The purpose of this study is to determine whether electrical stimulation enhances the effect of botulinum toxin type A (Dysport®) on myofascial pain syndrome.

Inclusion Criteria:

• Chronic neck and shoulder pain for at least 6 months, refractory with other conservative treatments
• Presents at baseline with pain score greater than 50mm on 100mm length VAS. Pain score will be measured as overall pain over the 7 days preceding the visit during activities
• Active trigger point (TrP) defined as a tender spot localised in a taut band of muscle fibres associated with tenderness AND referred pain recognised by the patient into well-defined areas that are remote from the TrP area at palpation AND preferably local twitch response at palpation AND/OR jump sign at palpation

Exclusion Criteria:

• Disc/bone disease
• History of surgery on neck
• Neurological deficits, neuromuscular junction disorder, Motor Neuron disease
• Patient has received anesthetic injections to the target trigger point within 4 weeks of study enrolment, or corticosteroid injections within 3 months
• Systemic inflammatory disease
• Hypersensitivity to Dysport®
• Diffuse tender points, or diagnosed with fibromyalgia
• Previous electrical stimulation
• Previous injection of Dysport® within 6 months of study enrolment