The Impact of Dry Needling on Electrophysiological and Ultrasound-based Biomarkers for Myofascial Pain

Inclusion Criteria: * Ages 18-80 * Presence of active trigger points with involvement of upper trapezius * Able to manage breakthrough pain with acetaminophen only, excluding stable doses of pain medications at time of enrollment, which can be continued Exclusion Criteria: * Multiple active trigger points in the trapezius muscle if physician assessment concludes that this may interfere with subject's ability to detect changes in pain improvement from trigger point therapy * Presence of cervical radicular pain, superimposed neuromuscular disease or condition that, in the opinion of the investigator, could confound interpretation of the data acquired from trapezius. * Fibromyalgia or other generalized pain condition * Opioid usage in the past 3 months * Active substance use disorder * Not on a stable dose for at least two weeks prior to study enrollment or unwilling to maintain a stable dose for duration of the study of the following drugs: 1. SSRIs, such as citalopram, escitalopram, fluoxetine, sertraline, 2. SNRIs, such as duloxetine, milnacipran, and venlafaxine 3. Tricyclic antidepressants, such as notritptyline, amitriptyline, and desipramine 4. Alpha 2 delta ligands: pregabalin, gabapentin 5. Specific anti-epileptics: topiramate, lamotrigine, oxcarbazepine, and phenytoin 6. Other: quinidine, mexiletine, and dalfampridine * Skin allergy or sensitivity that would preclude the use of adhesive electrodes * Significant systemic or psychiatric illness that in the opinion of the site Investigator would interfere with the individual's ability to participate in the trial * Anticoagulation (with coumadin, clopidogrel, or direct oral anticoagulants; aspirin acceptable) * TrP needle-based therapy in the past six weeks of the TrP to be studied * Body mass index \> 35 kg/m2 * Other factor that in the opinion of the site investigator would interfere with the ability to perform the study procedures