International Journal of Physical Medicine & Rehabilitation
Open Access
ISSN: 2329-9096
ISSN: 2329-9096
Jue Chen, Zhe Shang, Yubao Ma*
Background: Trapezius Myofascial Pain Syndrome (TMPS) is a common chronic musculoskeletal disorder causing neck shoulder pain and dysfunction. Conventional treatments have limitations such as adverse effects and unsatisfactory long term outcomes. Shock Wave Therapy (SWT) is a non invasive modality for myofascial disorders, yet evidence for TMPS remains limited by heterogeneous protocols and small sample sizes. This systematic review assesses the efficacy and safety of SWT for TMPS to inform clinical practice.
Methods: Following the Patient/Population, Intervention, Comparison and Outcome (PICO) framework, PubMed, Web of Science, Embase, and PEDro were searched from inception to June 2025 for Randomized Controlled Trials (RCTs) investigating SWT for TMPS. Eligible participants were adults diagnosed with TMPS. Intervention groups received SWT, including focused or radial shock waves, while controls received sham treatment, no treatment, or conventional therapies (physiotherapy, massage, acupuncture, or pharmacological treatment). Two reviewers independently performed study selection and data extraction. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale, and its influence on the interpretation of findings was considered in the synthesis.
Results: Fourteen RCTs involving 876 participants published between 2012 and 2025 were included, originating from Korea, Egypt, China, Turkey, Hungary, and Iran. The median PEDro score was 6 (range: 5-8), with most studies rated as moderate quality (scores 6-7/11). Control interventions varied across studies, including sham therapy, laser therapy, dry needling, taping, ultrasound, and exercise therapy. SWT protocols differed in type, frequency, and treatment duration. Overall, SWT demonstrated significant reductions in pain intensity and tenderness, and improvements in range of motion, with no serious adverse events reported.
Conclusion: Current evidence suggests that SWT is a safe and effective intervention for trapezius myofascial pain syndrome. However, as most included trials were of moderate methodological quality and considerable variability existed in SWT protocols (such as type, energy flux density, and treatment duration), the strength of evidence should be interpreted with caution. Further large scale, high quality RCTs are warranted to confirm its efficacy and elucidate underlying mechanisms.
Published Date: 2026-05-24; Received Date: 2026-04-24