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To compare the efficacy of extracorporeal shock wave therapy versus standard care (ultrasound + hot pack + self-stretch-exercises) in treatment of neck and upper back myofascial pain syndrome. Single-blind randomised clinical trial. Outpatients setting. Patients with neck and upper back myofascial pain. Participants were randomly allocated into shock wave group ( = 24), standard care (ultrasound + hot pack + self-stretch-exercises) group ( = 24) and control (self-stretch-exercises) group ( = 24) for four weeks. The primary outcomes we