CONTEXT AND OBJECTIVE: Myofascial syndrome is the most frequent condition of chronic pain. The objective of the present study was to compare the analgesic action of acupuncture and trigger point injection combined with cyclobenzaprine and dipyrone.

DESIGN AND SETTING: A randomized study was performed at the Pain Clinic. METHODS: Thirty patients were divided into two groups: G1 received trigger point injection of 0.25% bupivacaine (1 ml/point) twice a week, 10 mg/day cyclobenzaprine and 500 mg dipyrone every 8 h. G2 was submitted to classical and trigger point acupuncture twice a week. The patients were asked to continue physical exercise. The following parameters were evaluated: pain intensity rated on a numerical and verbal scale, quality of life before and four weeks after treatment, and quality of analgesia.

Among the 39 patients selected, nine (3 in group 1 and 6 in group 2) were excluded from the study because they did not attend the visits scheduled for the procedures and assessment or because they did not respond to the questionnaires.

Inclusion Criteria:- patients of both genders

• chronic myofascial syndrome (duration of more than three months),
• ranging in age from 18 to 65 year,
• pain intensity score of 3 or higher (rated on a numerical scale ranging from 0 to 10)

Exclusion Criteria:

• patients with disc herniation,
• osteoarthritis,
• vertebral collapse,
• temporomandibular joint dysfunction,
• infection, -
• tumors,
• coagulopathy, -
• psychiatric disease,
• cognitive disorders.
• Patients who had used any type of analgesic or muscle relaxant agent 15 days before the study and those taking anticoagulants