Sie sind auf Seite 1von 6

Akupunktur

DZ A
Deutsche Zeitschrift für
Originalia | original articles
D O I : 1 0 . 1 0 1 6 / j . d z a . 2 0 0 8 . 1 0 . 0 0 1     6     D t Z t s c h r f A k u p. 5 1 , 4 / 2 0 0 8

P. T. Dorsher 1, J. Fleckenstein 2

Trigger Points and Classical Acupuncture Points


Part 2: Clinical Correspondences in Treating Pain and Somatovisceral Disorders

Trigger-Punkte und klassische Akupunkturpunkte


Teil 2: Klinische Korrespondenzen in der Behandlung von Schmerzen und
somatoviszeralen Störungen

Abstract Zusammenfassung
Background: Anatomic comparisons of the locations of Hintergrund: Der Vergleich der Lokalisationen myofaszialer
myofascial trigger points (mTrPs) to those of classical acu- Triggerpunkte (mTrPs) mit der von klassischen Akupunktur-
puncture points in the first part of this study showed that punkten im ersten Teil dieser Studie zeigte, das mindestens
at least 238 (93.3 %) of 255 “common” mTrPs described 238 (93,3 %) der 255 „allgemeinen“ mTrPs, die im Trigger
by the Trigger Point Manual have proximate, anatomically Point Manual beschrieben werden, mit in ihrer Nähe gelegenen
corresponding classical acupoints that anatomy references Akupunkturpunkten dieselben Muskelregionen versorgen.
document enter the same muscle regions of those mTrPs. Zielsetzung: Festzustellen, ob diese Korrelations-Paare
Objectives: To determine whether these correlated com- aus mTrP und klasssischen Akupunkturpunkten ähnliche
mon mTrP–classical acupoint pairs have similar indica- Indikationen zur Behandlung von Schmerzen und somato-
tions for treating pain and somatovisceral disorders. viszeralen Störungen besitzen.
Methods: The clinical indications of the 238 anatomically Methoden: Die klinischen Indikationen der 238 anatomisch
corresponding classical acupoints were examined in acu- korrespondierenden klassischen Akupunkturpunkte wurden
puncture references to determine whether they include in- daraufhin untersucht, ob ihre Indiaktionen für die Therapie
dications for treating pain and/or somatovisceral disorders von Schmerzen und/oder somatoviszeralen mit den Indika-
that are comparable to those described for their correlated tionen für die mTrP des Trigger Point Manual korrelieren.
common mTrPs by the Trigger Point Manual. Ergebnisse: 93 % (221/238) der korrelierenden allgemei-
Results: 93 % (221/238) of the correlated common mTrPs nen mTrPs des Trigger Point Manual besitzen Schmerz-
have pain indications described by the Trigger Point Ma- Indikationen. Für 208/221 (94 %) der mit ihnen korrelie-
nual. Of their anatomically corresponding classical acu- renden klassischen Akupunktupunkte werden ähnliche
points, 208/221 (94 %) have similar regional pain indi- regionale Schmerz-Indikationen angegeben. Weitere sechs
cations described, and another 6 (3 %) of these acupoints (3 %) dieser Akupunkturpunkte besitzen Schmerz-Indika-
have indications for painful conditions in the distributions tionen für die Regionen des übertragenen Schmerzes der
of their correlated mTrPs’ described referred-pain. Only korrelierenden mTrPs. Nur 7 klassische Akupunkturpunkte,
7 classical acupoints that anatomically corresponded to die mit mTrPs korrelieren, haben keine vergleichbare
common mTrPs had no comparable pain indications. The Schmerz-Indikation. Das Trigger Point Manual beschreibt
Trigger Point Manual describes somatovisceral effects for somatoviszerale Effekte für 60 (24 %) der allgemeinen
60 (24 %) of its common mTrPs. Of their anatomically mTrPs. 82 % (49/60) der mit ihnen anatomisch korrelie-
corresponding classical acupoints, 82 % (49/60) have “de- renden klassischen Akupunkturpunkte haben sichere, wei-
finite” and another 11 % (7/60) have “probable” clinical tere 11 % (7/60) wahrscheinliche korrespondierende soma-
correspondences of their somatovisceral effects. toviszerale Effekte.
Conclusions: The marked correspondences of the pain in- Schlussfolgerungen: Die deutliche Übereinstimmung der
dications (up to 97 %) and somatovisceral indications (up Schmerz-Indikationen (bis zu 97%) und somatoviszeralen
to 93 %) of anatomically corresponding common mTrP- Indikationen (bis zu 93 %) der Paare der anatomisch korre-
classical acupoint pairs provide a second, clinical line of spondierenden allgemeinen mTrPs mit klassischen Akupunk-
evidence that trigger points and acupuncture points likely turpunkten liefern einen zweiten klinischen Beweis, dass Trig-
describe the same physiologic phenomena. gerpunkte und Akupunkturpunkte mit hoher Wahrscheinlich-
keit dieselben physiologischen Phänomene beschreiben.

Keywords Schlüsselwörter
Acupuncture, acupuncture point, myofascial pain, trigger Akupunktur, Akupunkturpunkt, myofaszialer Schmerz,
point therapy Triggerpunkttherapie

Peter T. Dorsher, MD 4500 San Pablo Road


Department of Physical Medicine and Rehabilitation Jacksonville, FL 32224
Mayo Clinic dorsher.peter@mayo.edu

1 From the Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida
2 and the Interdisciplinary Pain Center, Department of Anesthesiology, University of Munich
Originalia | original articles
P. T . D o r s h e r , J . F l e c k e n s t e i n Trigger Points and Classical Acupuncture Points

Introduction Methods
Less than 30 % of the acupuncture literature is devoted The clinical indications described in three authoritative acu-
to its use in the treatment of pain conditions [1], yet puncture references [2–4] for each of the 238 anatomically
this is likely its most familiar indication to the public correlated classical acupuncture points from the first part of
and allopathic physicians. All but 2 of the 361 classical this study [9] were examined for their uses in treating pain
acupuncture points do have pain indications described disorders. Since the main purpose of this study is specifically
[2–4], with the exceptions being points BL-8 and ST- to compare the acupuncture and myofascial pain traditions
17 (the latter point has no clinical indications). Thus, in the treatment of pain disorders, pain was not required to
though their pain uses are often not their primary cli- be the primary indication of a given classical acupuncture
nical indications, virtually every classical acupuncture point as long as that acupoint had a pain indication descri-
point has at least one indication for treating pain disor- bed by one or more of those acupuncture references.
ders that derives from thousands of years of accumulated For the analysis of the somatovisceral correspondences of the
clinical experience. acupuncture and myofascial pain traditions, the somatovis-
Trigger point therapy is primarily used to treat myofascial ceral effects of common mTrPs described in the Trigger Point
pain and dysfunction, and continues to be a widely used Manual [5, 6] were compiled. The somatovisceral indications
pain treatment method in contemporary medical practice described by acupuncture references [2–4] for the classical
both by primary care physicians and pain management acupoints that anatomically corresponded to those mTrPs
specialists [7, 8]. were examined for similarities in their clinical effects.
The qualitative and quantitative comparisons of the ana-
tomic locations of common mTrPs and classical acupoints
in the first part of the present study [9] demonstrated Results
that at least 93.3 % (238/255) of common mTrP regions
delineated in the Trigger Point Manual [5, 6] have ana- Of the 238 common mTrPs that anatomically corresponded
tomic correspondence with classical acupoints. Anatomic to a classical acupoint in the first part of this study [ 9],
correspondence was defined as being present when a 221 (93 %) have pain indications described in the Trigger
classical acupoint was proximate to a common mTrP and Point Manual [5, 6]. There are 17 common mTrP regions
demonstrated by anatomic references to enter the same that have no pain indications described- only somatovis-
muscle region of that trigger point. Another 6 common ceral effects. These include the pectoralis major “cardiac
mTrPs demonstrated anatomic and physiologic (referred- arrythmia”, the abdominal external oblique “belch but-
pain) relationships to the acupuncture meridians coursing ton”, and 15 lower abdominal wall musculature “causes
over them, though there were no proximate classical acu- diarrhea” mTrP regions [5, 6].
points. If these mTrPs were considered as corresponding, Another 43 common mTrP regions also have somatovisce-
then the anatomic correspondence of common mTrPs and ral effects described by the Trigger Point Manual [5, 6] that
classical acupoints rises to nearly 96 %. The quantitative are distinct from their regional pain indications (Table 1).
analysis of the anatomic proximity of correlated common Thus, a total of 60 common mTrP regions have somatovis-
mTrP- classical acupoint pairs produced estimates that ceral effects described.
82 % of these point pairs are located within 2 cm of each
other, and 95 % within 3 cm of each other. Though this Pain Correspondences
high degree of anatomic correspondence found between Comparable regional musculoskeletal or neurologic (“inter-
common mTrPs and classical acupoints is unlikely to oc- costal neuralgia”, for example) pain indications are descri-
cur by chance, skeptics might still raise this possibility to bed for 208 (94 %) of the 221 anatomically corresponding
challenge the correspondences of the myofascial pain and classical acupuncture points [2–4]. Another 6 (3 %) of the
acupuncture traditions in treating pain. If it can be de- classical acupoints have clinical indications for other pain-
monstrated that these anatomically corresponding trigger ful conditions in the distributions of their anatomically cor-
points and acupuncture points also have marked similari- responding mTrPs’ referred pain (Table 2). Overall, then, up
ty of their clinical uses and/or physiologic properties (re- to 214/221 (~97 %) of classical acupoints have clinical pain
ferred-pain and meridian distributions), then this would indications that are comparable to those described for their
provide corroborating clinical and physiologic evidence anatomically corresponding common trigger point regions.
that trigger points and acupoints likely describe the same Only 3 % (7/221) of mTrPs had clinical pain indications that
clinical phenomena. This in turn would suggest that the differed from those of their anatomically corresponding clas-
myofascial pain tradition likely represents an indepen- sical acupuncture points. This represented 6 distinct classical
dent discovery of the acupuncture tradition’s findings in acupoints (LI-17, LR-3, LR-9, MH-4, SP-8, and SP-11).
the treatment of pain disorders.
The purpose of the second part of this study is to compare Somatovisceral Correlations
the acupuncture and myofascial pain traditions’ clinical The Trigger Point Manual [5, 6] describes somatovisceral ef-
indications both in the treatment of pain and somatovis- fects for 60 common mTrP regions, which represents nearly
ceral disorders. 25 % of all trigger points outlined in that text. 17/60 (28 %) of

D t Z t s c h r f A k u p. 5 1 , 4 / 2 0 0 8     7     D Z A
Akupunktur

DZ A
Deutsche Zeitschrift für
Originalia | original articles

those common mTrP regions have only non-painful, soma- both constipation and enteritis. A clinician can theoretically
tovisceral indications described [5, 6], as outlined above. The produce opposite clinical effects at a given acupoint depen-
“causes diarrhea” trigger point regions represent 15 of those ding on how the needle is manipulated there.
regions; and as demonstrated in Figure 1, those common Overall, the somatovisceral indications of 49/60 (82 %)
mTrP regions are located in the distribution of the Spleen of common mTrP regions were definitely comparable to
and Stomach meridians over the lower anterior abdominal those of their anatomically corresponding classical acu-
wall musculature. These common mTrPs are proximate to points, and another 7 (11 %) of anatomically correspon-
classical acupoints SP-13 and SP-14 laterally and ST-27, ding common mTrP- classical acupoint pairs had probab-
ST-28, and ST-29 medially. Table 3 delineates the gastro- le corresponding somatovisceral effects (Table 4). Only 4
intestinal disorder indications of these classical acupoints (7 %) point pairs had no correlation of their somatovisceral
[2–4]. Note that some of these acupoints have indications for effects (Table 5).

Table 1 Somatovisceral Effects of Myofascial Trigger digastric, posterior belly difficulty swallowing
Points That Also Have Pain Indications
splenius capitis “ache inside the skull”,
Trigger Point Muscle Region Somatovisceral Effect vertex headache

trapezius, mid-point upper dizziness and “vertigo” splenius cervicis, “ache inside the skull“,
portion upper portion blurred near vision, diffuse
pain inside head focusing
sternocleidomastoid, ster- “sore throat” behind the eye
nal head, middle portion,
inferior rectus capitis posterior major “headache ghosts”

sternocleidomastoid, sternal paroxysmal dry cough obliquus capitis inferior “headache ghosts”
head, lower portion
pectoralis major, intermedi- “heart attack”
sternocleidomastoid, clavicu- postural dizziness & less often ate sternal section, upper
lar head, lower portion vertigo
sternocleidomastoid, sternal “sore throat” pectoralis major, intermedi- “heart attack”
head, middle portion, su- ate sternal section, middle
perior
pectoralis major, intermedi- “heart attack”
sternocleidomastoid, clavicu- postural dizziness & less ate sternal section, lower
lar head, middle portion often vertigo
pectoralis major, lateral free breast pain
sternocleidomastoid, clavicu- postural dizziness & less margin, medial
lar head, upper portion often vertigo
pectoralis major, lateral free breast pain
sternocleidomastoid, sternal “sore throat” margin, lateral
head, upper portion
pectoralis major, parasternal “heart attack”
masseter, superficial layer, posterior upper teeth pain section, upper
upper portion, anterior
pectoralis major, parasternal “heart attack”
masseter, superficial layer, posterior upper teeth pain section, lower
upper portion, posterior
pectoralis minor, upper mimics cardiac ischemia
masseter, superficial layer, posterior lower teeth pain
pectoralis minor, lower mimics cardiac ischemia
middle portion, anterior
sternalis mimics cardiac ischemia
masseter, superficial layer, posterior lower teeth pain
middle portion, posterior serratus anterior “short of breath”
masseter, deep layer tinnitus iliocostalis thoracis, mimics cardiac
mid-thoracic level ischemia or pleurisy
temporalis, anterior portion maxillary incisor pain
external oblique, anterior “heartburn”
temporalis, middle portion, pain in maxillary teeth
upper portion
anterior just behind incisor
(“intermediate teeth“) external oblique, anterior “inguinal and testicular
middle portion pain, lower quadrant
temporalis, middle portion, posterior maxillary teeth pain
abdominal pain”
posterior
external oblique, anterior “inguinal and testicular
lateral pterygoid, superior “sinusitis”
lower portion pain, lower quadrant
portion
abdominal pain”
lateral pterygoid, inferior “sinusitis”
rectus abdominus, upper “abdominal fullness, nausea,
portion
portion and vomitting”

D Z A     8     D t Z t s c h r f A k u p. 5 1 , 4 / 2 0 0 8
Originalia | original articles
P. T . D o r s h e r , J . F l e c k e n s t e i n Trigger Points and Classical Acupuncture Points

Other musculoskeletal effects of trigger point regions were


described for 15 regions which are generally non-painful
(Table 6), and the indications of their anatomically corre-
sponding classical acupoints demonstrated definite or pro-
bable agreement for 11/13 (85 %) of these point pairs.

Discussion

Melzack et al. [10] reported a 100 % anatomic correspon-


dence of 48 trigger points with 50 acupuncture points tradi-
tionally used to treat pain disorders but found their clinical
correspondence in treating pain disorders was somewhat
lower (71 %). In reality, however, if the data of Melzack et
al’s study [10] is carefully examined, then at least 9 and
probably 14 of their 15 “negative” mTrP-acupoint clinical
Figure 1. The “Causes Diarrhea” Trigger Point Regions & Their Relationships
to the Principal Meridians with their Classical Acupuncture Points
Table 2 Acupoints With Clinical Pain Indications in the (adapted from Primal Pictures images, with permission)
Distribution of Their Anatomically Correspon-
ding Trigger Points’ Referred-Pain Table 4 “Probable” Agreement Between Somatovisce-
ral Indications of Trigger Points and Classical
Trigger Point Muscle Corres- Acupuncture Point
Acupuncture Points
Region ponding Pain Indication(s)
Acupoint Trigger Point Myofascial Classical Acupoint
Muscle Region Indication Acupoint Indication
sphincter ani, GV-1 hemorrhoid pain,
superior region heaviness of sacrum temporalis, middle posterior GB-7 used to treat tooth
(perianal referred pain) portion, posterior upper decay with ST-42
tooth pain
sphincter ani, GV-1 hemorrhoid pain,
lateral region heaviness of sacrum lateral pterygoid, “sinusitis” ST-7 pain/swelling of
(perianal referred pain) upper cheek
levator ani GV-1 hemorrhoids, anal lateral pterygoid, “sinusitis” ST-7 pain/swelling of
(perianal referred pain) prolapse, lumbar pain lower cheek
gluteus medius, medial BL-27 testicular pain radia-
lower abdominal “causes ST-28 distension abdo-
region (referred pain to ting to lumbar region
obliques, right diarrhea” men, retention
ipsilateral low lumbar
feces
region & medial buttock)
adductor magnus, BL-36 difficult urination or lower abdominal “causes ST-28 distension
upper region (referred defecation, hemor- obliques, left diarrhea” abdomen, retenti-
pain into pelvis) rhoids, cold in uterus on feces

soleus, exceptional point GB-35 facial swelling, soleus “exceptio- pain to GB-35 swelling of face/
(referred pain to leg pain nal” lower jaw and eyes, throat pain-
ipsilateral face & jaw) portion, lateral cheek ful obstruction

Table 3 “Causes Diarrhea” Trigger Points and Gastrointestinal Indications of their Anatomically Corresponding Classical Acupoints
(D = Deadman, S = Shanghai, and C = Chen)
Trigger Point Region Myofascial Indication Classical Acupoint Acupoint Indication(s)
abdominal obliques (3 regions) “causes diarrhea” SP-13 constipation (D)
enteritis (C)
abdominal obliques (4 regions) “causes diarrhea” SP-14 diarrhea and dysentery (D)
enteritis (C)
abdominal obliques (4 regions) “causes diarrhea” ST-27 abdominal distension (D)
constipation, enteritis (C)
abdominal obliques (2 regions) “causes diarrhea” ST-28 retention of feces (D)
lower abdomen distension (C)
abdominal obliques (2 regions) “causes diarrhea” ST-29 colic (S)

D t Z t s c h r f A k u p. 5 1 , 4 / 2 0 0 8     9     D Z A
Akupunktur

DZ A
Deutsche Zeitschrift für
Originalia | original articles

pain correspondences were actually “positive” (comparab- classical acupoints is that no evidence of their similarities
le pain indications). These additional clinically correspon- in treating non-pain conditions was presented in that data.
ding point pairs include an iliocostalis mTrP and BL-47, a Beyond the issue that the examination of non-pain uses
hamstring mTrP and BL-37, longissimus mTrPs and BL-18 of trigger points and acupoints was not the purpose of
and BL-19, a subscapularis mTrP and HT-1, a gastrocne- Melzack et al’s study [10], Birch’s report [11] simply failed
mius mTrP and KI-10, a toe extensors mTrP and ST-37, to report the somatovisceral correspondence data that was
a tibialis anterior mTrP and ST-36, a scalene mTrP and present in their data, as outlined above. Note that there
LI-17, first dorsal interosseus and adductor pollicis mTrPs was a 100 % clinical correspondence of the somatovisceral
and LI-4, a pectoralis major mTrP and GB-22, and ad- indications of correlated trigger points and classical acu-
ductor longus mTrPs and LR-10 and LR-11. The degree of
mTrP- classical acupoint clinical pain correspondences in
Melzack et al’s data 10 then increase potentially to 98 % Table 6 Trigger & Acupuncture Points In Other Muscu-
(49/50). The present study serves to confirm those findings loskeletal Disorders
by demonstrating that at least 94% (and probably 97%) of
Trigger Musculoskele- Classical Acupuncture
classical acupoints have clinical pain indications [2–4] that
Point Region tal Indication Acupoint Indication
are comparable to those described for their anatomically
corresponding common trigger point regions [5, 6]. levator scapula, “torticollis” SI-15 shoulder pain,
Though the purpose of Melzack et al’s study [10] was to upper stiff neck
examine the anatomic and clinical similarities of trigger levator scapula, “torticollis” SI-14 neck rigidity,
points and acupuncture points in the treatment of pain lower stiffness
disorders, its data also provided evidence of somatovis-
infraspinatus, “shoulder joint SI-11 shoulder pain
ceral indication correspondences of the correlated trigger
superior region, pain” and heaviness
points and acupuncture points. Melzack et al’s data [10] lateral
documents 9 mTrP-acupoint somatovisceral correspon-
dences (all positive). These included a trapezius mTrP that infraspinatus, “shoulder joint SI-11 shoulder pain
treats cardiac pain syndromes and BL-16 that is used for superior regi- pain“ and heaviness
on, medial
heart pain and pericarditis [2, 3], a pectoralis major mTrP
that treats angina pectoris and KI- 23 that is used for chest extensor “stiff fingers” LI-10 pain and immo-
painful obstruction [2, 3], and a splenius capitis mTrP that digitorum bility of arm
treats headache and TE-16 that is indicated for heada- (3rd finger)
che [2, 3]. Birch’s 2003 re-analysis [11] of Melzack et al’s
data10 concluded that one (clinical) part of the reasons extensor “stiff fingers” TE-9 pain of forearm,
why he believed trigger points should not be compared to digitorum
(4th finger) paralysis of
upper limb

Table 5 “No Correlation” Between Somatovisceral Indi- supinator “tennis el- LU-5 elbow pain and
cations of Anatomically Correlated Trigger and bow” restriction
Acupuncture Points rectus femoris, “buckling hip ST-31 atrophy or blo-
Trigger Point Somatovisceral Correlated Acupuncture superior syndrome” ckage of muscles
Muscle Region Indication Acupoint Indication of thigh/buttock

sternocleido- postural dizzi- LI-17 loss of voice,


mastoid ness and less painful throat vastus “buckling knee SP-11 inguinal and ex-
clavicular head, often vertigo obstruction, medialis, syndrome” ternal genitalia
lower portion difficulty mid-portion problems
breathing
vastus “buckling knee SP-10 pain inner
sternocleido- postural dizzi- SI-16 deafness, medialis, syndrome” thigh, urinary
mastoid cla- ness and less tinnitus, lower portion & menstrual
vicular head, often vertigo ear pain problems
mid-portion
vastus inter- “buckling hip ST-31 contraction of
pectoralis ma- “cardiac KI-22 chest pain/ medius, supe- syndrome” thigh muscles,
jor, parasternal, arrhythmia” fullness, rior portion hemiplegia
lower intercostal
neuralgia vastus latera- “locked patella ST-34 knee pain, dif-
lis, distal por- syndrome” ficulty flexing/
adductor intrapelvic LR-10 difficult tion, anterior extending knee
magnus, upper pain (vagina, urination, pain
portion rectum, or of the genitals, vastus latera- “locked patella GB-33 inability to flex/
bladder pain) cold in the lis, distal por- syndrome” extend knee
uterus tion, posterior

D Z A     1 0     D t Z t s c h r f A k u p. 5 1 , 4 / 2 0 0 8
Originalia | original articles
P. T . D o r s h e r , J . F l e c k e n s t e i n Trigger Points and Classical Acupuncture Points

points in that data [10]! Birch’s 2003 report [11] attemp- The third (final) part of this study will provide yet an-
ted to generalize his demonstrably incorrect conclusion other line of evidence of the similarities of the myofascial
about the lack of reported somatovisceral effects of trigger pain and acupuncture traditions by demonstrating the
points in Melzack et al’s data [10] to all trigger points, even strong correspondences of the distributions of the myo-
though the Trigger Point Manual [5, 6] (that was available fascial referred-pain patterns and acupuncture meridians
to Birch for over a decade before his report) is demonstra- of anatomically corresponding common mTrP-classical
ted in the present study to document somatovisceral effects acupoint pairs.
for nearly 25 % of the 255 trigger point regions reported.
Moreover, the somatovisceral effects described for those
common mTrPs [5, 6] are similar to those described for Conclusions
their anatomically corresponding classical acupoints [2–4]
in over 93 % of comparisons! The Trigger Point Manual [5, 6] and authoritative acu-
This near-complete clinical correspondence of common puncture references [2–4] document that there are marked
mTrPs and classical acupuncture points in the treatment clinical correspondences of both the pain indications (up
of pain disorders (at least 94 %) as well as somatovisceral to 97 %) and somatovisceral indications (> 93 %) of ana-
disorders (at least 93 %) documented in the present study tomically corresponding common trigger point-classical
provides clinical evidence that complements the evidence of acupuncture point pairs (classical acupoints that are pro-
their anatomic correspondences (at least 93.3 %) presented ximate to and enter the muscle region of their correlated
in the first part of this study [9] to suggest that trigger points common mTrPs). This provides a second, clinical line of
and classical acupoints likely are describing the same phy- evidence that trigger points and acupuncture points likely
siologic phenomena. Even if skeptics were to argue that the are describing the same physiologic phenomena.
93.3 % anatomic correspondence found between common
mTrP regions and classical acupuncture points found in this
study could occur by chance (however unlikely), it would
be even more improbable that these anatomically correlated
point pairs would, by chance, also demonstrate nearly 97 %
correlation in their pain indications and a 94 % correlation
in their somatovisceral effects.
References
1. Helms JM. Acupuncture energetics: a clinical approach for physicians. Ber-
keley: Medical Acupuncture Publishers; 1995
Summary 2. Deadman P, Al-Khafaji M, Baker K. A manual of acupuncture. Hove, East
Sussex (UK): Journal of Chinese Medicine Publications; 1998
• 93 % (221/238) of anatomically corresponding 3. O’Connor J, Bensky D. Acupuncture: a comprehensive text. Chicago:
mTrPs have pain indications described by the Trig- Eastland Press; 1981
ger Point Manual. 4. Chen E. Cross-sectional anatomy of acupoints. Edinburgh: Churchill
Livingstone; 1995
• 94 % (208/221) of anatomically corresponding 5. Travell JG, Simons DG. Myofascial pain and dysfunction: the trigger point
classical acupoints have comparable regional pain manual. Vol 1. Baltimore: Williams and Wilkins; 1983
6. Travell JG, Simons DG. Myofascial pain and dysfunction: the trigger point
indications described. manual. Vol 2. Baltimore: Williams and Wilkins; 1992
• Another 6 classical acupoints (3 %) have indica- 7. Manchikanti, L. Medicare in interventional pain management: a critical
tions for painful conditions in the distributions of analysis. Pain Physician. 2006;9(3):171–197
8. Peng PW, Castano ED. Survey of chronic pain practice by anesthesiologists
their correlated mTrPs’ described referred-pain. in Canada. Canadian J Anesth. 2005;52(4):383–389
• 60 (24 %) of common mTrPs described by the Trig- 9. Dorsher PT, Fleckenstein J. Trigger points and classical acupuncture
ger Point Manual have somatovisceral effects points: part 1: qualitative and quantitative anatomic correspondences.
Dt Ztschr f Akup. 2008;51,3:15–24
• At least 93 % (56/60) of their anatomically corre- 10. Melzack R, Stillwell DM, Fox EJ. Trigger points and acupuncture points for
sponding classical acupoints have somatovisceral pain: correlations and implications. Pain. 1977;3:3–2
11. Birch S. Trigger point: acupuncture point correlations revisited. J Altern
indications described that are definitely or proba- Complement Med. 2003;9:91-103
bly comparable. 12. Wiseman N, Ellis A. Fundamentals of chinese medicine. Brookline, Para-
digm Publishers, 1996

D t Z t s c h r f A k u p. 5 1 , 4 / 2 0 0 8     1 1     D Z A