Background: Myofascial trigger points (TrP) are one of the most overlooked and ignored causes of musculoskeletal pain. Purpose: This current study is designed to investigate and compare the effects of extracorporeal shockwave and high-power pain threshold ultrasound in treating myofascial trigger points in upper trapezius. Materials and methods: This study will be conducted in outpatient clinic of faculty of physical therapy in Egyptian Chinese University. Sixty patients with upper trapezius trigger point participated in the study and each participant read and signs the consent form. Patients randomly divided into two equal groups Group (A) patients received high power pain threshold ultrasound while patients in group (B) received shockwave for 4 weeks. Visual analogue scale, algometer, cervical ROM and Arabic version of neck disability questionnaire were used for assessment before and after treatment. Results: In high power pain threshold ultrasound group, patients get improvements in VAS, algometric readings, right rotation ROM, right lateral bending ROM, and neck disability index. In shockwave group, patients get improvements in VAS, algometric readings, and neck disability index. When comparing both groups, high power pain threshold ultrasound group showed more improvement than shockwave in right rotation ROM (P=0.028) while shockwave group showed more improvement in NDI (P=0.031). Conclusion: extracorporeal shockwave and high power pain threshold ultrasound have similar effect in treating myofascial trigger points in upper trapezius but shockwave is more preferable when disability is the issue while ultrasound is the preferable when the ROM is the main concern.
