Pain ORIGINAL RESEARCH ARTICLE Remote Therapeutic Effectiveness of Acupuncture in Treating Myofascial Trigger Point of the Upper Trapezius Muscle ABSTRACT Chou L-W, Hsieh Y-L, Chen H-S, Hong C-Z, Kao M-J, Han T-I: Remote therapeutic effectiveness of acupuncture in treating myofascial trigger point of the upper trapezius muscle. Am J Phys Med Rehabil 2011;90:1036Y1049. Objective: This study aimed to investigate the remote effect of acupuncture (AcP) on the pain intensity and the irritability of the myofascial trigger point in the upper trapezius muscle. Design: Forty-five patients were equally divided into three groups: patients in the placebo control group received sham AcP, those in the simple needling group were treated using simple needling, and those in the modified AcP received AcP with the rapid Bscrewed in and out[ into multiple sites to elicit local twitch responses. The acupoints of Wai-guan and Qu-chi were treated. The outcome assessments included changes in subjective pain intensity, pressure pain threshold, range of motion, and mean amplitude of endplate noise in the myofascial trigger point region. Results: Immediately after acupuncture, all measured parameters improved significantly in the simple needling and modified AcP groups, but not in the placebo control group. There were significantly larger changes in all parameters in the modified AcP group than that in the simple needling group. Conclusions: The myofascial trigger point irritability could be suppressed after a remote acupuncture treatment. It appears that needling to the remote AcP points with multiple needle insertions of modified AcP technique is a better technique than simple needling insertion of simple needling technique in terms of the de- crease in pain intensity and prevalence of endplate noise and the increase in pressure pain threshold in the needling sites (represented either AcP points and or myofascial trigger points). We have further confirmed that the reduction in endplate noise showed good correlation with a decreased in pain. Key Words: Acupuncture, Endplate Noise, Myofascial Trigger Point, Pain Control, Remote Effects Authors: Li-Wei Chou, MD, MS Yueh-Ling Hsieh, PT, PhD Hsin-Shui Chen, MD Chang-Zern Hong, MD Mu-Jung Kao, MD Ting-I Han, MD Affiliations: From the Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung (L-WC, T-IH); School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung (L-WC); Department of Physical Therapy, China Medical University, Taichung (L-WC, Y-LH); Department of Physical Medicine and Rehabilitation, China Medical University, Bei-Gang Hospital, Bei-Gang (H-SC); Department of Physical Therapy, Hungkuang University, Taichung (C-ZH); and Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Taipei, Taiwan (M-JK). Correspondence: All correspondence and requests for reprints should be addressed to: Mu-Jung Kao, MD, No. 105, Yu-sheng St, Shilin District, Taipei City 111, Taiwan ROC. Disclosures: Chang-Zern Hong and Mu-Jung Kao contributed equally to this work. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. Supported by grants from of the National Science Council (NSC 96-2628-B-241-001-MY3 and NSC 97-2314YB-039-004-MY3) of Taiwan. Supported, in part, by the Taiwan Department of Health Clinical Trial and Research Center of Excellence (DOH100-TD-B-111-004). 0894-9115/11/9012-1036/0 American Journal of Physical Medicine & Rehabilitation Copyright * 2011 by Lippincott Williams & Wilkins DOI: 10.1097/PHM.0b013e3182328875 1036 Am. J. Phys. Med. Rehabil. & Vol. 90, No. 12, December 2011 Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.