THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE

Volume 14, Number 4, 2008, pp. 353–359

© Mary Ann Liebert, Inc.
DOI: 10.1089/acm.2007.0810

ORIGINAL PAPERS

Can Classical Acupuncture Points and Trigger Points

Be Compared in the Treatment of Pain Disorders?
Birch’s Analysis Revisited

PETER T. DORSHER, M.S., M.D.

ABSTRACT

Background: A 1977 study by Melzack et al. reported 100% anatomic and 71% clinical pain correspon-
dences of myofascial trigger points and classical acupuncture points in the treatment of pain disorders. A re-
analysis 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 (correla-
tion 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% clin-
ical 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 acupunc-
ture 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.

INTRODUCTION those physicians believed acupuncture to be efficacious.3 Al-

cupuncture was discovered about 2700 BC,1 with its
A tenets first compiled in the Nei Jing treatise about 200
BC.2 Acupuncture has been used clinically for nearly 5000
years to treat human illness, yet many allopathic physicians
continue to view acupuncture as “alternative” and unproven.
One study reported that only 47% of allopathic physicians
were willing to refer to acupuncturists and that only half of
though less than 30% of the acupuncture literature is de-
voted to its use in treating pain,4 pain is the indication most
familiar to the public and to allopathic physicians.
Myofascial pain’s history began in the early to mid
1800s as Balfour,5 a surgeon, postulated that muscle pain
originates from the muscle’s connective tissue; Froriep6 al-
ternatively theorized that muscle pain originates from the
muscle itself (“muscle calluses”). Lewis and Kellgren7 de-

Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida.

353
354
veloped the concept of referred pain from muscle a century
later, and subsequent muscle pain research results culmi-
nated in publication of the Trigger Point Manual.8,9 Trig-
ger point therapy is primarily used to treat myofascial pain
and dysfunction, and virtually all trigger points have re-
gional pain indications described, with the only exceptions
being the “cardiac arrhythmia,” “belch button,” and “causes
diarrhea” points.8,9
In 1977, Melzack et al.10 published the first study com-
paring the acupuncture and myofascial pain traditions for
treating pain disorders. This article reported that the studied
acupuncture and trigger points had a 100% anatomic corre-
spondence and a 71% clinical correspondence in treating
pain syndromes. The study examined only 48 distinct trig-
ger points, fewer than 20% of the points subsequently de-
scribed in the Trigger Point Manual,8,9 and compared them
to 50 acupoints typically used for major pain syndromes or
discrete pain locations.
In 2003, Birch11 analyzed both the data and theoretical
foundations of that study10 and reached markedly different
conclusions about the correspondences of trigger and
acupuncture points. Birch11 concluded that conceptually
trigger points should only be compared to a shi points, and
that, conceptual issues aside, likely fewer than 20% of the
studied acupoints would correlate with trigger points for
their pain uses, rather than the 71% correspondence reported
by Melzack et al.10
The purpose of the present study was to examine Birch’s
analysis11 and its conclusions regarding the correspondences
of trigger and acupuncture points.
METHODS
Birch11 attributed 3 assumptions to the study design de-
scribed by Melzack et al.,10 which were examined to assess
their validity:
1. All acupuncture points are defined as having pressure
pain.
2. The 35 correlated acupoints examined in the study of
Melzack et al.10 are normally used to treat pain condi-
tions and are among the more commonly used points in
general acupuncture practice.
3. Only needling acupoints proximate to the pain site are
important in treating pain conditions, so that only the lo-
cal indications of acupoints are necessary to establish
their correspondences to trigger points.
Four acupuncture reference texts4,12–14 were used to ex-
amine these assumptions. All 361 classical acupoints were
reviewed in these texts to see if pain indications were among
their described clinical uses. Myofascial pain and acupunc-
ture literature relevant to examining Birch’s 3 assumptions11
were also examined.
DORSHER
RESULTS
Assumption 1: All acupoints are defined as
having pressure pain
Birch11 asserted that trigger points should conceptually
only be compared to a shi rather than classical acupuncture
points because only a shi points are defined by tenderness.
This is incorrect. All 4 acupuncture references document the
fundamental importance of finding tenderness at classical
acupuncture points, particularly when treating pain condi-
tions. The O’Connor and Bensky text12 states that “when lo-
cating the precise position of an acupuncture point, the most
important single guide is sensitivity. . . . [A]cupuncture
points . . . are often sensitive to finger pressure, particularly
where an illness or symptom with which a certain point is
associated is present in the body.” Deadman et al.13 echo
this fundamental principle: “Equally commonly, local
points—whether channel points, extraordinary points, or
ahshi points—are needled in most cases of pain, and care-
ful palpation of the affected area, as well as detailed ques-
tioning, should be used to determine the channels or points
affected.” Master acupuncturist Dr. Shi Neng-yun15 simi-
larly states: “[I]f the true point is discovered the qi sensa-
tion should be strong. . . . [I]f the qi sensation is strong the
treatment will be effective.” Acupuncture references clearly
document that classical acupoints are tender (sensitive), par-
ticularly in pain disorders.
Birch11 also concluded that trigger points should not con-
ceptually be compared to classical acupoints because acu-
points have fixed anatomic locations while trigger points,
like a shi points, do not. This is incorrect. The cun system
only locates the neighborhood of acupuncture points, not
their absolute positions. O’Connor and Bensky12 state:
“[T]he purpose of proportional measurement is to facilitate
the finding of the approximate locations of points over gross
distances on the body, rather than to establish a single, ab-
solute standard for making fine measurements.” Dr. Shi
echoes: “[F]or point location the body measurements are
only guidelines to lead to the correct area. . . . [O]nce the
right neighborhood is located one must palpate to find the
hole (depression). . . . [O]ur ancestors said ‘select five points
to find the correct one.’. . . [T]he meaning of this is that one
finds the general location and then palpates up, down, left,
and right before determining the true point.”15 Birch’s as-
sertion that trigger points are not anatomically localized11 is
also inaccurate. The Trigger Point Manual8,9 documents ap-
proximately 255 “common” trigger point locations that are
frequently seen in clinical practice and reflect the authors’
clinical experience in treating myofascial pain. As noted in
Birch’s study, Travell and Rinzler16 reported that trigger
points had similar distributions among different patients,
thus appearing to be anatomically defined points that, when
treated, could improve pain conditions. Other myofascial re-
searchers, including Gutstein,17 Kellgren,18 and Sola and
CLASSICAL ACUPOINTS & TRIGGER POINTS IN PAIN
Kuitert,19 independently found trigger point locations that
are anatomically similar to those described by Travell and
Simons.8,9 Why did all these independent researchers find
trigger points in similar locations if trigger points are not lo-
calizable, as Birch asserts?
Finally, a recent study20 demonstrated that more than 92%
of the common trigger point locations described in the Trig-
ger Point Manual8,9 are in locations anatomically similar to
those of acupoints, most of which were described more than
2000 years ago (Fig. 1). Why should these clinicians, sepa-
rated by millennia, different cultures, and disparate levels of
scientific knowledge, have such similar findings?
Assumption 2: The correlated classical acupoints
are normally used in the treatment of pain
conditions and are among the more commonly
used points in general practice
A third reason Birch11 asserted why trigger points con-
ceptually should not be compared to classical acupoints in
treating pain disorders was that most (60%) of the 50 acu-
points examined in the study by Melzack et al.10 were not
recommended for treating pain in the acupuncture literature
FIG. 1. Anatomic relationships of common trigger points and acupuncture points.
355
Birch reviewed and only 11% were commonly recom-
mended points for treating pain. These findings are implau-
sible, as Deadman et al.13 and O’Connor and Bensky12 doc-
ument that all but 2 of 361 classical acupoints (BL-8 and
ST-17) do have pain indications described (almost always
for musculoskeletal pain near these points). Table 1 shows
the pain indications of the 50 acupoints examined in the
study by Melzack et al.,10 according to those acupuncture
references. All 35 classical acupoints that anatomically cor-
related to trigger points in that study had appropriate pain
indications listed in at least 1 of these texts. The references’
pain indications were similar for 31 (89%) of these acu-
points.
Birch11 further contended that because in his analysis
only about 20% of the 50 acupoints examined in the study
by Melzack et al.10 are commonly used in clinical practice
for any condition and about 45% are not used at all, then
those acupoints should probably not have been used for cor-
relations to trigger points. This logic is flawed, given that
the purpose of the study by Melzack et al.10 was to com-
pare the trigger point and acupuncture traditions for treat-
ing pain. Deadman et al.13 document that “equally com-
monly, local points—whether channel points, extraordinary
 TABLE 1. PAIN INDICATIONS OF THE POINTS EXAMINED IN THE STUDY BY MELZACK ET AL.10

Acupoint Deadman indications13 Shanghai indications12

GV-26 AC Pain and stiffness of spine, lumbar spine sprain/pain Acute low-back pain, mouth or eye muscle spasms
GV-23 L Headache with nasal obstruction, pain of eyes Headache, sore eyes
GV-20 L Headache, vertex pain Headache, vertex pain
GV-9 AC Pain lumbar spine, pain and heaviness of limbs, Intercostal neuralgia, chest pain, back pain
fullness of chest and lateral costal regions
GV-4 AC Lumbar pain and stiffness, headache, cold painful Low-back pain, sciatica
obstruction of hands and feet
GV-3 L Lateral knee pain, pain in crotch and lumbar region Low-back pain, knee pain
due to taxation injury
CV-4 L Twisting pain below umbilicus, back pain Abdominal pain, twisting pain below naval
BL-60 L/D Ankle pain, pain behind knee, sciatica, lumbar pain, Headache, low-back pain, sciatica, diseases of ankle
contraction in back and shoulder, stiff neck joint and surrounding soft tissues
BL-57 AC Low-back and leg pain, heel pain, cramps, sciatica Low-back and leg pain, sciatica, twisted muscles of
calf (spasm)
BL-40 L Pain and stiffness of lumbar spine, knee pain, headache Low-back pain, sciatica, arthritis in knee, gastro-
cnemius spasm
BL-43 L Back and shoulder pain Pain along spine
BL-23 L Pain and soreness of lumbar region and knees Low-back pain, low-back soft tissues injury
BL-21 L Pain and contraction of the back, epigastric pain Pain along spine, stomachache
BL-18 AC Spine pain, lumbar pain, pain in neck and shoulders, Intercostal neuralgia, pain of lumps in chest and
supraorbital region pain, nose pain, lateral costal abdomen
region pain
BL-17 AC Back pain, rigidity of spine, pain of whole body Diaphragm spasms
BL-12 L Lumbar pain, stiff neck, shoulder pain Shoulder sprain, stiff neck, pain in the chest and back
SI-3 D Headache, stiffness and pain of neck, shoulder, elbow Intercostal neuralgia, stiff neck, low-back pain,
and arm pain finger spasm
HT-5 L Pain and heaviness of wrist and elbow, pain of elbow Chest pain, headache
and upper arm
HT-3 L Swelling and pain of elbow joint, headache, pain of Headache, stiff neck, axilla pain, diseases of the
axilla elbow, ulnar neuralgia
KI-3 AC Lumbar pain, pain of abdomen and lateral costal region, Low-back pain, toothache, pain in sole of foot
leg pains
SP-10 L Pain inner thigh, pain and itching of genitals Distended abdomen due to rebellious qi
SP-9 L Pain and swelling of knee, painful obstruction of leg, Knee pain, pain of low back and leg, abdominal
lumbar pain, lower abdominal pain pain
Sp-6 L/D Leg pain, shin pain, painful obstruction of lower limbs Abdominal pain
SP-4 D Pain of heel, heat in soles of feet, abdominal pain Foot and ankle pain, stomachache
ST-44 D Eye pain, toothache, face pain, abdominal pain, painful Trigeminal neuralgia, stomachache, toothache
obstruction of throat, pain and swelling in dorsum
of foot
ST-36 D Pain of knee and shin, pain of thigh and shin, lumbar Abdominal pain and distention
pain with inability to turn, painful obstruction of
throat
ST-35 L Pain and swelling of knee joint Knee pain, diseases of knee and surrounding tissues
ST-34 L Pain and swelling of knee, pain of knee and leg, Pain of low back and leg, diseases of knee and
lumbar pain, epigastric pain surrounding tissues
ST-25 L Abdominal pain Abdominal pain, low-back pain
ST-8 L Headache, bursting eye pain Headache, migraine
ST-7 L Pain of cheek and face, toothache, ear pain Toothache, earache, temporomandibular arthritis,
trigeminal neuralgia
CLASSICAL ACUPOINTS & TRIGGER POINTS IN PAIN 357

TABLE 1. PAIN INDICATIONS OF THE POINTS EXAMINED IN THE STUDY BY MELZACK ET AL.10 (CONT’D)

Acupoint Deadman indications13 Shanghai indications12

ST-6 L Tension and pain of jaw, toothache, neck pain Temporomandibular arthritis, toothache,
masseter spasm
ST-4 L Pain of cheek, trigeminal neuralgia, toothache Trigeminal neuralgia
LI-15 L Shoulder pain, numbness and contraction of arm Shoulder joint pain
LI-11 L Pain and immobility of elbow and shoulder Arthritic pain in upper limb
LI-5 L Pain and weakness of wrist, contraction of the 5 Pain in the wrist, disease of the soft tissues of the
fingers wrist joint
LI-4 L/D Pain of arm, headache, contraction of the fingers, eye Headache, eye pain, toothache, pain in general
pain, toothache
LU-5 L Elbow pain, pain upper arm and shoulder Arm and elbow swelling and pain, throat pain,
chest pain
GB-34 L/D Pain and redness of knee, lateral costal pain and Intercostal neuralgia, perifocal shoulder inflammation,
fullness, elbow pain, stiffness in neck and shoulders, knee pain
sciatica
GB-30 L Pain of buttock, sciatica, pain or sprain of hip and leg, Pain in low back and leg, pain of lower back and
lumbar and lateral costal region pain groin, diseases of hip joint and surrounding soft
tissues
GB-21 L Pain and stiffness of neck, pain of shoulder and back Pain in back of shoulder, stiff neck
GB-20 L Pain and stiffness of neck, headache, redness and pain Stiff neck, headache, sore eyes
of the eyes
TE-14 L Shoulder pain, paralysis and pain of the arm Shoulder joint pain, perifocal inflammation of
shoulder joint
TE-10 L Elbow pain, neck and upper back pain, eye pain, Diseases of soft tissues of elbow, pain neck,
throat pain shoulder and back, eye pain, headache
TE-5 D Pain and numbness of elbow and arm, pain in shoulder Pain in joints of upper limbs, headache, stiff neck,
and back, severe pain in fingers, eye pains, ear rib pains
pain, headache
TE-4 L Wrist pain and weakness, shoulder and arm pain Pain and diseases of soft tissues of the wrist, pain
and weakness of wrist
LR-3 AC Headache, lumbar pain, pain in inner/outer knee, Headache, soreness of joints of the extremities, eye
lower leg pain, pain in medial malleolus pain, chest and rib pain, low-back pain
Tai Yang L Headache, toothache, trigeminal neuralgia Headache, trigeminal neuralgia

AC, accessory point; D, distant point use; L, local point use.

points, or ahshi points—are needled in most cases of pain.”
It is not conceptually relevant, when attempting to correlate
the uses of trigger points and acupoints for treating pain dis-
orders, to use as a correlation criterion how frequently those
acupoints are used in clinical practice or whether they are
used more commonly for conditions other than pain disor-
ders. As an analogy, the medication amitriptyline was orig-
inally developed for treatment of depression, but subsequent
clinical experience has demonstrated its efficacy for treat-
ing insomnia, urge incontinence, sialorrhea, headache, and
neuropathic pain conditions. If Birch’s reasoning would be
applied to amitriptyline, then this antidepressant medication
should never have been used clinically or studied for treat-
ing other conditions. This would not be logical or optimal
practice.
Assumption 3: Only treating acupoints near the site
of pain is important in treating pain, and the
acupoints’ local indications are sufficient to
establish a correlation between trigger and
acupuncture points
Although Birch11 correctly reported that the study by
Melzack et al.10 only correlated trigger points with acupoints
that were near the site of pain, this assumption implied that
their study did not address the importance of treating dis-
358
tant acupoints in pain disorders. In fact, the study by
Melzack et al.10 devoted 3 full paragraphs in its Discussion
section to the importance of stimulation of distant points in
treating pain and its implications in regard to the organiza-
tion of central nervous system pain pathways. Local and dis-
tant acupoints are frequently needled when treating pain con-
ditions, and the local acupoints were obviously the only ones
proximate to the trigger points.
Further, the concept that treatment of distal trigger points can
produce relief of proximal pain conditions does exist in the my-
ofascial pain tradition. The Trigger Point Manual9 describes a
vastus lateralis trigger point that has referred pain extending up
to the hip trochanter area, another in the lateral soleus muscle
that has its referred pain described at the lumbosacral junction,
and an “exceptional” soleus trigger point that has its referred
pain to the ipsilateral cheek and temporomandibular joint area.
These trigger points’ myofascial referred pain patterns follow
the meridian distributions of their anatomically corresponding
acupuncture points!20
DISCUSSION
Classical acupuncture points are most often used for treat-
ing conditions other than pain, yet pain is one of the most
common reasons a patient presents for treatment to any
health care provider. All but 2 of the 361 classical acupoints
(BL-8 and ST-17) have pain indications described,12,13
which are almost always for musculoskeletal pain near these
points.
The approximately 255 common trigger point locations
described in the Trigger Point Manual8,9 reflect some 50
years of the authors’ clinical experience in treating myofas-
cial pain and are the trigger points seen most frequently in
clinical practice (not the only trigger points that exist). Anal-
ogously, the 361 classical acupuncture points are not the
only acupuncture points but rather the most clinically im-
portant and commonly used points that reflect nearly 5000
years of clinical experience.
Although the myofascial pain tradition evolved thousands
of years after the acupuncture tradition and with use of differ-
ent terminology and methodology, the common trigger point
locations described in the Trigger Point Manual8,9 have marked
(92%) anatomic correspondence to the locations of classical
acupuncture points.20 Table 1 shows that acupuncture refer-
ences describe regional pain indications for all 49 classical
acupuncture points (and Tai Yang) studied by Melzack et al.10
and that these pain indications are similar to those of their
anatomically corresponding trigger points. This marked clini-
cal correspondence of the myofascial and acupuncture tradi-
tions in treating pain (as well as somatovisceral disorders) has
been confirmed in subsequent, larger comparisons of 255 com-
mon trigger points described in the Trigger Point Manual to
acupuncture points.20 That the acupuncture and myofascial pain
traditions discovered fundamentally similar anatomic and clin-
DORSHER
ical findings suggests they are describing the same physiologic
phenomena, as originally proposed by Melzack et al.10 A fu-
ture report will further the physiologic correspondences of the
myofascial pain and acupuncture traditions by demonstrating
that there are also marked correspondences of referred pain pat-
terns and acupuncture meridian distributions (Dorsher & Fleck-
stein, unpublished data).
The study by Melzack et al.10 anatomically correlated
common trigger points only to nearby classical acupoints;
however, it discussed at length the importance and the pos-
sible neurophysiologic mechanisms of the acupuncture tra-
dition’s findings that treatment of distant acupuncture points
enhances pain treatment efficacy. The present study also
provided examples from the Trigger Point Manual8,9 of trig-
ger points that follow the acupuncture principle of “select-
ing points below to treat above.”
The significance of these findings is their implication that
the myofascial pain tradition represents an independent re-
discovery of illness treatment principles that traditional Chi-
nese medicine (TCM) described in the Nei Jing2 in a dif-
ferent culture and era using different terminologies and
methodologies. There is evidence that other civilizations,
separated from the acupuncture and myofascial pain tradi-
tions by different eras, cultures, and geographic locations,
also found similar illness treatment concepts. Ötzi, the 5200-
year-old “Iceman” found in the Tyrol Alps, has tattoo marks
on his knee and ankle (near acupoints LR-8 and BL-60, re-
spectively) that have been postulated to represent acupunc-
ture-like treatment points for sciatica.21 Imhotep, physician
to the Egyptian pharaohs around 2600 BC, is the probable
source of spine and limb injury treatments described in the
Ebers and Smith papyri (17th century BC). Some of these
treatment concepts are similar to those of TCM.22 Mayan
healers (“curanderos”) used “jup” and “tok” needling tech-
niques analogous to those of TCM “to move the stagnant
blood and air.”23 This use suggests that these traditions must
have a common underlying anatomic basis or physiologic
basis, or both.
The data from the Trigger Point Manual8,9 can then be
viewed, in essence, as an independent validation of the
acupuncture tradition’s findings using modern scientific
methodology, and myofascial pain research results can thus
be used to help elucidate the mechanisms of acupuncture’s
effects. Both traditions’ literature should be viewed as com-
plementary to each other in this regard.
The present study demonstrates that, contrary to Birch’s
stance,11 there is a sound conceptual basis for comparing the
myofascial pain and acupuncture traditions, at least in the
treatment of pain disorders.
CONCLUSIONS
Common trigger points and classical acupuncture points
can conceptually be compared in the treatment of pain dis-
CLASSICAL ACUPOINTS & TRIGGER POINTS IN PAIN
orders, as both types of points are tender (sensitive) points,
both types of points have consistent anatomic locations, and
99.5% of classical acupuncture points do have pain indica-
tions to compare to those of trigger points. Even if acupunc-
ture points’ pain indications are not among their most com-
monly recommended uses, this is not conceptually relevant
when a study’s main purpose is to compare their pain uses
to those of trigger points. Although separated by thousands
of years in their development, both the myofascial pain and
acupuncture traditions have extensive clinical and basic sci-
ence research that can complement each other in enhancing
the contemporary understanding of pain physiology and op-
timal pain treatment. Data from the myofascial pain tradi-
tion serve to independently validate the acupuncture treat-
ment principles outlined in the Nei Jing.
ACKNOWLEDGMENTS
Editing, proofreading, and reference verification were
provided by the Section of Scientific Publications, Mayo
Clinic.
REFERENCES
1. Eckman P. In the Footsteps of the Yellow Emperor: Tracing
the History of Traditional Acupuncture. San Francisco: Cy-
press Book, 1996.
2. Huang Di Nei Jing (Yellow Emperor’s Inner Classic),
100–200 BC.
3. Astin JA, Marie A, Pelletier KR, Hansen E, Haskell WL. A
review of the incorporation of complementary and alternative
medicine by mainstream physicians. Arch Intern Med 1998;
158:2303–2310.
4. Helms JM. Acupuncture Energetics: A Clinical Approach for
Physicians. Berkeley, CA: Medical Acupuncture Publishers,
1995.
5. Balfour W. Observations on the pathology and cure of rheuma-
tism. Edinburgh Med Surg J 1815;11:168–187.
6. Froriep R. An Account of the Pathology and Therapy of
Rheumatism [in German]. Weimar, Germany: self-publication,
1843.
7. Lewis T, Kellgren JH. Observations relating to referred pain,
visceromotor reflexes, and other associated phenomena. Clin
Sci 1939;1:47–71.
8. Travell JG, Simons DG. Myofascial Pain and Dysfunction:
The Trigger Point Manual. Baltimore: Williams and Wilkins,
1983.
359
9. Travell JG, Simons DG. Myofascial Pain and Dysfunction:
The Trigger Point Manual. Vol. 2. Baltimore: Williams and
Wilkins, 1992.
10. Melzack R, Stillwell DM, Fox EJ. Trigger points and acupunc-
ture points for pain: correlations and implications. Pain
1977;3:3–23.
11. Birch S. Trigger point: acupuncture point correlations revis-
ited. J Altern Complement Med 2003;9:91–103.
12. O’Connor J, Bensky D. Transl. O’Connor J, Bensky D.
Acupuncture: A Comprehensive Text. Shanghai College of
Traditional Medicine. Chicago: Eastland Press, 1981.
13. Deadman P, Al-Khafaji M, Baker K. A Manual of Acupunc-
ture. Hove, East Sussex, England: Journal of Chinese Medical
Publications, 1998.
14. Wiseman N, Ellis A. Fundamentals of Chinese Medicine.
Brookline: Paradigm Publishers, 1996.
15. Ellis A. The Clinical Experience of Dr Shi Neng-Yun. (Trans-
lated by A. Ellis.) Berkeley, CA: Thin Moon Publishing, 1996.
16. Travell J, Rinzler SH. The myofascial genesis of pain. Post-
grad Med 1952;11:425–434.
17. Gutstein M. Diagnosis and treatment of muscular rheumatism.
Br J Phys Med 1938;1:302–311,321.
18. Kellgren JH. Observations on referred pain arising from mus-
cle. Clin Sci 1937–8;3:175–190.
19. Sola AE, Kuitert JH. Myofascial trigger point pain in the neck
and shoulder girdle: report of 100 cases treated by injection of
normal saline. Northwest Med 1955;54:980–984.
20. Dorsher PT. Trigger points and acupuncture points: Anatomic
and clinical correlations. Med Acupunct 2006;17:20–23.
21. Rosenweig B. Prehistoric Ice Man May Have Used Acupunc-
ture. CTVGlobemedia, Discover Channel Canada, 2008. On-
line document at: www.exn.ca/Stories/1998/12/04/53.asp Ac-
cessed January 14, 2008.
22. A short history: Australian Medical Acupuncture College. On-
line document at: www.acupunctureaustralia.org/pages/ashort
history.htm Accessed January 14, 2008.
23. Bowen-Jones A. The Fascinating Similarities Between Chinese
Medicine and Mayan Healing: Gavin Menzies. 1421—The
Year China Discovered the World, 2007. Online document at:
www.1421.tv/pages/evidence/content.asp?EvidenceID398
Accessed January 14, 2008.
Address reprint requests to:
Peter T. Dorsher, M.S., M.D.
Department of Physical Medicine and Rehabilitation
Mayo Clinic
4500 San Pablo Road
Jacksonville, FL 32224.
E-mail: dorsher.peter@mayo.edu