Original research on three chronic musculoskeletal conditions which include failed back surgery, reflex sympathetic dystrophy, and cumulative trauma disorder are presented. Data demonstrates that myofascial pain syndrome frequently plays an important role in the genesis of pain in the above conditions. Treatment results improve substantially when myofascial approach is utilized in those cases in which conventional therapeutic interventions fail. Significant reduction of pain and decreased tenderness are achieved using Fischer’s needling and infiltration technique, followed by specific physical therapy that consists of heat, electric stimulation, stretching, and relaxation exercises. The correction of the perpetuating and predisposing factors that cause myofascial pain syndrome is important for long term results.