Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 6 , Pages 905-912, June 2009

Remote Influences of Acupuncture on the Pain Intensity and the Amplitude Changes of Endplate Noise in the Myofascial Trigger Point of the Upper Trapezius Muscle

  • Li-Wei Chou, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, China Medical University, Taichung, Taiwan
    • School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
    • ,
  • Yueh-Ling Hsieh, PT, PhD

      Affiliations

    • Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
    • Department of Physical Therapy, Hungkuang University, Taichung, Taiwan
    • ,
  • Mu-Jung Kao, MD

      Affiliations

    • Department of Rehabilitation Medicine, Taipei City Hospital, Taipei, Taiwan
    • ,
  • Chang-Zern Hong, MD

      Affiliations

    • Department of Physical Therapy, Hungkuang University, Taichung, Taiwan
    • Corresponding Author InformationCorrespondence to Chang-Zern Hong, MD, Dept of Physical Therapy, Hungkuang University, 34 Chung-Chie Rd, Shalu, Taichung, Taiwan

Abstract 

Chou L-W, Hsieh Y-L, Kao M-J, Hong C-Z. Remote influences of acupuncture on the pain intensity and the amplitude changes of endplate noise in the myofascial trigger point of the upper trapezius muscle.

Objective

To investigate the remote effect of acupuncture on the pain intensity and the endplate noise (EPN) recorded from a myofascial trigger point (MTrP) of the upper trapezius muscle.

Design

Randomized controlled trial.

Setting

University hospital.

Participants

Patients (N=20) with active MTrPs in upper trapezius muscles and no experience in acupuncture therapy.

Interventions

Patients were divided into 2 groups. Those in the control group received sham acupuncture, and those in the acupuncture group received modified acupuncture therapy with needle insertion into multiple loci to elicit local twitch responses. The acupuncture points of Wai-guan and Qu-chi were treated.

Main Outcome Measures

Subjective pain intensity (numerical pain rating scale) and mean EPN amplitude in the MTrP of the upper trapezius muscle.

Results

The pain intensity in the MTrP was significantly reduced after remote acupuncture (from 7.4±0.8 to 3.3±1.1; P<.001), but not after sham acupuncture (from 7.4±0.8 to 7.1±0.9; P>.05). The mean EPN amplitude was significantly lower than the pretreatment level after acupuncture treatment (from 21.3±9.5μV to 9.5±3.5μV; P<.01), but not after sham acupuncture treatment (from 19.6±7.6μV to 19.3±7.8μV; P>.05). The change in the pain intensity was significantly correlated with the change of EPN amplitude (r = 0.685).

Conclusions

Both subjective changes in the pain intensity and objective changes of the EPN amplitude in the MTrP region of the upper trapezius muscle were found during and after acupuncture treatment at the remote ipsilateral acupuncture points. This study may further clarify the physiological basis of the remote effectiveness of acupuncture therapy for pain control.

Key Words: Acupuncture, Electromyography, Trigger points, myofascial, Pain, Rehabilitation

List of Abbreviations: EMG, electromyography, EPN, endplate noise, LTR, local twitch response, MTrP, myofascial trigger point

 

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(09)00185-3

doi:10.1016/j.apmr.2008.12.020

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 6 , Pages 905-912, June 2009

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