Chinese Herbal Medicine for Dialysis-related Myofascial Pain: Study Protocol for A Pilot Randomized Study

Inclusion Criteria: * Adults (aged ≥ 20 y) undergoing conventional HD three times a week via an AV fistula; * To have myofascial trigger points (MTrPs) in one or more of the following muscles around the AV fistula: the flexor carpi radialis, palmaris longus, the pronator teres, the palmaris longus, and/or the finger flexor, diagnosed by dialysis-related myofascial pain, which must be experiencing pain during HD \[M1\]; * Onset of symptoms within 1 month before enrollment; * Capable of giving adequate response to pain; * Have an exquisite tenderness was found on palpation in the taut band with moderate intensity of pain at baseline (ie, a pain score \> 3 on a numeric rating scale); * Can commit to not change their medication and dialytic method during the 10 weeks of this study. Exclusion Criteria: * Severe chronic or acute disease interfering with attendance for therapy; * Have comorbid conditions such as rheumatoid arthritis, stroke, tumor, coagulopathy, chronic liver disease, radiculopathies of the upper limb, recent history of cervical/shoulder/arm surgery, or trauma; * Have depression and/or presence of a psychiatric disorder; * Have taken painkillers, muscle relaxant, and anti-inflammatory medications or used topical anesthetics in the past week; * Have allergy to Chinese herbal product; * Unable to understand or sign an informed consent form.