Therapeutic Effect of Superficial Acupuncture in Treating Myofascial Pain of the Upper Trapezius Muscle: A Randomized Controlled Trial

Abstract

The aim of this study was to compare the treatment efficacies of superficial acupuncture and traditional acupuncture on trigger points of the upper trapezius muscle. Forty people were recruited and randomly allocated to the traditional and superficial acupuncture groups. Each subject received two treatments per week in a four-week period. Outcomes were measured by visual analogue scale (VAS), the Northwick Park neck pain questionnaire scores (NPQ), and pressure pain threshold (PPT) assessments of trigger points. Data collected before the interventions were considered as baseline. Assessments were performed after the first treatment and at the end of the second and fourth weeks of treatment. Patients reported significant (p<0.05) and immediate improvements in VAS and PPT for both superficial acupuncture and traditional acupuncture after the first treatment and after two and four weeks. Significant improvements (p<0.05) in NPQ were attained after two weeks of treatments in both groups. Because superficial acupuncture is associated with less pain while producing immediate pain relief, we recommend it for treating myofascial pain syndrome in the upper trapezius muscle.

Rate and maintenance of improvement of myofascial pain with dry needling alone vs. dry needling with intramuscular electrical stimulation: a randomized controlled trial

“…DN has demonstrated mechanical, biochemical, vascular and neurophysiological effects [7][8][9][10][19][20][21][22][23][24][25][26][27][28][29][30]. Studies identified DN to be an effective technique to reduce pain, disability, and range of motion (ROM) deficits, while increasing pain pressure thresholds (PPT) [13,23,29,[31][32][33][34][35][36][37][38][39][40][41] In a randomized trial of 65 subjects with nonspecific low back pain, Griswold et al [33] compared segmental and distal DN without needle manipulation to non-thrust manipulation (NTM) after 6 sessions over 3 weeks. Outcome measures were the Owestry Disability Index (ODI), Patient Specific Functional Scale (PSFS), Numerical Pain Rating Scale (NPRS), and PPT.…”

The evaluation of electroacupuncture in the management of motion sickness syndrome in healthy male adults, in a double blinded study.

“…This could involve slight anaesthesia, heat, sight pain, electrical current or tension sensation at the point where the needle is inserted(50). However, the Teh Chi, although it is connected to the effectiveness of acupuncture, it is not always required for it and many practitioners do not try to obtain that as it requires mainly deeper acupuncture, which could be more painful and connected with more complications as well (51).…”

“…One of the eminent acupuncture practitioners of that time Dou Han Qing organised and documented the various needling techniques and suggested many ways with the aim to eliminate the discomfort and increase the speed of needle insertion at the same time (38). Other practitioners of acupuncture focused on the improvement of the sterilisation process, as only recently single use sterile needles were introduced for acupuncture, while other dealt mainly with the complications, such as broken needles( 38) (51). The acupuncture needles made of steel, still in use in our days, developed later probably during the 18 th to 19 th century.…”

“…During the acupuncture procedure, the needles are inserted into the skin or even deeper to the muscle depending on the area treated. In a recent study, C. Wang et al found no difference in the efficacy between deep traditional and superficial acupuncture and thus recommended the use of more superficial acupuncture technique as a way to decrease the pain or adverse reaction of a more deeper technique (51).The accurate acupoint needling is preceded by a palpation of the presumed area, and the practitioner inserts the needle where a small cavity is presented (47).…”

“…Much research has been done on this field. For instance C. Wang et al found that the application of acupuncture treatment on trapezius muscle decreased the pain symptoms of the patients, which were "dose depended" as the beneficial effect increased as the applications of acupuncture increased during the fourth week of the patients' treatment (51). Moreover, X. Zhang et al noticed in their meta-analysis on the acupuncture treatment for fibromyalgia that acupuncture and electroacupuncture found to be significantly effective compared to the control groups with lasting results and that they were also found to be superior in comparison with the common used pharmacological treatment (59).…”