Patients with an myofascial trigger point (MTrP) in their upper trapezius will be divided into three groups: Group A receiving MTrP injection with normal saline (control group), Group B with hypo-osmolar dextrose (5% dextrose), and Group C with hyper-osmolar dextrose (15% dextrose). Clinical outcomes and morphological changes will be measured before the injection, one hour after, one week after, two weeks after, and one month after the injection to delineate the therapeutic effects of dextrose injection for an MTrP.
1). Patients should be 20 years of age or older;
2). They are able to communicate freely;
(a). a localized tender spot in a palpable taut band of muscle fibers,
(b). recognized pain (as the usual clinical complaint) when the tender spot is compressed,
(1). acute or serious medical problems;
(2). cognitive impairment or psychiatric disorder;
(3). coagulopathy or any other bleeding disorder;
(4). taking medication of anticoagulation or antithrombolytics;