03/07/08
Fonte: FOLHA DE SÃO PAULO - CADERNO EQUILIBRIO

Acupuntura e terapia miofascial são semelhantes

Um estudo desenvolvido pela Clínica Mayo da Flórida, EUA, sugere que acupuntura (foto) e terapia miofascial têm resultados semelhantes no alívio para a dor musculoesquelética crônica.
A pesquisa mostrou que ambas as técnicas têm características comuns: utilizam pontos desencadeantes nos músculos e na fáscia (faixa de tecido fibroso que reveste músculos, ossos, órgãos e outras estruturas do corpo) para tratar a dor.

Peter Dorsher, especialista em dor crônica da Clínica Mayo, analisou estudos publicados sobre as duas técnicas e demonstrou que esses pontos são anatômico e clinicamente similares no tratamento. Em outro estudo recente, ele observou que pelo menos 92% dos pontos da terapia miofascial correspondiam anatomicamente aos pontos da acupuntura e que a correspondência clínica era maior do que 95%.
A acupuntura chinesa clássica trata a dor e uma variedade de problemas de saúde com o uso de agulhas finas para restaurar a transmissão nervosa, explica o médico.

Já a terapia miofascial utiliza pontos-gatilho para aliviar a dor, que são sensíveis ao toque. Para diminuir a dor nesses pontos, os profissionais usam injeções, compressão, massagem, estimulação elétrica e estiramento, entre outras técnicas.

O que provavelmente une essas duas disciplinas é o sistema nervoso, que transmite a dor, explica o médico.

Obs. Na verdade, as duas técnicas são as mesmas. A técnica miofascial é a acupuntura primitiva: os antigos chineses aplicavam estímulo com o uso de agulhas no local onde sentia a dor, e posteriormente foi evoluindo de forma mais complexa.

Atualmente, o conceito de acupuntura inclui o uso de estimulação elétrica e injeção no local de dor.

Dr. Hong Jin Pai

Veja o artigo original:

*J Altern Complement Med. 2008 May;14(4):353-9.*
Can classical acupuncture points and trigger points be compared in the treatment of pain disorders? Birch's analysis revisited.
Dorsher PT.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville,
Florida 32224, USA. dorsher.peter@mayo.edu

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.
*Mayo Clinic study shows acupuncture and myofascial trigger therapy treat same pain areas*
*Acupuncture and myofascial trigger therapy treat same pain areas,
Mayo specialist says*
Tuesday, May 13, 2008
JACKSONVILLE, Fla. – Ancient acupuncture and modern myofascial pain therapy each focus on hundreds of similar points on the body to treat pain, although they do it differently, says a physician at Mayo Clinic in Jacksonville who analyzed the two techniques. Results of the study, published May 10 in the Journal of Complementary and Alternative Medicine, suggest that people who want relief from chronic musculoskeletal pain may benefit from either therapy, says chronic pain specialist Dr. Peter Dorsher of the Department of
Physical Medicine and Rehabilitation at Mayo Clinic. "This may come as a surprise to those who perform the two different techniques, because the notion has been that these are exclusive therapies separated by thousands of years," he says. "But this study shows that in the treatment of pain disorders, acupuncture and myofascial techniques are fundamentally similar – and this is good news for anyone looking for relief."
Classic Chinese acupuncture treats pain and a variety of health disorders using fine needles to "reset" nerve transmission, Dorsher says. Needles are inserted in one or several of 361 classical acupoints to target specific organs or pain problems. "This is a very safe and effective technique," he says. Myofascial trigger-point therapy, which has evolved since the mid-1800s, focuses on tender muscle or "trigger point" regions. There are about 255 such regions described by the Trigger Point Manual, the seminal textbook on myofascial pain. These are believed to be sensitive and painful areas of muscle and fascia, the web of soft tissue that surrounds muscle, bones, organs and other body structures.
To relieve pain at these trigger points, practitioners use injections, deep pressure, massage, mechanical vibration, electrical stimulation and stretching, among other techniques.
In the study, Dorsher analyzed studies published on both techniques and demonstrated that acupuncture points and trigger points are anatomically and clinically similar in their uses for treatment of pain disorders.
In another recent study, he found that at least 92 percent of common trigger points anatomically corresponded with acupoints, and that their clinical correspondence in treating pain was more than 95 percent. "That means that the classical acupoint was in the same body region as the trigger point, was used for the same type of pain problem, and the trigger point referred pain pattern followed the meridian pathway of that acupoint described by the Chinese more than 2,000 years before," Dorsher says. Myofascial pain therapy has lately incorporated the use of acupuncture needles in a treatment called "dry needling" to treat muscle trigger points. "I think it is fair to say that the myofascial pain tradition represents an independent rediscovery of the healing principles of traditional Chinese medicine," Dorsher says. "What likely unites these two disciplines is the nervous system, which transmits pain."
The study was funded by Mayo Clinic.

Fonte: http://www.mayoclinic.org/news2008-jax/4798.html