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Open research questions in Myofascial pain diagnosis and treatment

189 gap statements mined from Myofascial pain diagnosis and treatment papers in our 7.9M-paper local library, which holds 943 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • However, its effectiveness in reducing muscular stiffness and pain among office workers has not been extensively studied.

    Therapeutic effect of focused-extracorporeal shockwave therapy on muscular and adjacent tissue stiffness and pain changes in myofascial pain syndrome: A randomized controlled trial study · 2025 · DOI

  • Dry needling is frequently used for managing myofascial pain, yet the influence of needle manipulation technique on physiological responses remains uncertain.

    Comparative effects of static, classical, and sham dry needling on muscle properties and autonomic nervous system activity in cervical myofascial pain syndrome · 2025 · DOI

  • The need for more research on the long-term effects of IASTM. The need for more research on the use of IASTM in treating various musculoskeletal conditions.

    Myofascial release and fascial-targeted mechanical interventions in musculoskeletal rehabilitation: mechanisms, modalities, and integrative physiology · 2026 · DOI

  • A limitation for device use is the cost and accessibility. Foam rollers and basic massage tools are cheap and widely available. In contrast, high-quality massage guns can be expensive, and shockwave machines are very costly and thus limited to clinics with those resources. Additionally, certain devices require expertise to use correctly (Kerautret et al., 2020).

    Myofascial release and fascial-targeted mechanical interventions in musculoskeletal rehabilitation: mechanisms, modalities, and integrative physiology · 2026 · DOI

  • The comparative clinical profiles of interfascial plane injection and trigger point injection for upper trapezius myofascial pain syndrome are unclear.

    Comparison of interfascial plane injection and trigger point injection for upper trapezius myofascial pain syndrome in young women: a prospective cohort study · 2026 · DOI

  • There is a lack of studies comparing the effects of SNAGs and INIT on NSNP. The pathoanatomical origins of NSNP cannot be recognized.

    Effect of sustained natural apophyseal glides versus integrated neuromuscular inhibition technique on non specific neck pain · 2026 · DOI

  • The lack of explicit information on the assessment of evoked pain hypersensitivity in all vignettes. The potential incorporation bias due to the reliance on the same evidence-based variables for both the index test and the reference standard.

    Comment on Bilika et al. Applying Nociplastic Pain Criteria in Chronic Musculoskeletal Conditions: A Vignette Study. J. Clin. Med. 2025, 14, 1179 · 2026 · DOI

  • Comparative evidence for combined manual and electrotherapeutic interventions remains limited. There is a need to compare the effects of integrated neuromuscular inhibitory technique combined with surged faradic current versus manual trigger point release on pain, cervical range of motion, and disability in adults with chronic upper trapezius pain.

    Comparative Effects of Integrated Neuromuscular Inhibitory Technique Combined with Surged Faradic Current Versus Manual Trigger Point Release in Chronic Upper Trapezius Myofascial Pain: A Randomized Controlled Trial · 2026 · DOI

  • The gap in understanding the effects of fascia-focused physiotherapy on chronic low back pain and comorbid depression. The need for a biopsychosocial approach to chronic low back pain management.

    Fascia-Focused Versus Conventional Physiotherapy for Chronic Low Back Pain and Comorbid Depression in Psychosomatic Inpatients · 2026 · DOI

  • Given the limited significant results, further research is neces-One of the most important limitations of this study is the lack of long-term follow-up data. Another limitation is that the degree of pes planus was assessed using the Feiss line test, which, although commonly used clinically, is a subjective method with mixed evidence regarding its validity and reliability.

    Investigation of foot function, pain, flexibility and muscular performance levels according to the degree of pes planus in patients with plantar fasciitis: a cross-sectional study · 2026 · DOI

  • Future studies should conduct controlled trials comparing the effectiveness of AEP and CM with other physiotherapy methods.

    Effects of Aquatic Exercise Programme and Massage on Pain Intensity and Muscle Elastic Properties in Chronic Nonspecific Low Back Pain: A Pilot Study · 2026 · DOI

  • There is a need to evaluate the effects of AEP and CM on pain intensity and muscle elastic properties in chronic nonspecific LBP.

    Effects of Aquatic Exercise Programme and Massage on Pain Intensity and Muscle Elastic Properties in Chronic Nonspecific Low Back Pain: A Pilot Study · 2026 · DOI

  • The current understanding of the etiology of chronic non-specific low back pain is limited. There is a need for further research on the role of fascial fixation of the saphenous nerve in the adductor canal as a potential cause of chronic non-specific low back pain.

    CHRONIC NON-SPECIFIC LOW BACK PAIN AS A CONSEQUENCE OF FASCIAL FIXATION OF THE SAPHENOUS NERVE IN THE ADDUCTOR CANAL · 2026 · DOI

  • Laser therapy remains promising but under-investigated in fibromyalgia and its specific benefit over other modalities is not well established. Low-Level Laser Therapy (Photobiomodulation): Some pilot and small studies suggest potential symptom improvement, but high-quality RCTs are scarce. While laser evidence is limited in fibromyalgia, nerve glides have some supportive RCT evidence for symptom reduction.

    Efficacy of PEMF and myofascial release Vs laser and nerve glide techniques in case of lumbar fibromyalgia · 2026 · DOI

  • Further randomized controlled studies with larger samples are required to confirm the findings. Studies investigating the long-term effects of fascial manipulation are needed. Research on the underlying mechanisms of fascial manipulation and its effects on fascial tissue is necessary.

    Fascial Manipulation in Physiotherapy of Young Active Football Players: A Comprehensive Case Series · 2026 · DOI

  • Musculoskeletal disorders are a significant health problem worldwide. Cervical sprain can lead to limitations in activities of daily living. Access to rehabilitation programs can be limited for patients with limited mobility or those living in remote areas.

    Telerehabilitation in patients with neck sprain at the first level of care · 2026 · DOI

  • The exact mechanism of action of Agnikarma is still unclear to modern medicine. There is a need for further research on the efficacy and safety of Agnikarma in managing Gridhrasi.

    ROLE OF AGNIKARMA IN THE MANAGEMENT OF GRIDHRASI: A REVIEW · 2026 · DOI

  • The lack of a comprehensive systematic review on morphological adaptations in the musculoskeletal system. The need to understand the optimal dose and type of exercise for musculoskeletal health.

    [English original] Full study of characteristics of morphological adaptations in response to chronic exercise across musculoskeletal tissues: a systematic review · 2026 · DOI

  • The literature is lacking methodologically sound studies concerning frequency and magnitude of the suggested effects of WATSU, dose-response, or responder-profiles among patients.

    SYSTEMATIC REVIEW ON APPLICATIONS, INDICATIONS, AND EFFECTS OF PASSIVE HYDROTHERAPY WATSU (WATERSHIATSU) · 2026 · DOI

  • Seventh, because the included cohorts were predominantly middle-aged and did not assess sarcopenia directly, the applicability of the synthesized evidence to older adults living with, or at risk of, sarcopenia remains uncertain and is an explicit priority for future age-stratified study.

    Sarcopenia and related musculoskeletal phenotypes in patients considered for spinal cord stimulation: a scoping review · 2026 · DOI

  • The search results were limited to studies published between 2000 and 2023 without language restrictions.

    Dry needling in multiple sclerosis: a scoping review · 2025 · DOI

  • To investigate the optimal dose and type of exercise for musculoskeletal health. To examine the effects of exercise on musculoskeletal tissues in different populations. To develop exercise programs aimed at improving musculoskeletal health.

    [English original] Full study of characteristics of morphological adaptations in response to chronic exercise across musculoskeletal tissues: a systematic review · 2026 · DOI

  • There is currently no gold standard for the diagnosis of deep gluteal syndrome. The role of ligamentous pathology as a cause of nerve compression has been overlooked.

    Sciatic Nerve Anatomical Variations and Deep Gluteal Syndrome: Clinical Relevance and Current Evidence — A Narrative Literature Review · 2026 · DOI

  • The absence of a gold standard - The potential incorporation bias due to the overlap in evidence-based discriminating variables - The lack of explicit discussion of the fourth step in the grading…

    Comment on Bilika et al. Applying Nociplastic Pain Criteria in Chronic Musculoskeletal Conditions: A Vignette Study. J. Clin. Med. 2025, 14, 1179 · 2026 · DOI

  • Future studies should investigate the combined effect of manual therapy techniques with therapeutic exercises, stretching, postural correction, and ergonomic training IJFMR260482425 Volume 8, Issue 4, July-August 2026…

    Immediate Effect of Positional Release Technique versus Active Release Technique on Upper Trapezius Myofascial Pain, Tightness and Neck Disability in College‑Going Students: A Comparative Study · 2026 · DOI

Most-cited papers in Myofascial pain diagnosis and treatment

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Open questions raised by papers listed on this page include: (1) The comparative clinical profiles of interfascial plane injection and trigger point injection for upper trapezius myofascial pain syndrome are unclear (“Comparison of interfascial plane injection and trigger point injection for…”, 2026); (2) There is a lack of studies comparing the effects of SNAGs and INIT on NSNP (“Effect of sustained natural apophyseal glides versus integrated neuromuscular…”, 2026); (3) The lack of explicit information on the assessment of evoked pain hypersensitivity in all vignettes (“Comment on Bilika et al. Applying Nociplastic Pain Criteria in Chronic…”, 2026); (4) Comparative evidence for combined manual and electrotherapeutic interventions remains limited (“Comparative Effects of Integrated Neuromuscular Inhibitory Technique Combined…”, 2026); (5) Future studies should conduct controlled trials comparing the effectiveness of AEP and CM with other physiotherapy methods (“Effects of Aquatic Exercise Programme and Massage on Pain Intensity and Muscle…”, 2026). 189 gap statements have been mined from Myofascial pain diagnosis and treatment papers in our 7.9M-paper local library, which holds 943 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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