Can classical acupuncture points and trigger points be compared in the treatment of pain disorders? Birch's analysis revisited.
BACKGROUND
A 1977 study by Melzack et al. reported 100% anatomic and 71% clinical pain correspondences of myofascial trigger points and classical acupuncture points in the treatment of pain disorders. A reanalysis of this study's data using different acupuncture resources by Birch a quarter century later concluded that correlating trigger points to classical acupuncture points was not conceptually possible and that the only class of acupuncture points that could were the a shi points. Moreover, Birch concluded that no more than 40% of the acupuncture points examined by Melzack et al. correlated clinically for the treatment of pain (correlation was more like 18%-19%).


OBJECTIVE
To examine Birch's claims that myofascial trigger points cannot conceptually be compared to classical acupuncture points and that most (at least 60%) of the classical acupuncture points examined by the study of Melzack et al. are not recommended for treating pain conditions, negating their findings of a 71% clinical pain correspondence of trigger points and acupuncture points.


METHODS
Acupuncture references and literature were reviewed to examine the validity of the Birch study findings.


RESULTS
Acupuncture references support the conceptual comparison of trigger points to classical acupuncture points in the treatment of pain disorders, and their clinical correspondence in this regard is likely 95% or higher.


CONCLUSIONS
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.
Dorsher
Peter T
PT
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida 32224, USA. dorsher.peter@mayo.edu
D015667:Acupuncture Analgesia / Q000379:methods*; D015669:Acupuncture Points; D015670:Acupuncture Therapy / Q000379:methods; D001415:Back / Q000294:innervation; D019317:Evidence-Based Medicine; D005121:Extremities / Q000294:innervation; D006257:Head / Q000294:innervation; D006801:Humans; D009209:Myofascial Pain Syndromes / Q000503:physiopathology*; D009333:Neck / Q000294:innervation; D010147:Pain Measurement; D017288:Pain Threshold; D012677:Sensation; D013909:Thorax / Q000294:innervation