Inclusion criteria:
Both male and female patients
Age over 18 years and under 60 years
Pre diagnosed patients with FMS referred through consultant
Manifesting chronic widespread musculoskeletal pain symptoms
Presence of active trigger points, as confirmed by physical examination
Willing and able to provide informed consent to participate in the study.
Ability to understand and comply with the study requirements
No contraindications to dry needling or IMS
Exclusion criteria:
Pregnancy or breastfeeding
Use of any medications that could interfere with the study results (e.g. muscle relaxants, opioids) within the past 48 hours.
Previous treatment with dry needling or IMS within the past 6 months
Presence of any other conditions that could interfere with the study results (e.g. cancer, infection)
Participation in any other clinical trials within the past 30 days
Anatomical anomaly Structural disorder of spinal alignment (Scoliosis, kyphosis, lordosis)o Any bone abnormality in neck region
Traumatic/ Inflammatory/ Infectious Conditions such as Recent Trauma, Nerve root compromise, Metabolic or serious spinal pathologies (e.g., fractures, tumors, inflammatory, and infectious diseases), Previous neck surgery
Psycho-social Instability such as Diagnosed stress/ depression/ Anxiety
Risk Profile such as High Risk
Inability to understand or comply with the study requirements, as determined by the physiotherapist