A follow-up study of 118 patients was performed to determine the effect of various conservative treatments for MPD after six months to 12 years. Of the patients, 82% were females; 62 were females younger than 40 years old. During treatment, patients were made aware of muscle spasm, and consciousness of the role of muscles in MPD was raised. Of 105 patients who were contacted, 65 had no further problems, 26 thought the problem was improved and under control, and 14 had not improved or had sought treatment elsewhere. Musculature and psychological factors play major roles in the MPD syndrome.