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Manual acupuncture for myofascial pain syndrome: a systematic review and meta-analysis
  1. Rong Wang1,2,
  2. Xiuxia Li3,4,
  3. Shenghu Zhou1,
  4. Xiaogang Zhang5,
  5. Kehu Yang3,4,
  6. Xusheng Li1
  1. 1Department of Joint Surgery, Lanzhou General Hospital, Lanzhou Military Command, Lanzhou, China
  2. 2Gansu University of Chinese Medicine, Lanzhou, China
  3. 3Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
  4. 4Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
  5. 5Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
  1. Correspondence to Professor Xusheng Li, Lanzhou General Hospital, Lanzhou Military Command, 333 Binhe South Road, Lanzhou, Gansu 730050, China; lixusheng1968{at}


Objective To assess the efficacy of manual acupuncture (MA) in the treatment of myofascial pain syndrome (MPS).

Methods We searched for randomised controlled trials (RCTs) comparing MA versus sham/placebo or no intervention in patients with MPS in the following databases from inception to January 2016: PubMed; Cochrane Library; Embase; Web of Science; and China Biology Medicine. Two reviewers independently screened the literature extracted data and assessed the quality of the included studies according to the risk of bias tool recommended by the Cochrane Handbook (V.5.1.0). Then, a meta-analysis was performed using RevMan 5.3 software.

Results Ten RCTs were combined in a meta-analysis of MA versus sham, which showed a favourable effect of MA on pain intensity after stimulation of myofascial trigger points (MTrPs; standardised mean difference (SMD) −0.90, 95% CI −1.48 to −0.32; p=0.002) but not traditional acupuncture points (p>0.05). Benefit was seen both after a single treatment (SMD −1.05, 95% CI −1.84 to −0.27; p=0.009) and course of eight sessions (weighted mean difference (WMD) −1.96, 95% CI −2.72 to −1.20; p<0.001). We also found a significant increase in pressure pain threshold following MA stimulation of MTrPs (WMD 1.00, 95% CI 0.32 to 1.67; p=0.004). Two of the included studies reported mild adverse events (soreness/haemorrhage) secondary to MA.

Conclusions Through stimulation of MTrPs, MA might be efficacious in terms of pain relief and reduction of muscle irritability in MPS patients. Additional well-designed/reported studies are required to determine the optimal number of sessions for the treatment of MPS.


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  • XXL is joint first author.

  • Contributors RW and XXL were responsible for the conception and design of the study. XSL, XZ, SZ and KY were responsible for data acquisition. SZ and KY analysed and interpreted the data in collaboration with XZ. RW and XXL wrote the first draft of the manuscript. All authors critically revised the manuscript for important intellectual content and approved the final version accepted for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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