Myofascial pain syndrome (MPS) is considered as one of the possible etiologies for shoulder pain. However, MPS rarely occurs as a primary origin of pain. Considerable evidences suggest that MPS is caused by or related to a lesion in another soft tissue, such as rotator cuff disease. The brachialis muscle is one of the main elbow flexors. Patients with rotator cuff disease combined with suspected MPS on the brachialis muscle do not respond well to conventional conservative therapy that only targets rotator cuff tendon itself.