Comparison of Superficial and Deep Acupuncture in the Treatment of Lumbar Myofascial Pain: A Double-Blind Randomized Controlled Study

Ceccherelli, Francesco; Rigoni, Maria Teresa; Gagliardi, Giuseppe; Ruzzante, Leonardo

doi:10.1097/00002508-200205000-00003

Cited by 126 publications

(85 citation statements)

References 12 publications

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“…In most previous studies, the stimulation site has been a traditional acupoint. [4][5][6][7] However, in our previous study, we found that treatment at trigger points may be more effective on low back pain in elderly patients than at traditional acupuncture points. 9 The myofascial trigger point has been defined as a localized, hyperirritable spot in a palpable taut band of skeletal muscle fibres.…”

Section: Figure 3 Effect Of Acupuncture On Chronic Low Back Pain By Vmentioning

confidence: 82%

“…In group A, the mean number of muscles identified with trigger points was 2.2 (range 1-4) and the number of needles 3.6 (range 2-7). In group B, the mean number of muscles was 2.6 (range 2-5), and needles 3.5 (range [3][4][5][6][7][8].…”

Section: Interventionsmentioning

confidence: 97%

“…[3][4][5][6][7] Trigger point acupuncture therapy is one of the important treatments for myofascial pain syndrome. 8 Our previous study suggested that deep needling at a trigger point may be more effective on low back pain in elderly patients than standard needling of conventional points.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Trigger Point Acupuncture on Chronic Low Back Pain in Elderly Patients – a Sham-Controlled Randomised Trial

Itoh¹,

Katsumi²,

Hirota³

et al. 2006

Acupunct Med

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Introduction There is some evidence for the efficacy of acupuncture, but it remains unclear whether trigger point acupuncture is effective. Our objective was to evaluate the effects of trigger point acupuncture on pain and quality of life in chronic low back pain patients compared with sham acupuncture. Methods Twenty-six consecutive out-patients (17 women, 9 men; age range: 65-91 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back pain for at least six months and normal neurological examination, were randomised to two groups. Each group received one phase of trigger point acupuncture and one of sham acupuncture with a three week washout period between them, over 12 weeks. Group A (n=13) received trigger point acupuncture in the first phase and sham acupuncture in the second. Group B (n=13) received the same interventions in the reverse order. Outcome measures were pain intensity (visual analogue scale, VAS) and Roland Morris Questionnaire. Results Nineteen patients were included in the analysis. At the end of the first treatment phase, group A receiving trigger point acupuncture scored significantly lower VAS (P<0.001) and Roland Morris Questionnaire scores (P<0.01) than the sham control group. There were significant within-group reductions in pain in both groups during the trigger point acupuncture phase but not in the sham treatment phase. However, the beneficial effects were not sustained. Conclusion These results suggest that trigger point acupuncture may have greater short term effects on low back pain in elderly patients than sham acupuncture.

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Section: Figure 3 Effect Of Acupuncture On Chronic Low Back Pain By Vmentioning

confidence: 82%

Section: Interventionsmentioning

confidence: 97%

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Effects of Trigger Point Acupuncture on Chronic Low Back Pain in Elderly Patients – a Sham-Controlled Randomised Trial

Itoh¹,

Katsumi²,

Hirota³

et al. 2006

Acupunct Med

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“…At the end of the study, the group that received deep needling to MTrPs reported less pain intensity and improved quality of life compared with the standard acupuncture group or the superficial needling group, but the differences were not statistically significant. In discussion of the results Ceccherelli et al 31 suggested that muscular afferents are more important for the transmission of acupuncture analgesic signals than the skin afferents. They supported this theory by citing Chiang's et al 33 observation that the blockade of nervous afferent fibers from the skin did not eliminate the acupuncture analgesia, whereas the anesthetic blockade in deep tissues did eliminate acupuncture analgesia.…”

Section: Deep Versus Superficial Needlingmentioning

confidence: 99%

“…Pain measurements decreased significantly in both groups and remained low at both 3 and 6 months. Ceccherelli et al 31 compared the therapeutic effects of superficial and deep dry needling in a prospective, double-blind RCT of 42 patients with lumbar myofascial pain. In the first group, the needle was inserted into the skin above the MTrP to a depth of 2 mm; the second group received intramuscular needling (approximately 1.5 cm) at 4 arbitrarily selected MTrPs.…”

Section: Deep Versus Superficial Needlingmentioning

confidence: 99%

Dry Needling in the Management of Musculoskeletal Pain

Kalichman

Vulfsons²

2010

The Journal of the American Board of Family Medicine

198

130

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Myofascial pain is a common syndrome seen by family practitioners worldwide. It can affect up to 10% of the adult population and can account for acute and chronic pain complaints. In this clinical narrative review we have attempted to introduce dry needling, a relatively new method for the management of musculoskeletal pain, to the general medical community. Different methods of dry needling, its effectiveness, and physiologic and adverse effects are discussed. Dry needling is a treatment modality that is minimally invasive, cheap, easy to learn with appropriate training, and carries a low risk. Its effectiveness has been confirmed in numerous studies and 2 comprehensive systematic reviews. The deep method of dry needling has been shown to be more effective than the superficial one for the treatment of pain associated with myofascial trigger points. However, over areas with potential risk of significant adverse events, such as lungs and large blood vessels, we suggest using the superficial technique, which has also been shown to be effective, albeit to a lesser extent.Additional studies are needed to evaluate the effectiveness of dry needling. There also is a great need for further investigation into the development of pain at myofascial trigger points. (J Am Board Fam Med 2010;23:640 -646.)

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Acupuncture for Chronic Pain

et al. 2012

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Background Although acupuncture is widely used for chronic pain, there remains considerable controversy as to its value. We aimed to determine the effect size of acupuncture for four chronic pain conditions: back and neck pain, osteoarthritis, chronic headache, and shoulder pain. Methods We conducted a systematic review to identify randomized trials of acupuncture for chronic pain where allocation concealment was determined unambiguously to be adequate. Individual patient data meta-analyses were conducted using data from 29 of 31 eligible trials, with a total of 17,922 patients analyzed. Results In the primary analysis including all eligible trials, acupuncture was superior to both sham and no acupuncture control for each pain condition (all p<0.001). After exclusion of an outlying set of trials that strongly favored acupuncture, the effect sizes were similar across pain conditions. Patients receiving acupuncture had less pain, with scores 0.23 (95% C.I. 0.13, 0.33), 0.16 (95% C.I. 0.07, 0.25) and 0.15 (95% C.I. 0.07, 0.24) standard deviations lower than sham controls for back and neck pain, osteoarthritis, and chronic headache respectively; the effect sizes in comparison to no acupuncture controls were 0.55 (95% C.I. 0.51, 0.58), 0.57 (95% C.I. 0.50, 0.64) and 0.42 (95% C.I. 0.37, 0.46). These results were robust to a variety of sensitivity analyses, including those related to publication bias. Conclusions Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture.

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Comparison of Superficial and Deep Acupuncture in the Treatment of Lumbar Myofascial Pain: A Double-Blind Randomized Controlled Study

Abstract: Clinical results show that deep stimulation has a better analgesic effect when compared with superficial stimulation.

Cited by 126 publications

References 12 publications

Effects of Trigger Point Acupuncture on Chronic Low Back Pain in Elderly Patients – a Sham-Controlled Randomised Trial

Effects of Trigger Point Acupuncture on Chronic Low Back Pain in Elderly Patients – a Sham-Controlled Randomised Trial

Dry Needling in the Management of Musculoskeletal Pain

Acupuncture for Chronic Pain

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