Multimodal Physiotherapy Interventions for Cervical Myofascial Pain (2019-2025): A Structured Narrative Literature Review of Randomized Trials.

Cervical myofascial pain syndrome (MPS) causes substantial pain and disability, but recent physiotherapy evidence remains fragmented. This structured narrative literature review synthesized randomized controlled trials (RCTs) from 2019 to 2025 on non-pharmacological physiotherapy interventions for cervical myofascial pain. PubMed and PEDro were searched for English-language RCTs, and reporting followed the Scale for the Assessment of Narrative Review Articles (SANRA). Sixty-seven trials were included.  Dry needling (DN) was most studied, with consistent short- to mid-term improvements in pain, pressure pain threshold (PPT), and range of motion (ROM), especially when paired with exercise or manual therapy. Myofascial release methods (ischemic compression, cupping, instrument-assisted soft tissue mobilization, integrated neuromuscular inhibition technique) yielded short-term analgesia and functional gains, with some protocols showing better retention. Structured exercise produced the most reliable benefits and enhanced outcomes when combined with DN or release techniques. Extracorporeal shockwave therapy (ESWT) and transfer of energy capacitive and resistive therapy (TECAR) performed comparably to DN in several trials, though long-term efficacy and cost-effectiveness data are limited. Laser, transcutaneous electrical nerve stimulation (TENS), and microcurrent showed mixed but generally positive effects. Multimodal programs outperformed single-modality care. Future research should adopt standardized, sham-controlled designs with extended follow-up periods to establish long-term efficacy and cost-effectiveness.