Objective: To compare the therapeutic effect of hot pack with streching exercise and Thai massage to myofascial pain syndrome in subacute or chronic neck and upper back pain.Design: Prospective randomized experimental studyMethod: Patients with subacute or chronic myofascial pain in neck and upper back pain were recruited from August 2007 to January 2008. They were randomly divided into two groups for therapy: hot pack with streching exercise (group I) or Thai massage (group II).  Pain score (VAS), cervical range of motion (ROM) and quality of life (SF-36) were assessed. Result: In a comparison of therapy, pain score and cevical ROM were significantly improved in both groups but not significantly different between groups except pain score and extension motion after 1st treatment.  Patients’ quality of life was improved after treatment but not significantly different between groups.