Soft Tissue Pain
Soft tissue pain is discomfort around the bones and muscles. This may also involve tendons, ligaments, or other support structures.
It is treated with medicine. Some people turn to natural therapies to help ease pain.
May Be Effective
These therapies may ease pain:
May Not Be Effective
Unlikely to Be Effective
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Herbs and Supplements to Be Used With Caution
Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions. Some supplements discussed here have certain concerns.
Acupuncture A1. Lam M, Galvin R, Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2013;38(24):2124-2138.
A1. Cox J, Varatharajan S, Côté P, Optima Collaboration. Effectiveness of acupuncture therapies to manage musculoskeletal disorders of the extremities: a systematic review. J Orthop Sports Phys Ther. 2016;46(6):409-429.
A2. Leite PMS, Mendonça ARC, et al. Does electroacupuncture treatment reduce pain and change quantitative sensory testing responses in patients with chronic nonspecific low back pain? A randomized controlled clinical trial. Evid Based Complement Alternat Med. 2018;2018:8586746.
A3. Li X, Wang R, et al. Acupuncture for Myofascial Pain Syndrome: A Network Meta-Analysis of 33 Randomized Controlled Trials. Pain Physician. 2017 Sep;20(6):E883-E902.
A4. Wang R, Li X, et al. Manual acupuncture for myofascial pain syndrome: a systematic review and meta-analysis. Acupunct Med. 2017 Aug;35(4):241-250.
A5. Seo SY, Lee KB, et al. Effectiveness of Acupuncture and Electroacupuncture for Chronic Neck Pain: A Systematic Review and Meta-Analysis. Am J Chin Med. 2017;45(8):1573-1595.
A6. Yuan QL, Wang P, et al. Acupuncture for musculoskeletal pain: A meta-analysis and meta-regression of sham-controlled randomized clinical trials. Sci Rep. 2016 Jul 29;6:30675.
A7. Wong Lit Wan D, Wang Y, et al. Local and distant acupuncture points stimulation for chronic musculoskeletal pain: A systematic review on the comparative effects. Eur J Pain. 2015 Oct;19(9):1232-1247.
A8. Law D, McDonough S, et al. Laser acupuncture for treating musculoskeletal pain: a systematic review with meta-analysis. J Acupunct Meridian Stud. 2015 Feb;8(1):2-16.
B1. van den Dolder PA, Ferreira PH, et al. Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis. Br J Sports Med. 2014;48(16):1216-1226.
B2. Bervoets DC, Luijsterburg PA, et al. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. J Physiother. 2015 Jul;61(3):106-116.
B3. Furlan AD, Giraldo M, et al. Massage for low-back pain. Cochrane Database Syst Rev. 2015 Sep 1;(9):CD001929.
B4. van den Dolder PA, Ferreira PH, et al. Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis. Br J Sports Med. 2014 Aug;48(16):1216-26. doi: 10.1136/bjsports-2011-090553. Epub 2012 Jul 26. Review. PubMed PMID: 22844035.
C1. Chiesa A, Serretti A. Mindfulness-based interventions for chronic pain: a systematic review of the evidence. J Altern Complement Med. 2011;17(1):83-93.
C2. la Cour, Petersen M. Effects of mindfulness meditation on chronic pain: a randomized controlled trial. Pain Med. 2015;16(4):641-652.
C3. Bawa FL, Mercer SW, et al. Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis. Br J Gen Pract. 2015 Jun;65(635):e387-400.
D1. Yelland MJ, Glasziou PP, et al. Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial. Spine (Phila Pa 1976). 2004;29(1):9-16.
Rabago D, Best TM, et al. A systematic review of prolotherapy for chronic musculoskeletal pain. Clin J Sport Med. 2005;15(5):376-380.
Yelland MJ, Sweeting KR, et al. Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial. Br J Sports Med. 2011;45(5):421-428.
E1. Bai R, Li C, et al. Effectiveness of spa therapy for patients with chronic low back pain: An updated systematic review and meta-analysis. Medicine (Baltimore). 2019 Sep;98(37):e17092.
F1. Coulter ID, Crawford C, et al. Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel. Pain Physician. 2019 Mar;22(2):E55-E70.
F2. Rubinstein SM, de Zoete A, et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019 Mar 13;364:l689.
Coulter ID, Crawford C, et al. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J. 2018 May;18(5):866-879.
Paige NM, Miake-Lye IM, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. JAMA. 2017 Apr 11;317(14):1451-1460.
Gross A, Langevin P, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev. 2015 Sep 23;(9):CD004249.
Franke H, Franke JD, et al. Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2014 Aug 30;15:286.
G1. Li Y, Li S, et al. Effects of yoga on patients with chronic nonspecific neck pain: A PRISMA systematic review and meta-analysis. Medicine (Baltimore). 2019 Feb;98(8):e14649.
G2. Cramer H, Klose P, et al. Effects of yoga on chronic neck pain: a systematic review and meta-analysis. Clin Rehabil. 2017 Nov;31(11):1457-1465.
G3. Wieland LS, Skoetz N, et al. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev. 2017 Jan 12;1:CD010671.
G4. Holtzman S, Beggs RT. Yoga for chronic low back pain: a meta-analysis of randomized controlled trials. Pain Res Manag. 2013 Sep-Oct;18(5):267-272.
G5. Cramer H, Lauche R, et al. A systematic review and meta-analysis of yoga for low back pain. Clin J Pain. 2013 May;29(5):450-460.
H1. Luz Júnior MAD, Almeida MO, et al. Effectiveness of Kinesio Taping in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review With Meta-analysis. Spine (Phila Pa 1976). 2019 Jan 1;44(1):68-78.
I1. Zadro JR, Shirley D, et al. Is Vitamin D Supplementation Effective for Low Back Pain? A Systematic Review and Meta-Analysis. Pain Physician. 2018 Mar;21(2):121-145.
I2. Gaikwad M, Vanlint S, et al. Does vitamin D supplementation alleviate chronic nonspecific musculoskeletal pain? A systematic review and meta-analysis. Clin Rheumatol. 2017 May;36(5):1201-1208.
Trigger Point Dry Needling
J1. Hall ML, Mackie AC, et al. Effects of dry needling trigger point therapy in the shoulder region on patients with upper extremity pain and dysfunction: a systematic review with meta-analysis. Physiotherapy. 2018 Jun;104(2):167-177.
J2. Liu L, Huang QM, et al. Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2018 Jan;99(1):144-152.e2.
J3. Rodríguez-Mansilla J, González-Sánchez B, et al. Effectiveness of dry needling on reducing pain intensity in patients with myofascial pain syndrome: a Meta-analysis. J Tradit Chin Med. 2016 Feb;36(1):1-13.
J4. Liu L, Huang QM, et al. Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2015 May;96(5):944-955.
J5. Ong J, Claydon LS. The effect of dry needling for myofascial trigger points in the neck and shoulders: a systematic review and meta-analysis. J Bodyw Mov Ther. 2014 Jul;18(3):390-398.
J6. Kietrys DM, Palombaro KM, et al. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013 Sep;43(9):620-634.
K1. Hall A, Copsey B, et al. Effectiveness of Tai Chi for Chronic Musculoskeletal Pain Conditions: Updated Systematic Review and Meta-Analysis. Phys Ther. 2017 Feb 1;97(2):227-238.
L1. Webb TR, Rajendran D. Myofascial techniques: What are their effects on joint range of motion and pain? - A systematic review and meta-analysis of randomised controlled trials. J Bodyw Mov Ther. 2016 Jul;20(3):682-699.
M1. Yamato TP, Maher CG, et al. Pilates for low back pain. Cochrane Database Syst Rev. 2015 Jul 2;(7):CD010265.
M2. Miyamoto GC, Costa LO, et al. Efficacy of the Pilates method for pain and disability in patients with chronic nonspecific low back pain: a systematic review with meta-analysis. Braz J Phys Ther. 2013 Nov-Dec;17(6):517-532.
M3. Aladro-Gonzalvo AR, Araya-Vargas GA, et al. Pilates-based exercise for persistent, non-specific low back pain and associated functional disability: a meta-analysis with meta-regression. J Bodyw Mov Ther. 2013 Jan;17(1):125-136.
Muscle Energy Technique
N1. Franke H, Fryer G, et al. Muscle energy technique for non-specific low-back pain. Cochrane Database Syst Rev. 2015 Feb 27;(2):CD009852.
Traditional Chinese Medicine
O1. Yuan QL, Guo TM, et al. Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis. PLoS One. 2015 Feb 24;10(2):e0117146.
P1. Gross A, Kay TM, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015 Jan 28;1:CD004250.
Q1. Oltean H, Robbins C, et al. Herbal medicine for low-back pain. Cochrane Database Syst Rev. 2014 Dec 23;(12):CD004504.
Last reviewed February 2020 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 11/11/2020
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