Ultrasound-guided techniques in the treatment of myofascial pain syndrome: a comparison of superficial and deep dry needling.

AIMS: To compare the effectiveness of ultrasound (US)-guided superficial dry needling (SDN) and deep dry needling (DDN) in patients with myofascial pain syndrome (MPS) of the upper trapezius muscle. MATERIAL AND METHODS: This prospective, single-blind, randomized study included 80 patients with upper trapezius MPS. Patients were assigned to SDN or DDN groups. Under US guidance, needles were inserted into the subcutaneous deep fascia in the SDN group and directly into muscle trigger points in the DDN group. Both groups received a one-week home exercise program. Outcomes were evaluated before and one week after treatment using the numeric pain rating scale (NPRS), neck Bournemouth questionnaire (NBQ), neck disability index (NDI), pressure pain threshold (PPT), and cervical range of motion (ROM). RESULTS: Both groups showed significant improvements in NPRS, NBQ, NDI, and PPT (p