Efficacy of Focused ESWT and Dry Needling Among Patients With Myofascial Pain Syndrome of the Upper Trapezius Muscle

Inclusion Criteria: * The participant who is diagnosed with myofascial pain syndrome based on the criteria listed below: The trigger point must be in a taut band of the upper trapezius muscle. The trigger point in the muscle is hypersensitivity to pain. Pain radiates to the specific pattern of the upper trapezius muscle. When pressure is applied to the trigger point, the participant perceives the same pain sensation as their pain complaint. * The participant who has a VAS score of \> or = 5 points * The participant who has had myofascial pain for \> or = 3 months Exclusion Criteria: The participant who has * Unresolved neurological or musculoskeletal problems, such as fibromyalgia, cervical radiculopathy, and cervical spine fracture. * History of cervical spine or shoulder surgery * Uncontrolled underlying diseases, such as psychological problems, cancer, or acute renal or hepatic failure * Received treatment by other physical modalities or steroid injection into the trigger point within 3 months, or was treated by analgesic drugs within 2 weeks. * Contraindicated to ESWT or DN * Refuse to attend the study