American Journal of Sports Science and Medicine. 2014, 2(5), 181-189
DOI: 10.12691/AJSSM-2-5-2
Review Article

A Review of the Scientific Evidence for Acupuncture and Dry Needling Compared in Common Sporting Conditions and Medical Disorders

Alex Huntly1 and Daniel Berdejo-del-Fresno1,

1England Futsal National Team, The Football Association, London, UK

Pub. Date: October 20, 2014

Cite this paper

Alex Huntly and Daniel Berdejo-del-Fresno. A Review of the Scientific Evidence for Acupuncture and Dry Needling Compared in Common Sporting Conditions and Medical Disorders. American Journal of Sports Science and Medicine. 2014; 2(5):181-189. doi: 10.12691/AJSSM-2-5-2

Abstract

There is an evidence base of varying strength for the use of acupuncture in conditions, such as chronic low back pain, myofascial trigger point, osteoarthritis, pain relief, performance enhancement and respiratory disorders. The aim of this study was to review the evidence base of acupuncture for common conditions that occur in sport. A literature review of how acupuncture works and what it can treat was performed. Evidence for each condition was critically appraised. There are significant differences in the perceived effectiveness of acupuncture for different conditions and mechanisms. Chronic low back pain, myofascial trigger point, acute low back pain and osteoarthritis were perceived to be effective. All of the reviewed mechanisms of acupuncture were perceived more effective than Chinese meridian. Those conditions that were rated as less effective generally had less supporting evidence or were not relevant to sporting populations.

Keywords

trigger point, low back pain, traditional chinese medicine

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  The peripheral afferent pathway in acupuncture analgesia. Chung-Hua i Hsueh Tsa Chih [Chinese Medical Journal]. 1974; 6: 360-364.
 
[2]  Andersson S, Lundeberg T. Acupuncture - from empiricism to science - functional backgroud to acupuncture effects in pain and disease. Medical Hypotheses. 1995; 45 (3): 271-281.
 
[3]  Ballegaard S, Jensen G, Pedersen F, Nissen VH. Acupuncture in severe, stable angina-pectoris - A randomised trial. Acta Medica Scandinavica. 1986; 220 (4): 307-313.
 
[4]  Ballegaard S, Pedersen F, Pietersen A, Nissen VH, Olsen NV. Effects of acupuncture in moderate, stable angina-pectoris - a controlled study. Journal of Internal Medicine. 1990; 227 (1): 25-30.
 
[5]  Biernacki W, Peake MD. Acupuncture in treatment of stable asthma. Respiratory Medicine. Sep 1998; 92 (9): 1143-1145.
 
[6]  Blom M, Lundeberg T, Dawidson I, Angmarmansson B. Effects on local blood flux of acupuncture stimulation used to treat xerostomia in patients suffering from sjogrens-syndrome. Journal of Oral Rehabilitation. 1993; 20 (5): 541-548.
 
[7]  Brain SD. Sensory neuropeptides: their role in inflammation and wound healing. Immunopharmacology. 1997; 37 (2-3): 133-152.
 
[8]  Brinkhaus B, Becker-Witt C, Jena S, et al. Acupuncture randomized trials (ART) in patients with chronic low back pain and osteoarthritis of the knee - Design and protocols. Forschende Komplementarmedizin Und Klassische Naturheilkunde. 2003; 10 (4): 185-191.
 
[9]  Brukner P, Khan K. Clinical sports medicine. 3rd ed. London: McGraw-Hill; 2007.
 
[10]  Ceccherelli F, Bordin M, Gagliardi G, Caravello M. Comparison between superficial and deep acupuncture in the treatment of the shoulder's myofascial pain: A randomized and controlled study. Acupuncture & Electro-Therapeutics Research. 2001; 26 (4): 229-238.
 
[11]  Cook J. Funky treatments in elite sports people: do they just buy rehabilitation time? British Journal of Sports Medicine. 2010; 44 (4): 221-221.
 
[12]  Chen B, Wang D, Pan I. Changes of opiate-like substance level in the perfusate of peri aqueductal gray after electro acupuncture and brain stimulation in rabbit. Acta Physiologica Sinica. 1983; 34 (4): 385-391.
 
[13]  Cho SH, Hwang EW. Acupuncture for primary dysmenorrhoea: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology. Apr 2010b; 117 (5): 509-521.
 
[14]  Cho SH, Kim J. Efficacy of acupuncture in management of premenstrual syndrome: A systematic review. Complementary Therapies in Medicine. 2010a; 18 (2): 104-111.
 
[15]  Dhillon S. The acute effect of acupuncture on 20-km cycling performance. Clinical Journal of Sport Medicine. 2008; 18 (1): 76-80.
 
[16]  Dorfer L, Moser M, Spindler K, Bahr F, Egarter-Vigl E, Dohr G. 5200-year-old acupuncture in central Europe? Science. Oct 9 1998; 282 (5387): 242-243.
 
[17]  Edwards J, Knowles N. Superficial dry needling and active stretching in the treatment of myofascial pain--a randomised controlled trial. Acupunct Med. 2003; 21 (3): 80-86.
 
[18]  Engberg S, Cohen S, Sereika SM. The efficacy of acupuncture in treating urge and mixed incontinence in women: a pilot study. Journal of Wound, Ostomy, & Continence Nursing. Nov-Dec 2009; 36 (6): 661-670.
 
[19]  Ernst E, White A. Acupuncture: a scientific appraisal. Oxford: Butterworth-Heinemann; 1999.
 
[20]  Ezzo J, Vickers A, Richardson MA, et al. Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. Journal of Clinical Oncology. Oct 1 2005; 23 (28): 7188-7198.
 
[21]  Filshie J, White A. Medical acupuncture: a western scientific approach. Edinburgh: Churchill Livingstone; 1998.
 
[22]  Fink M, Wolkenstein E, Karst M, Gehrke A. Acupuncture in chronic epicondylitis: a randomized controlled trial. Rheumatology. Feb 2002; 41 (2): 205-209.
 
[23]  Fleckenstein J, Zaps D, Ruger LJ, et al. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey. Bmc Musculoskeletal Disorders. 2010; 11. Figure 2 PC6 acupuncture point
 
[24]  Frost FA, Jessen B, Siggaardandersen J. Control, double-blind comparison of mepivacaine injection versus saline injection for myofascial pain. Lancet. 1980; 1 (8167): 499-501.
 
[25]  Fung KP, Chow OK, So SY. Attenuation of exercise-induced asthma by acupuncture. Lancet. Dec 20-27 1986; 2 (8521-22): 1419-1422.
 
[26]  Furlan AD, van Tulder MW, Cherkin DC, et al. Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev. 2005 (1): CD001351.
 
[27]  Gao M, Wang MZ, Li KY, He LF. Changes of mu opioid receptor binding sites in rat brain following electroacupuncture. Acupuncture & Electro-Therapeutics Research. 1997; 22 (3-4): 161-166.
 
[28]  Garvey TA, Marks MR, Wiesel SW. A prospective, randomised, double-blind evaluation of trigger-point injection therapy for low-back pain. Spine. 1989; 14 (9): 962-964.
 
[29]  Gerwin RD, Shannon S, Hong CZ, Hubbard D, Gevirtz R. Interrater reliability in myofascial trigger point examination. Pain. 1997; 69 (1-2): 65-73.
 
[30]  Gonçalves-Nordon D, Gianini RJ, Regina-Azevedo, G. Development and validation of an index for evaluating the quality of acupuncture articles. Rev Fac Cienc Méd Sorocaba. 2012: 14 (2): 59-63.
 
[31]  Gonçalves-Nordon D, Gianini RJ, Regina-Azevedo, G. Development and validation of an index of the adequacy of the control technique for acupuncture studies. Rev Fac Cienc Méd Sorocaba. 2013: 15 (1): 186-191.
 
[32]  Gonçalves-Nordon D. The relation between quality clinical trials and acupuncture efficacy. Rev Fac Cienc Méd Sorocaba. 2013: 15 (2): 6-10.
 
[33]  Guo HF, Tian J, Wang X, Fang Y, Hou Y, Han J. Brain substrates activated by electroacupuncture (EA) of different frequencies (II): Role of Fos/Jun proteins in EA-induced transcription of preproenkephalin and preprodynorphin genes. Brain Res Mol Brain Res. 1996; 43 (1-2): 167-173.
 
[34]  Haake M, Muller HH, Schade-Brittinger C, et al. German acupuncture trials (GERAC) for chronic low back pain - Randomized, multicenter, blinded, parallel-group trial with 3 groups. Archives of Internal Medicine. 2007; 167 (17): 1892-1898.
 
[35]  Haker E, Lundeberg T. Acupuncture treatment in epicondylalgia: a comparative study of two acupuncture techniques. Clinical Journal of Pain. Sep 1990; 6 (3): 221-226.
 
[36]  Hempen C-H, Chow VW. Pocket atlas of acupuncture. Stuttgart ; New York: Thieme; 2006.
 
[37]  Hong CZ. Lidocaine injection versus dry needling to myofascical trigger point - the importance of the local twitch response. American Journal of Physical Medicine & Rehabilitation. 1994; 73 (4): 256-263.
 
[38]  Huguenin L, Brukner PD, McCrory P, Smith P, Wajswelner H, Bennell K. Effect of dry needling of gluteal muscles on straight leg raise: a randomised, placebo controlled, double blind trial. British Journal of Sports Medicine. 2005; 39 (2): 84-90.
 
[39]  Hui KKS, Liu J, Makris N, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: Evidence from fMRI studies in normal subjects. Human Brain Mapping. 2000; 9 (1): 13-25.
 
[40]  Hui KKS, Liu J, Marina O, et al. The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. Neuroimage. 2005; 27 (3): 479-496.
 
[41]  Jaeger B, Skootsky SA. Double blind controlled study of different myofascial trigger point injection techniques. Pain. 1987 (SUPPL. 4): S292.
 
[42]  Kalauokalani D, Cherkin DC, Sherman KJ, Koepsell TD, Deyo RA. Lessons from a trial of acupuncture and massage for low back pain: patient expectations and treatment effects. (0362-2436).
 
[43]  Kim L-W, Zhu J. Acupuncture for essential hypertension. Alternative Therapies in Health & Medicine. Mar-Apr 2010; 16 (2): 18-29.
 
[44]  Langevin HM, Bouffard NA, Badger GJ, Churchill DL, Howe AK. Subcutaneous tissue fibroblast cytoskeletal remodeling induced by acupuncture: Evidence for a mechanotransduction-based mechanism. Journal of Cellular Physiology. 2006; 207 (3): 767-774.
 
[45]  Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anatomical Record. 2002; 269 (6): 257-265.
 
[46]  Langevin HM. Connective tissue: A body-wide signaling network? Medical Hypotheses. 2006; 66 (6): 1074-1077.
 
[47]  Lee A, Done ML. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database of Systematic Reviews. 2004 (3): CD003281.
 
[48]  Lee H, Ernst E. Acupuncture for labor pain management: A systematic review. American Journal of Obstetrics and Gynecology. 2004; 191 (5): 1573-1579.
 
[49]  Lee H, Kim SY, Park J, Kim YJ, Park HJ. Acupuncture for Lowering Blood Pressure: Systematic Review and Meta-analysis. American Journal of Hypertension. 2009; 22 (1): 122-128.
 
[50]  Lee H, Park H-J, Park J, et al. Acupuncture application for neurological disorders. Neurological Research. 2007; 29 Suppl 1: S49-54.
 
[51]  Linde K, Streng A, Jurgens S, et al. Acupuncture for patients with migraine - A randomized controlled trial. Jama-Journal of the American Medical Association. 2005; 293 (17): 2118-2125.
 
[52]  Longbottom J. Acupuncture in manual therapy. Edinburgh: Churchill Livingstone; 2010.
 
[53]  Lund I, Lundeberg T. Are minimal, superficial or sham acupuncture procedures acceptable as inert placebo controls? Acupunct Med. 2006; 24 (1): 13-15.
 
[54]  Lundeberg T, Bondesson L, Thomas M. Effect of acupuncture on experimentally induced itch. British Journal of Dermatology. 1987; 117 (6): 771-777.
 
[55]  Macdonald AJR, Macrae KD, Master BR, Rubin AP. Superficial acupuncture in the relief of chronic low-back-pain - A placebo-controlled randomised trial. Annals of the Royal College of Surgeons of England. 1983; 65 (1): 44-46.
 
[56]  MacPherson H, Asghar A. Acupuncture needle sensations associated with De Qi: a classification based on experts' ratings. Journal of Alternative & Complementary Medicine. Sep 2006; 12 (7): 633-637.
 
[57]  Manheimer E, White A, Berman B, Forys K, Ernst E. Meta-analysis: Acupuncture for low back pain. Annals of Internal Medicine. 2005; 142 (8): 651-663.
 
[58]  Manheimer E, Zhang G, Udoff L, et al. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. British Medical Journal. 2008; 336 (7643): 545-+.
 
[59]  Mann F. Reinventing acupuncture: a new concept of ancient medicine. 2nd ed. Oxford: Butterworth-Heinemann; 2000.
 
[60]  Melchart D, Linde K, Fischer P, et al. Acupuncture for idiopathic headache. Cochrane Database of Systematic Reviews. 2001 (1): CD001218.
 
[61]  Melzack R, Stillwell DM, Fox EJ. Trigger points and acupuncture points for pain - correlations and implications. Pain. 1977; 3 (1): 3-23.
 
[62]  Molsberger AF, Boewing G, Diener HC, et al. Designing an acupuncture study: The nationwide, randomized, controlled, German acupuncture trials on migraine and tension-type headache. Journal of Alternative and Complementary Medicine. 2006; 12 (3): 237-245.
 
[63]  Mukaino Y, Park J, White A, Ernst E. The effectiveness of acupuncture for depression--a systematic review of randomised controlled trials. Acupuncture in Medicine. Jun 2005; 23 (2): 70-76.
 
[64]  National Institute for Health and Clinical E, National Collaborating Centre for Primary C. Low back pain: early management of persistent non-specific low back pain. London: National Institute for Health and Clinical Excellence; 2009.
 
[65]  Nichols AW, Harrigan R. Complementary and alternative medicine usage by intercollegiate athletes. Clinical Journal of Sport Medicine. May 2006; 16 (3): 232-237.
 
[66]  Njoo KH, Vanderdoes E. The occurence and interrater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius - A prospective-study in nonspecific low-back pain patients and controls in general practice. Pain. 1994; 58 (3): 317-323.
 
[67]  Ozerkan KN, Bayraktar B, Yucesir I, Cakir B, Yilddiz F. Effectiveness of Omura's ST.36 point (True ST.36) needling on the Wingate anaerobic test results of young soccer players. Acupuncture & Electro-Therapeutics Research. 2009; 34 (3-4): 205-216.
 
[68]  Pariente J, White P, Frackowiak RSJ, Lewith G. Expectancy and belief modulate the neuronal substrates of pain treated by acupuncture. Neuroimage. 2005; 25 (4): 1161-1167.
 
[69]  Proctor ML, Smith CA, Farquhar CM, Stones RW. Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhoea. Cochrane Database of Systematic Reviews. 2002 (1): CD002123.
 
[70]  Rampes H, Sharples F, Maragh S, Fisher P. Introducing complementary medicine into the medical curriculum. Journal of the Royal Society of Medicine. 1997; 90 (1): 19-22.
 
[71]  Saladin KS, Van Wynsberghe D. Anatomy and physiology: the unity of form and function. 2nd ed. Boston; London: McGraw-Hill; 2001.
 
[72]  Sandberg M, Lundeberg T, Lindberg LG, Gerdle B. Effects of acupuncture on skin and muscle blood flow in healthy subjects. European Journal of Applied Physiology. 2003; 90 (1-2): 114-119.
 
[73]  Sato A, Sato Y, Shimura M, Uchida S. Calcitonin gene-related peptide produces skeletal muscle vasodilation following antidromic stimulation of unmyelinated afferents in the dorsal root in rats. Neuroscience Letters. 2000; 283 (2): 137-140.
 
[74]  Simons DG, Travell JG, Simons LS. Travell and Simons' myofascial pain and dysfunction: The trigger point manual, Vol. 1. Upper half of body, Second edition. Travell and Simons' myofascial pain and dysfunction: The trigger point manual, Vol. 1. Upper half of body, Second edition. 1999: xviii+1038p.
 
[75]  Smidt N, van der Windt DAWM, Assendelft WJJ, Deville WLJM, Korthals-de Bos IBC, Bouter LM. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial.[Summary for patients in Aust J Physiother. 2002; 48 (3): 239; PMID: 12369566]. Lancet. Feb 23 2002; 359 (9307): 657-662.
 
[76]  Smith C, Crowther C, Beilby J. Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial. Birth. Mar 2002; 29 (1): 1-9.
 
[77]  Smith CA, Hay PP, Macpherson H. Acupuncture for depression. Cochrane Database of Systematic Reviews. 2010 (1): CD004046.
 
[78]  Stener-Victorin E, Humaidan P. Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer. Acupunct Med. 2006; 24 (4): 157-163.
 
[79]  Thomas KJ, MacPherson H, Ratcliffe J, et al. Longer term clinical and economic benefits of offering acupuncture care to patients with chronic low back pain. Health Technology Assessment. 2005; 9 (32): III-+.
 
[80]  Thomas M, Eriksson SV, Lundeberg T. A comparitive-study of diazepam and acupuncture in patients with osteoarthritis pain - A placebo controlled-study. American Journal of Chinese Medicine. 1991; 19 (2): 95-100.
 
[81]  Tough EA, White AR, Cummings TM, Richards SH, Campbell JL. Acupuncture and dry needling in the management of myofascial trigger point pain: A systematic review and meta-analysis of randomised controlled trials. European Journal of Pain. 2009; 13 (1): 3-10.
 
[82]  Treede RD, Meyer RA, Raja SN, Campbell JN. Peripheral and central mechanisms of cutaneous hyperalgesia. Progress in Neurobiology. 1992; 38 (4): 397-421.
 
[83]  Trinh KV, Phillips SD, Ho E, Damsma K. Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheumatology. Sep 2004; 43 (9): 1085-1090.
 
[84]  Vickers AJ, Rees RW, Zollman CE, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ. Mar 27 2004; 328 (7442): 744.
 
[85]  Wall PD, Melzack R, McMahon SB, Koltzenburg M. Wall and Melzack's textbook of pain. 5th ed. Philadelphia: Elsevier/Churchill Livingstone; 2006.
 
[86]  Wang KM, Yao SM, Xian YL, Hou ZL. A study on the receptive field of acupoints and the relationship between characteristics of needling sensation and groups of afferent fibers. Scientia Sinica Series B-Chemical Biological Agricultural Medical & Earth Sciences. 1985; 28 (9): 963-977.
 
[87]  Wang KM, Yao SM, Xian YL, Hou ZL. A study on the receptive-field of acupoints and the relationship between characteristics of needling sensation and groups of afferent fibres. Scientia Sinica Series B-Chemical Biological Agricultural Medical & Earth Sciences. 1985; 28 (9): 963-977.
 
[88]  Weidner C, Klede M, Rukwied R, et al. Acute effects of substance P and calcitonin gene-related peptide in human skin - A microdialysis study. Journal of Investigative Dermatology. 2000; 115 (6): 1015-1020.
 
[89]  White A, Cummings TM, Filshie J. An introduction to Western medical acupuncture. Edinburgh: Churchill Livingstone Elsevier; 2008.
 
[90]  White A, Foster NE, Cummings M, Barlas P. Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology. 2007; 46 (3): 384-390.
 
[91]  White P. A background to acupuncture and its use in chronic painful musculoskeletal conditions. Journal of the Royal Society for the Promotion of Health. Sep 2006; 126 (5): 219-227.
 
[92]  Williamson L, Yudkin P, Livingstone R, Prasad K, Fuller A, Lawrence M. Hay fever treatment in general practice: a randomised controlled trial comparing standardised Western acupuncture with Sham acupuncture. Acupuncture in Medicine. May 1, 1996; 1996; 14: 6-10.
 
[93]  World_Health_Organisation. Acupuncture: Review and analysis of reports on controlled clinical trials: WHO Library Cataloguing-in-Publication Data; 2003.
 
[94]  Yu DY, Lee SP. Effect of acupuncture on bronchial asthma. Clinical Science & Molecular Medicine. Nov 1976; 51 (5): 503-509.