Seventy adults with myofascial pain syndrome in the neck and/or upper back were randomized to receive radial shockwave therapy (n=34) or sham placebo therapy (n=36). Both groups also received standard physical therapy stretches and home exercises. The primary outcomes were numeric pain score (NPS) and neck disability index (NDI). Secondary outcomes included pressure pain threshold (PPT) and SF-12 scores. Outcomes were assessed at baseline, 4, 8, and 12 weeks. Overall, both groups showed statistically and clinically significant improvements in NPS and PPT across all follow-up periods, with the placebo group also showing significant NDI improvements at all intervals and some SF-12 physical score gains. However, no significant between-group differences were found for any outcome at any time point. These findings suggest RSWT offers no additional benefit over placebo when combined with standard exercises, but may be considered as an adjunct to standard care.