Can Classical Acupuncture Points and Trigger Points Be Compared in the Treatment of Pain Disorders? Birch's Analysis Revisited

Dorsher, Peter T.

doi:10.1089/acm.2007.0810

Cited by 46 publications

(26 citation statements)

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“…Interestingly, despite significant evidence to the contrary, many within the profession have confined their use of DN to only targeting trigger points in muscle. Importantly, this narrow philosophy is likely due to the general exclusion of the acupuncture literature from the PT Profession [217] which ironically is conducted in the main by physiotherapists, [218] medical physicians [219][220][221][222] and PhDs, [223,224] not traditional Chinese acupuncturists. Certainly the terminology, theoretical constructs, and underlying science surrounding the insertion of needles without injectate is different among traditional Chinese acupuncture and Western-based DN communities; however, the actual technical delivery and the analgesic mechanisms underpinning such have many similarities between professions [2,225].…”

Section: Resultsmentioning

confidence: 99%

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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There are a number of biochemical, biomechanical, endocrinological and neurovascular mechanisms underpinning the anti-nociceptive and anti-inflammatory effects of dry needling (DN). While myofascial trigger points likely play a role in peripheral pain, a diagnostic tool for localizing them has not been validated, and DN studies that have targeted trigger points to elicit localized twitch responses have reported mixed results. Therefore, the mechanism responsible for DN-mediated analgesia may be more complicated. DN activates opioid-based pain reduction, mediated by endogenous cannabinoids and the sympathetic nervous system, and non-opioid pain relief via serotonin and norepinephrine from the brain stem. DN also triggers the hypothalamic-pituitary-adrenal axis centrally and the corticotropin releasing hormone-proopiomelanocortin-corticosteroid axis locally to inhibit cox-2, reducing inflammatory cytokines. Recent studies demonstrate that DN combined with mechanical and/or electrical stimulation may reverse PKC-mediated peripheral hyperalgesic priming by normalizing nociceptive channels, to include TRPV, ASIC, TTX and P2X/Y. Electrical DN (EDN) stimulates immune cells, fibroblasts and keratinocytes to release CGRP and substance-P, altering the stimulation of TTX receptors to reverse hyperalgesia. It also encourages the supraoptic nucleus to release oxytocin to quiet ASIC receptors peripherally and stimulate opioid interneurons spinally. Moreover, EDN inhibits ERK1/2 kinase pathways of inflammation in the spinal cord and stimulates Aδ fibers and N/OFQ to reverse C-fiber mediated central changes. Mechanotransduction of fibroblasts and peripheral nerves via TRPV1 and P2X/Y-mediated intracellular Ca 2+ wave propagation and subsequent activation of the nucleus accumbens inhibits spinal pain transmission via glycinergic and opioidergic interneurons. The increased ATP is metabolized to adenosine, which activates P1 purinergic receptors, events considered key to DN analgesia and rho kinase-based tissue remodeling. Mechanotransduction-mediated release of histamine further explains analgesia secondary to needling points distal to pain. DN-mediated analgesia is dependent on a number of synergistic physiologic events involving biochemical and mechanical processes in neural, connective and muscle tissue.

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Section: Resultsmentioning

confidence: 99%

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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“…Thus, in pain conditions, trigger points may represent similar (if not the same) physiological phenomena as acupuncture points. 23 …”

Section: Theories Of Acupuncturementioning

confidence: 99%

Dry Needling versus Acupuncture: The Ongoing Debate

Zhou

Brogan

2015

Acupunct Med

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Although Western medical acupuncture (WMA) is commonly practised in the UK, a particular approach called dry needling (DN) is becoming increasingly popular in other countries. The legitimacy of the use of DN by conventional non-physician healthcare professionals is questioned by acupuncturists. This article describes the ongoing debate over the practice of DN between physical therapists and acupuncturists, with a particular emphasis on the USA. DN and acupuncture share many similarities but may differ in certain aspects. Currently, little information is available from the literature regarding the relationship between the two needling techniques. Through reviewing their origins, theory, and practice, we found that DN and acupuncture overlap in terms of needling technique with solid filiform needles as well as some fundamental theories. Both WMA and DN are based on modern biomedical understandings of the human body, although DN arguably represents only one subcategory of WMA. The increasing volume of research into needling therapy explains its growing popularity in the musculoskeletal field including sports medicine. To resolve the debate over DN practice, we call for the establishment of a regulatory body to accredit DN courses and a formal, comprehensive educational component and training for healthcare professionals who are not physicians or acupuncturists. Because of the close relationship between DN and acupuncture, collaboration rather than dispute between acupuncturists and other healthcare professionals should be encouraged with respect to education, research, and practice for the benefit of patients with musculoskeletal conditions who require needling therapy.

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“…Weiterhin wurde die Schröpfakupunktur mit der Neuraltherapie unter der Vorstellung einer positiv beeinflussbaren Interaktion zwischen Akupunkturpunkten, Schröpfzonen und Triggerpunkten bei chronischen Schmerzsyndromen kombiniert [22]. Dabei beruht die Schmerzlinderung durch Ausschaltung eines Triggerpunktes auf einer Elimination des nozizeptiven Herdes in dem für die Schmerzentstehung zuständigen Muskel [23].…”

Section: Diskussionunclassified

Stationäre naturheilkundliche Therapie eines chronischen, postoperativen Schmerzsyndroms nach Neck-Dissection

Sameš¹,

Kraft

2010

Forsch Komplementmed

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Einleitung: Bei papillÄren SchilddrÜsenkarzinomen bei einer TumorgrÖße >1 cm besteht die Therapie der Wahl in der totalen bzw. fast totalen Thyroidektomie mit modifizierter Neck-Dissection der zentralen (perithyroidealen, prÄlaryngealen, paratrachealen und tracheoÖsophagealen) Lymphknoten und anschließender postoperativer Radiojodtherapie. Allerdings ist die Neck-Dissection hÄufig mit postoperativen BewegungseinschrÄnkungen der homolateralen Halsmuskulatur und Schulter-Arm-Region sowie Schmerzsyndromen assoziiert. Dieser auch als «Postradical Neck Pain Syndrome» (PRNS) bezeichnete Zustand besteht Überwiegend aus einer schmerzhaft eingeschrÄnkten Beweglichkeit der Schulter, Scapula alata und Hemmung der FÄhigkeit der Armabduktion oberhalb der Horizontalebene. Falldarstellung: Eine 56-jÄhrige Patientin wurde wegen eines seit 2 Jahren bestehenden PRNS, das nach totaler Thyroidektomie und modifizierter Neck-Dissection beidseits aufgrund eines papillÄren SchilddrÜsenkarzinoms aufgetreten war, mit entsprechend hohem Leidensdruck stationÄr aufgenommen. Im Rahmen dieser stationÄren Rehabilitationsmaßnahme wurde die Patientin multimodal unter naturheilkundlichen Gesichtspunkten behandelt. Dabei kam ein komplexes Therapieprogramm aus hydrotherapeutischen, physiotherapeutischen und ausleitenden Therapieverfahren wie z.B. dem Kantharidenpflaster oder der SchrÖpfakupunktur mit dem Ziel einer Schmerzreduktion, einer Zunahme der zervikalen Beweglichkeit sowie einer LebensqualitÄtsverbesserung zur Anwendung. Ergebnisse: Nach 4-wÖchiger stationÄrer naturheilkundlicher Therapie konnte sowohl eine signifikante Schmerzreduktion des links-zervikalen, neuropathischen Schmerzes als auch eine beeindruckende Zunahme der zuvor deutlich eingeschrÄnkten Beweglichkeit von HalswirbelsÄule und linkem Schultergelenk dokumentiert werden. ZusÄtzlich verbesserte sich die gesundheitsbezogene LebensqualitÄt der Patientin, evaluiert anhand des SF-36, wÄhrend des stationÄren Therapieprogramms in den Skalen «Schmerz» sowie «Allgemeines Wohlbefinden» signifikant. Schlussfolgerung: Naturheilkundliche Therapieverfahren kÖnnen einen zusÄtzlichen Stellenwert in der komplexen Behandlung eines PRNS einnehmen. Weitere klinische Studien zur ÜberprÜfung der Behandlungsergebnisse sind notwendig.

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Can Classical Acupuncture Points and Trigger Points Be Compared in the Treatment of Pain Disorders? Birch's Analysis Revisited

Abstract: Although separated by 2000 years temporally, the acupuncture and myofascial pain traditions have fundamental clinical similarities in the treatment of pain disorders. Myofascial pain data and research may help elucidate the mechanisms of acupuncture's effects.

Cited by 46 publications

References 4 publications

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Dry Needling versus Acupuncture: The Ongoing Debate

Stationäre naturheilkundliche Therapie eines chronischen, postoperativen Schmerzsyndroms nach Neck-Dissection

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