Background Pain conditions rank among the top reasons for seeking medical care. The Huangdi Neijing (~200 BCE) first described focal painful muscle sites as well as “classical” acupoints and their therapeutic needling. The Trigger Point Manual (1983) introduced the concept of myofascial trigger points (mTrPs), illustrating their clinically “most common” locations and their treatment using dry needling or local anesthetic injection. In 1977, the first study comparing the use of mTrPs and classical acupoints in treating pain disorders was published, finding for the 58 mTrPs examined, 100% had a proximate acupoint that had a similar pain indication in 71% of comparisons. Our 2008 study extended this analysis to all the Trigger Point Manual's 255 most common mTrP locations, finding that those mTrPs had > 93% anatomic and > 94% pain indication correspondences to classical acupoints. Subsequent publication of new mTrP data and digital 3D anatomy references allow an enhanced ability to explore acupuncture and trigger points' clinical relationships. Objective The aim of this study was to examine the anatomic correspondences of the most common mTrP locations in the Trigger Point Manual with those of classical acupoints using 3D anatomic references and to explore their clinical correspondences in treating pain conditions. Methods To allow examination of their spatial relationships, the 361 classical acupoint and 255 most common mTrP locations were placed on their anatomically relevant 3D muscle images using Adobe PhotoshopTM (San Jose, CA). Proximate acupuncture and trigger points entering the same muscle region were defined as anatomically corresponding point pairs. Each point pairs’ clinical pain indications were examined for similarities. Seven new mTrP regions introduced in the Trigger Point Manual (third edition) were analyzed similarly. Results Overall, 248 (95%) of the 262 most common mTrP locations anatomically correspond to a classical acupoint location. Anatomically corresponding mTrP–acupoint pairs had similar pain indications in > 97% of comparisons. The statistical odds that these correspondences occurred by chance were calculated to be essentially zero. Conclusion This study’s findings of 95% anatomic and > 97% clinical pain indication correspondences between the Trigger Point Manual's most common mTrP and those of classical acupoints provide strong evidence these points are describing the same clinical phenomenon in the treatment of pain.

The “most common” myofascial trigger points and classical acupuncture points. Part 1

期刊论文
发表日期：

2025年4月22日

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Peter T. Dorsher,
Oskar Schmid,
Johannes Fleckenstein

摘要

Background

Pain conditions rank among the top reasons for seeking medical care. The Huangdi Neijing (~200 BCE) first described focal painful muscle sites as well as “classical” acupoints and their therapeutic needling. The Trigger Point Manual (1983) introduced the concept of myofascial trigger points (mTrPs), illustrating their clinically “most common” locations and their treatment using dry needling or local anesthetic injection. In 1977, the first study comparing the use of mTrPs and classical acupoints in treating pain disorders was published, finding for the 58 mTrPs examined, 100% had a proximate acupoint that had a similar pain indication in 71% of comparisons. Our 2008 study extended this analysis to all the Trigger Point Manual's 255 most common mTrP locations, finding that those mTrPs had > 93% anatomic and > 94% pain indication correspondences to classical acupoints. Subsequent publication of new mTrP data and digital 3D anatomy references allow an enhanced ability to explore acupuncture and trigger points' clinical relationships.

Objective

The aim of this study was to examine the anatomic correspondences of the most common mTrP locations in the Trigger Point Manual with those of classical acupoints using 3D anatomic references and to explore their clinical correspondences in treating pain conditions.

Methods

To allow examination of their spatial relationships, the 361 classical acupoint and 255 most common mTrP locations were placed on their anatomically relevant 3D muscle images using Adobe Photoshop^TM (San Jose, CA). Proximate acupuncture and trigger points entering the same muscle region were defined as anatomically corresponding point pairs. Each point pairs’ clinical pain indications were examined for similarities. Seven new mTrP regions introduced in the Trigger Point Manual (third edition) were analyzed similarly.

Results

Overall, 248 (95%) of the 262 most common mTrP locations anatomically correspond to a classical acupoint location. Anatomically corresponding mTrP–acupoint pairs had similar pain indications in > 97% of comparisons. The statistical odds that these correspondences occurred by chance were calculated to be essentially zero.

Conclusion

This study’s findings of 95% anatomic and > 97% clinical pain indication correspondences between the Trigger Point Manual's most common mTrP and those of classical acupoints provide strong evidence these points are describing the same clinical phenomenon in the treatment of pain.