Objective. To investigate the effects of Manual Ischemic Compression (MIC) and Instrumental Ischemic Compression (ICG) and Pressure Algometer (ICA), in the treatment of women with MPS in descending trapezius. Patients and Methods. This is a double-blinded, randomized, placebo-controlled trial. Patients were randomized into 3 groups: MIC, ICG, and ICA. Pain, pressure pain threshold (PPT), electromyography, disability (NDI), anxiety (GAD-7), and adverse treatment effects (AE) were assessed. The Shapiro-Wilk test was performed to verify the normality of the data, followed by consistent tests, being considered significant when p < 0.05. Results. There was no intergroup difference for any analyzed variables. In the intragroup comparison, MIC group presented pain reduction (F: 7.70; p = 0.0002), between baseline and 1 week; and anxiety (p = 0.048), between baseline and 4 weeks. All groups showed increase in PPT (F: 37.62; p < 0.0001) and decrease in NDI score (F: 53.29; p < 0.0001). About AE, the MIC group reported the highest mean value of discomfort after the technique, 7.22.Conclusions. An intragroup improvement was observed in the pain and anxiety variables for the MIC group, when compared to the baseline with one week and four weeks, respectively. There was an improvement in all groups in the PPT and NDI; however, with no differences between groups in the post-treatment. Study registration. Brazilian Registry of Clinical Trials: ReBEC: RBR-2q24nb.