{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:37:40Z","timestamp":1791261460257,"version":"4.1.0"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Japanese Non-surgical Orthopedics Society","award":["JNOS202302"],"award-info":[{"award-number":["JNOS202302"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Myofascial pain syndrome (MPS) is a major cause of chronic neck pain, with tissue ischemia implicated as a contributing factor. This prospective, single-arm interventional study evaluated the analgesic effect of ultrasound-guided fascia hydrorelease (US-FHR) performed around arteries supplying the neck in patients with chronic neck MPS. Thirteen adults (median age 53.0 years; 38.5% female) underwent US-FHR targeting the perivascular fascia of either the transverse cervical or dorsal scapular artery using 2 mL of normal saline. Pain intensity was assessed by visual analog scale (VAS) at rest and during movement; disability by the 5-item Pain Disability Index, Japanese version (PDI-5-J); and arterial blood flow volume before and after the procedure. The primary outcome, pain VAS during movement, decreased from 49.0 mm (interquartile range [IQR], 44.5\u201364.0) at baseline to 22.0 mm (IQR, 14.5\u201331.5) at 15 min and 22.0 mm (IQR, 14.0\u201334.0) at 1 week (Hodges-Lehmann median difference, 30.5 mm [95% CI, 24.5 to 36.5] and 28.5 mm [95% CI, 18.5 to 37.0]; both P\u2009&lt;\u20090.001). Pain VAS at rest improved from 21.0 mm (IQR, 13.0\u201343.5) to 8.0 mm at 15 min and 1 week (median difference, 14.5 mm [95% CI, 9.0 to 24.0; P\u2009=\u20090.001] and 13.5 mm [95% CI, 6.0 to 21.0; P\u2009=\u20090.007]). PDI-5-J decreased from 17.0 (IQR, 10.5\u201323.0) to 13.0 (IQR, 4.0\u201317.5) at 1 week (median difference, 5 [95% CI, 2\u20138; P\u2009=\u20090.004]). Blood flow volume increased from 11.2 mL\/min (IQR, 4.5\u201314.4) to 17.2 mL\/min (IQR, 6.1\u201323.7) immediately after US-FHR (median difference,\u2009+\u20094.1 mL\/min [95% CI,\u2009+\u20092.5 to +8.9; P\u2009=\u20090.001]), although transient. One patient experienced transient bleeding that was promptly controlled. In this single-arm feasibility study, US-FHR around the target artery was simple and safe to perform and was associated with reduced neck pain. Because the study lacked a control group, these preliminary findings should be regarded as hypothesis-generating and require confirmation in controlled trials; they may also inform the future evaluation of MPS in other anatomical regions. Trial registration: UMIN Clinical Trials Registry, UMIN000053612.<\/jats:p>","DOI":"10.1371\/journal.pone.0350882","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:26:05Z","timestamp":1785518765000},"page":"e0350882","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["The analgesic effect of ultrasound-guided fascia hydrorelease around the artery for myofascial neck pain: a prospective single-arm interventional study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6303-8666","authenticated-orcid":true,"given":"Tadanao","family":"Hiroki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2001-4464","authenticated-orcid":true,"given":"Tadashi","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Horigome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masei","family":"Suda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3082-1374","authenticated-orcid":true,"given":"Sho","family":"Fukui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5796-4308","authenticated-orcid":true,"given":"Takashi","family":"Suto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Obata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"issue":"3","key":"pone.0350882.ref001","article-title":"Global, regional, and national burden of neck pain, 1990\u20132020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021","volume":"6","author":"A-M Wu","year":"2024","journal-title":"Lancet Rheumatol"},{"issue":"1","key":"pone.0350882.ref002","doi-asserted-by":"crossref","first-page":"101944","DOI":"10.1016\/j.berh.2024.101944","article-title":"Myofascial pain - a major player in musculoskeletal pain","volume":"38","author":"C Lam","year":"2024","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"2","key":"pone.0350882.ref003","first-page":"230","article-title":"Prevalence of cervical myofascial pain syndrome and its correlation with the severity of pain and disability in patients with chronic non-specific neck pain","volume":"9","author":"K Ezzati","year":"2021","journal-title":"Arch Bone Jt Surg"},{"issue":"1","key":"pone.0350882.ref004","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s40122-013-0006-y","article-title":"Myofascial pain syndrome: a treatment review","volume":"2","author":"MJ Desai","year":"2013","journal-title":"Pain Ther"},{"key":"pone.0350882.ref005","doi-asserted-by":"crossref","first-page":"245","DOI":"10.2147\/JPR.S390386","article-title":"Is exercise rehabilitation an effective adjuvant to clinical treatment for myofascial trigger points? 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