OBJECTIVE: To assess the effects of silver needle thermal conduction therapy on spinal neurotransmitter activation and inflammation reduction in the myofascial trigger point musculature of a rat model with myofascial pain syndrome (MPS). METHODS: The MPS rat model was induced by a combination of impact and exercise fatigue. MPS rats were then subjected to silver needle thermal conduction therapy for 14 days. Thermal and mechanical pain thresholds were assessed using the thermal hyperalgesia and mechanical hyperalgesia tests. Transverse and longitudinal sections of the right medial thigh muscle were prepared for histological analysis using HE staining. Western blot and immunohistochemistry were used to measure the expression of calcitonin gene-related peptide (CGRP), substance P (SP), and 5-hydroxytryptamine (5-HT) in the L4-6 segment of the spinal cord. Additionally, the levels of inflammatory cytokines, including interleukin 1-β (IL-1β) and tumor necrosis factor α (TNF-α), in the right medial femoral muscle were assessed via ELISA. RESULTS: MPS rats exhibited a decreased thermal and mechanical pain threshold compared to control rats. Muscle fiber atrophy and deformation were observed in the MPS rats. Levels of IL-1β and TNF-α were elevated in the right medial femoral muscle, while CGRP and SP expression were increased, and 5-HT expression was decreased in the spinal cord. Silver needle thermal conduction therapy effectively reversed these pathological changes in the MPS rats. CONCLUSIONS: Silver needle thermal conduction therapy alleviated MPS in rats by modulating spinal neurotransmitter expression and reducing muscle inflammation.