Analgesic Effects of Percussive Massage Therapy Compared to Manual Myofascial Techniques in Myofascial Trigger Point Treatment: A Randomized Pilot Study

Background: Myofascial trigger points (MTrPs) are a frequent cause of musculoskeletal pain. Manual myofascial techniques (MMT) are widely used to reduce pain, but they require expertise and physical effort. Percussive massage therapy (PMT) has recently emerged as a device-assisted alternative, delivering rapid mechanical pulses that combine elements of deep tissue and vibration therapy. Although PMT is increasingly applied in sports and rehabilitation, evidence on its objective analgesic effects—especially compared with established manual methods—remains limited. Methods: Sixty patients diagnosed with MTrPs were randomly allocated to either PMT (n = 30; 28♂/2♀; mean age 31.07 ± 10.32 years) or MMT (n = 30; 29♂/1♀; mean age 33.20 ± 9.87 years). Each group received three sessions over six days (10 minutes per session). Pain was assessed before the first and five minutes after the final session using a visual analogue scale (VAS) and pressure pain threshold (PPT) algometry. Within- and between-group differences were analyzed using a two-way mixed-design analysis of variance (Time × Treatment), with p ≤ 0.05 considered significant. Results: Both PMT and MMT significantly reduced pain on the VAS (main effect of Time, p < 0.001), with no significant difference between groups in the amount of improvement (Time × Treatment interaction, p = 0.119). Both groups also showed a significant increase in pressure pain threshold (main effect of Time, p < 0.001); however, PMT produced a significantly greater increase than MMT (Time × Treatment interaction, p = 0.035). Conclusions: Both PMT and MMT significantly reduce subjective pain at MTrPs, with no evidence that one method is superior on the VAS. However, PMT produced a significantly greater improvement in objective pressure pain threshold than MMT, indicating an additional, measurable benefit of the device-assisted technique beyond what is captured by subjective pain scales alone.