Comparing exercise, needling, and injections for shoulder muscle pain

This trial is testing three different treatment approaches for myofascial pain syndrome — a condition that causes persistent muscle pain and tightness in the upper shoulder and neck. All participants will do stretching and range-of-motion exercises, but some will also receive dry needling (using thin sterile needles under ultrasound guidance) or an interfascial block (a mixture of numbing medication injected between muscle layers, also guided by ultrasound). The goal is to find out which combination works best to reduce pain and improve function.

Myofascial pain syndrome in the shoulder and neck area is common and often lasts for months or years, limiting people's ability to move and work. While exercise is a standard treatment, doctors want to know whether adding minimally invasive procedures like dry needling or targeted injections can give patients faster relief and better long-term results.