Quick Summary
Myofascial pain syndrome is a common muscular pain condition driven by myofascial trigger points — tender, tight knots within a taut band of muscle, most often in the upper trapezius and levator scapulae. These trigger points cause deep aching and can refer pain into your head, shoulder blade and upper back, and they are frequently linked to desk work, sustained posture and stress. At J&J Therapy we combine hands-on manual therapy, Swiss Storz Medical shockwave therapy and a targeted exercise programme. Most patients notice meaningful improvement within 4–6 sessions.
What Is Myofascial Pain Syndrome?
Myofascial pain syndrome — often shortened to MPS — is a regional muscular pain condition defined by the presence of myofascial trigger points. A trigger point is a discrete, highly sensitive spot located within a palpable taut band of muscle. Pressing on it is painful locally and often reproduces the exact pattern of pain you recognise as your own.
Trigger points are described as either active or latent. An active trigger point produces pain spontaneously or on movement and refers pain to a distant area, such as from the upper trapezius up into the side of your head. A latent trigger point only hurts when pressed, but it can still restrict your movement and increase muscle stiffness, and it may become active under sustained mechanical or emotional stress (StatPearls, Cervical Myofascial Pain, 2023).
The neck and shoulder region is one of the most commonly affected areas. In a study of people with chronic non-specific neck pain, trigger points were most prevalent in the trapezius, with active trigger points found bilaterally in the upper trapezius and levator scapulae in the majority of participants (Cerezo-Téllez et al., Pain Medicine, 2016). The wider burden of neck pain is considerable: the Global Burden of Disease study estimated that neck pain affected 203 million people worldwide in 2020, with case numbers projected to rise to 269 million by 2050 (GBD 2021 Neck Pain Collaborators, The Lancet Rheumatology, 2024). Women are affected more often than men, and prevalence peaks between the ages of 45 and 74.
The leading explanation is the integrated hypothesis: excessive activity at the nerve–muscle junction keeps a small group of muscle fibres in sustained contraction, which restricts local blood flow and creates a low-oxygen, chemically irritated environment. Sampling studies have shown that active trigger points sit in a distinct biochemical environment, with lowered pH and raised inflammatory and pain-sensitising substances, helping to explain the self-perpetuating pain–tension–pain cycle (Shah & Gilliams, 2008).
This is also why shockwave therapy is a well-matched treatment for this condition. Research suggests that shockwave therapy may help deactivate trigger points by improving local blood flow in poorly perfused tissue and by modulating pain signalling within the muscle, which supports its use alongside manual therapy and exercise (Zhang et al., Archives of Physical Medicine and Rehabilitation, 2020; Jun et al., American Journal of Physical Medicine & Rehabilitation, 2021).
Do You Experience These Symptoms?
✓ Deep, aching pain across your neck and the top of your shoulder
✓ One or more tender knots that hurt sharply when pressed
✓ Pain that spreads, or refers, from the knot into your head, shoulder blade or upper back
✓ Tension-type headaches, particularly when the upper trapezius or levator scapulae is involved
✓ Stiffness and reduced movement when turning or side-bending your neck
✓ A sensation of a permanently tight band or cord within the muscle
✓ Symptoms that worsen with stress, poor sleep, or prolonged desk and screen work
These symptoms can be treated.
The sooner you begin, the better your chances of a smoother recovery.
What Causes Myofascial Pain Syndrome?
• Sustained posture and desk or screen work
Prolonged sitting, forward head posture and low-level static loading of the neck and shoulder muscles are the most common mechanical drivers of trigger points.
The upper trapezius and levator scapulae are particularly vulnerable, which is why office and computer-based work is repeatedly linked with higher rates of neck pain.
• Repetitive strain and muscle overuse
Repeated or unaccustomed loading — carrying heavy bags on one shoulder, overhead tasks, or repetitive arm movements — can overload muscle fibres and provoke taut bands.
Poor workstation ergonomics and a lack of movement breaks make this considerably more likely.
• Acute strain or trauma
A sudden awkward movement, a lifting strain or a whiplash-type injury can activate trigger points in the neck and shoulder muscles.
Cervical myofascial pain frequently follows overuse of, or direct trauma to, the muscles that support your neck and shoulder girdle.
• Psychological stress and poor sleep
Emotional stress raises resting muscle tension and is a well-recognised aggravating factor for trigger points.
Disturbed or unrefreshing sleep is commonly associated with the persistence of myofascial pain, and anxiety and low mood can influence how long symptoms last.
• Contributing health and lifestyle factors
Physical inactivity and general deconditioning reduce the tolerance of your neck and shoulder muscles to everyday loading.
In some cases an underlying spinal problem, such as facet joint irritation or degenerative change, can predispose to or perpetuate trigger points.
How We Treat Myofascial Pain Syndrome at J&J Therapy
Hands-On Manual Therapy
Hands-on trigger point release, ischaemic compression and soft tissue mobilisation to deactivate tender knots in your neck and shoulder muscles, combined with gentle cervical and thoracic joint mobilisation to restore comfortable movement.
Shockwave Therapy*
Swiss Storz Medical MASTERPULS
to help deactivate myofascial trigger points and improve local blood flow in the affected neck and shoulder muscles.
Non-invasive, evidence-based. Typically 3–5 sessions, usually one per week.
Targeted Exercise Programme
Personalised stretching for the upper trapezius and levator scapulae, progressive deep neck flexor and scapular strengthening, and postural re-education to reduce the sustained loading that keeps trigger points active and to lower the risk of recurrence.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
Progressive weakness, numbness or pins and needles in your arms or legs, clumsy hands, or problems with balance, walking or bladder and bowel control
Unexplained weight loss, fever or night sweats, or a history of cancer, alongside severe or constant neck pain
Neck pain following a fall, road traffic collision or direct blow, particularly with tenderness over the bones of your spine
Severe headache of sudden onset, visual disturbance, dizziness or difficulty swallowing
FAQs About Myofascial Pain Syndrome
Does shockwave therapy work for neck and shoulder trigger points?
Evidence shows that shockwave therapy can reduce pain and tenderness in myofascial pain syndrome affecting the trapezius and neck. A meta-analysis of eleven randomised controlled trials found a significant improvement in pain intensity and in pressure pain threshold, although no significant change in neck disability scores (Jun et al., American Journal of Physical Medicine & Rehabilitation, 2021). Trials comparing radial shockwave with dry needling for active upper trapezius trigger points have reported comparable results (Manafnezhad et al., Journal of Back and Musculoskeletal Rehabilitation, 2019). The research is mainly short-term, so we assess your suitability first and use shockwave as part of a combined programme rather than on its own.
How many sessions will I need?
Most patients notice meaningful improvement within 4–6 sessions when manual therapy, shockwave and exercise are combined. Shockwave itself is usually delivered over 3–5 weekly sessions. We reassess your pain, tenderness and neck movement as we go, and if there is no meaningful change after a full course we will review the diagnosis with you.
Is myofascial pain syndrome serious?
No — it is a benign muscular pain condition and is not dangerous, although it can be persistent and uncomfortable. Our physiotherapists first screen for the warning signs listed above, then treat the trigger points themselves along with the postural, workload and stress factors that keep them active.
Do I need a scan or a referral from my GP?
Usually not. Myofascial pain is diagnosed clinically by examining your muscles, palpating for taut bands and trigger points, and assessing your neck movement. Imaging is reserved for cases with warning signs or features suggesting a different cause, and you can book directly with us without a GP referral.
What is the difference between myofascial pain and fibromyalgia?
Myofascial pain syndrome is regional — it affects a specific muscle or group of muscles, such as your neck and shoulder, and is centred on identifiable trigger points. Fibromyalgia is a widespread condition involving pain across multiple body regions, usually with fatigue and sleep disturbance. The two can occur together, and our assessment helps distinguish them so that your treatment is directed appropriately.
This page is for general information only and does not replace professional medical advice.
Reviewed by Lavya Arigalayan, MSc, HCPC Registered Physiotherapist.
Last reviewed:
2026년 8월 20일