Inclusion Criteria:  18 years or older Diagnosed with myofascial pain of the posterior neck or back. *The diagnosis of myofascial pain was based on established criteria of having a palpable taut band (trigger point) that when depressed reproduced the patient's pain.  Exclusion Criteria:  midline spinal tenderness evidence of radiculopathy pregnant have an allergy to lidocaine altered or deemed incapable of making informed consent had signs of infection or skin breakdown over the trigger point.