The anatomic, clinical, and physiologic correspondences of myofascial trigger points and classical acupuncture points

Abstract

: Chronic musculoskeletal pain conditions are among the most common presenting complaints of patients seeking health care treatments. These chronic pain conditions result in disability, reduced quality of life, and significant health system economic burdens. Myofascial pain syndrome (MPS) is the most common chronic musculoskeletal pain condition, and its prevalence increases with age. Given the average age of individuals globally is increasing as is the average human lifespan, socioeconomic and healthcare burdens related to MPS will rise in the coming decades. The allopathic medicine standard for treating MPS is outlined in the Trigger Point Manual , which illustrates >200 of the “most common” myofascial trigger point (mTrP) locations, their clinical (pain and non-pain) indications, and their myofascial referred-pain patterns. Though early MPS practitioners typically administered local anesthetic and/or corticosteroid injections to deactivate mTrPs, the Trigger Point Manual documents dry needling of mTrPs is similarly effective. Over the past 2–3 decades In the United States, there has been significant growth of dry needling skill certification of physical and occupational therapists, who utilize acupuncture needles to deactivate mTrPs. There has been controversy since the 1970’s regarding whether any anatomic and/or physiologic relationship exists between these “most common” mTrPs and their referred-pain patterns described by allopathic researchers, and the classical acupuncture points and primary channels described by Traditional Chinese Medicine some 2,000 years previously. If these “most common” mTrPs and classical acupoints can be shown to be similar anatomically, clinically, and physiologically, this would not only allow integration of ancient and contemporary clinical and research databases to optimally treat MPS, but also would have potential importance in elucidating acupuncture’s mechanisms. This review summarizes prior literature findings regarding the anatomic, clinical, and physiologic correspondences of the “most common” mTrPs and classical acupoints, and the clinical and research implications of these relationships.