Clinical Research Directory

Inclusion Criteria: * Thoracic back pain as the primary complaint * Clinically significant myofascial contribution, defined by at least two of the following: * Localized tenderness * Paravertebral muscle spasm * Trigger points * Reduced skin or fascial mobility * Persistent pain despite at least 6 weeks of conservative treatment * Absence of more specific causes of pain, as determined by clinical examination and additional investigations when indicated * Age over 18 years Conditions to be excluded prior to enrollment include: * Neuropathic pain patterns, including: * Cervical or thoracic radicular pain * Intercostal neuralgia * Dorsal scapular neuralgia * Other neuralgias of thoracic region * Pleural pain patterns * Ischemic pain patterns (e.g., ischemic heart disease) * Predominantly postural pain associated with female sex and osteopenia suggestive of vertebral compression fractures Exclusion Criteria: * Lack of written informed consent * Active malignancy * Recent trauma * Age \> 70 years * Local or systemic infection * Presence of another more likely pain etiology * Severe scoliosis and/or significant chest wall deformity * History of thoracic or upper abdominal surgery * History of spinal surgery of any kind