire that measures functional disability associated with neck pain. It consists of 10 items scored from 0 to 5, covering pain intensity and daily activities. Higher scores indicate greater disability. The NDI is commonly used in clinical practice and research to assess baseline status and monitor treatment outcomes.
Pressure Pain Threshold (PPT)
Pressure Pain Threshold (PPT) is a quantitative measure of pain sensitivity assessed using a pressure algometer. It represents the minimum amount of pressure that evokes pain. PPT is widely used in clinical and research settings to evaluate mechanical pain sensitivity, detect hyperalgesia, and monitor treatment effects. Lower PPT values indicate increased pain sensitivity, while higher values reflect reduced sensitivity.
12-Item Short Form Survey (SF-12)
The 12-Item Short Form Survey (SF-12) is a brief, validated questionnaire used to assess overall health-related quality of life. It measures physical and mental health through 12 questions derived from the SF-36. The survey generates two main scores: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Higher scores indicate better health status. The SF-12 is widely used in clinical practice and research due to its brevity, reliability, and ability to capture general functional health.
Central Sensitisation Inventory
A self-report inventory, the Central Sensitization Inventory (CSI), will be used to assess the overlapping symptom dimensions of Central Sensitivity Syndromes. This measure is intended as a screening instrument to help identify the presence of a Central Sensitivity Syndrome, and to alert clinicians that presenting symptoms may be related to central sensitisation. Part A of the Central Sensitisation Inventory assesses 25 health-related symptoms that are common to Central Sensitivity Syndrome, with total scores ranging from 0-100. Part B (which is not scored) asks if one has previously been diagnosed with one or more specific disorders, including seven separate Central Sensitivity Syndromes
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Lead sponsor
Haydarpasa Numune Training and Research Hospital
Sponsor institution
