Clinical Outcomes of Aggressive Multimodal Management in Cervicothoracic Myofascial Pain Syndrome: A Prospective Controlled Observational Study

Myofascial pain syndrome (MPS) is one of the most common causes of chronic neck and shoulder pain encountered in clinical practice; however, despite its high prevalence, it is frequently underdiagnosed because of overlapping clinical presentations with other musculoskeletal and neurological disorders. The condition is characterized by hyperirritable trigger points within skeletal muscles that produce localized tenderness, referred pain, restricted mobility, and functional impairment. This prospective controlled observational study aimed to evaluate the clinical outcomes of aggressive multimodal therapy compared with conventional conservative treatment in patients with cervicothoracic MPS. Sixty patients diagnosed with cervicothoracic MPS were enrolled and allocated into two groups: Group A (n = 30) received aggressive multimodal therapy, while Group B (n = 30) received conventional conservative treatment. Baseline evaluation included assessment of pain intensity using the Visual Analog Scale (VAS), cervical range of motion measurements, and trigger point mapping, with follow-up assessments conducted at 48 hours, 6 weeks, and 6 months. Baseline pain intensity was comparable between the two groups, with mean VAS scores of 8.1 in Group A and 8.0 in Group B. The intervention group demonstrated significantly greater pain reduction at all follow-up time points, with mean VAS scores decreasing to 4.0 versus 6.7 at 48 hours, 2.0 versus 4.8 at 6 weeks, and 2.5 versus 5.1 at 6 months in Groups A and B, respectively. Significant clinical improvement was observed in 80% of patients receiving aggressive multimodal therapy compared with 40% of those receiving conventional treatment (p < 0.001). These findings suggest that aggressive multimodal therapy, consisting of trigger point injections and structured rehabilitation, provides superior pain relief and functional recovery compared with conventional conservative management in patients with cervicothoracic myofascial pain syndrome.