Short-term effects of therapeutic massage alone or combined with conventional physiotherapy in myofascial pain syndrome: A randomized controlled trial

Background Myofascial pain syndrome (MPS) is a musculoskeletal disorder characterized by trigger points and functional limitations. Massage interventions are used in physiotherapy; however, their effectiveness versus conventional physiotherapy remains unclear.Objective To compare the short-term effects of conventional physiotherapy, therapeutic massage, and a combined treatment approach on pain, pressure pain threshold, muscle activity, functional disability, and quality of life in individuals with chronic MPS.Methods In this randomized controlled trial, 60 participants with upper trapezius MPS (31 females, 29 males; mean age 42.20 years) were allocated to three groups (1:1:1): Conventional physiotherapy (Group A), therapeutic massage (Group B), or combined treatment (Group C). Interventions were applied three times per week for four weeks. Outcomes included pain intensity (VAS), pressure pain threshold (PPT), upper trapezius muscle activity assessed by surface electromyography (sEMG), functional disability (NDI), and health-related quality of life assessed using the SF-12 physical and mental component scores, all assessed at baseline and after the 4-week intervention period.Results Significant time × group interactions were observed for all outcomes (all p < .001; partial η2 = 0.90–0.99). Post hoc analyses indicated that Groups B and C achieved greater reductions in VAS and NDI scores and greater improvements in the SF-12 physical component score compared with Group A (all p < .001), with no significant differences between Groups B and C. In contrast, Group C showed greater improvements in PPT, EMG-rest, EMG-Abd90, and the SF-12 mental component score than both Groups A and B (all p < .001).Conclusion Therapeutic massage, applied alone or in combination with conventional physiotherapy, may provide greater short-term improvement in pain and function than conventional physiotherapy alone in individuals with chronic MPS. The combined approach may offer additional short-term benefits for neuromuscular and psychosocial outcomes.