J Man Manip Ther. 2026 Sep 8:1-9. doi: 10.1080/10669817.2026.2729532. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify the modalities most commonly used by outpatient physical therapists in the United States for the treatment of myofascial trigger points (MTrPs), determine how frequently those modalities are used, and examine the factors influencing modality selection.

METHODS: A descriptive, exploratory, cross-sectional internet survey was administered through Qualtrics to a convenience sample of licensed physical therapists practicing in outpatient settings in the United States between 17 March 2025, and 7 April 2025. Participants were recruited through the Tennessee Physical Therapy Association and two multistate outpatient orthopedic networks. Responses were analyzed using descriptive statistics, including frequencies and percentages.

RESULTS: Fifty-nine outpatient physical therapists completed the survey. Manual release (93.2%) and dry needling (88.1%) were the most commonly reported modalities for MTrP management, and manual release was the most frequently used intervention overall (55.9%). The most commonly endorsed reasons for selecting a modality were the ability to provide precise treatment (100%), rapidly reduce symptoms (98.1%), and achieve long-lasting results (90.7%). Cost-effectiveness was endorsed by 59.3% of respondents, while ultrasound was reported by only 5.1%.

DISCUSSION: In this exploratory sample, outpatient physical therapists favored hands-on and needling-based approaches for the management of MTrPs, with treatment precision and perceived clinical effectiveness appearing to drive decision-making more strongly than cost. These findings support the continued clinical use of manual therapy and dry needling in contemporary outpatient practice while suggesting a diminished role for ultrasound as a stand-alone modality; because the sample was a convenience sample drawn from a single state association and two multistate networks, findings should not be generalized beyond this sample without further study.

PMID:42709560 | DOI:10.1080/10669817.2026.2729532