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Acupuncture for trigger points might be better

PainSci » bibliography » Itoh et al 2007
updated
Tags: neck pain, acupuncture, TrPs, injections, needling, study_trial, study_rct, head/neck, anatomy, spine, spine pain, alternative medicine, controversial, manual therapy, professions, treatment, modalities, quackery, traditional Chinese medicine, ancient, vitalism, muscle, pain problems, medicine, provocation, regeneration

One page on PainSci cites Itoh 2007: The Complete Guide to Trigger Points & Myofascial Pain

PainSci commentary on Itoh 2007: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

The evidence is overwhelming that acupuncture is not generally useful for treating neck pain, or any other kind of pain (see Does Acupuncture Work for Pain?). However, to the extent that it sometimes seems to have some minor benefits, it may be due to the extent that acupuncture involves needling of trigger points, either accidentally or deliberately. Although this study was small and its evidence is weak, that is precisely what this study seems to show: a few acupuncture patients got better results when the acupuncture was directed at trigger points.

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

INTRODUCTION: There is some evidence for the efficacy of acupuncture in chronic neck pain (CNP) treatment, but it remains unclear which acupuncture modes are most effective. Objective was to evaluate the effects of trigger point acupuncture on pain and quality of life (QOL) in CNP patients compared to three other acupuncture treatments (acupoints, non-trigger point and sham treatment).

METHODS: Forty out-patients (29 women, 11 men; age range: 47-80 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating CNP for at least 6 months and normal neurological examination were randomised to one of four groups over 13 weeks. Each group received two phases of acupuncture treatment with an interval between them. The acupoint group (standard acupuncture; SA, n=10) received treatment at traditional acupoints for neck pain, the trigger point (TrP, n=10) and non-trigger point (non-TrP, n=10) groups received treatment at tenderness points for the same muscle, while the other acupuncture group received sham treatments on the trigger point (SH, n=10). Outcome measures were pain intensity (visual analogue scale; VAS 0-100mm) and disease specific questionnaire (neck disability index; NDI, 60-point scale).

RESULTS: After treatment, the TrP group reported less pain intensity and improved QOL compared to the SA or non-TrP group. There was significant reduction in pain intensity between the treatment and the interval for the TrP group (p<0.01, Dunnett's multiple test), but not for the SA or non-TrP group.

CONCLUSION: These results suggest that trigger point acupuncture therapy may be more effective on chronic neck pain in aged patients than the standard acupuncture therapy.

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