Brazilian Journal of Pain
Brazilian Journal of Pain
Original Article

Influence of acupuncture on the pain perception threshold of muscles submitted to repetitive strain

Influência da acupuntura no limiar de percepção dolorosa de musculatura submetida a esforço repetitivo

Sandra Silvério-Lopes; Maria Paula Gonçalves da Mota

Downloads: 0
Views: 219


BACKGROUND AND OBJECTIVES: Muscle pain is one of the causes of the leave of absence in physical activities, as well as limiting factor in sports performance. The objective of this study was to evaluate the early and late response to the pain perception threshold after acupuncture in a single application, in subjects submitted to repetitive strain.

METHODS: Clinical-experimental quantitative trial, with control group and blind, with 47 healthy women, aged between 18 and 55 years (36.3±10.6), divided deterministically by sequential alternation to the groups: acupuncture (GACP n=16), Sham (Gsham n=16) and control (CGRT n=15). The repetitive strain was performed in the Reformer equipment of the Pilates method, before and after the intervention, with 0,25x40mm needles. The GACP received the needling at point ST36 (Zusanli). The Gsham received superficial needling out of the acupuncture point, and the CGRT only performed the exercise. All patients had the needles for 20 minutes, except for the CGRT who remained only at rest. A digital pressure algometer was used at point BL57 (Chengshan). The algometry was conducted before the intervention and the exercise, immediately after, and after 24 hours.

RESULTS: The GACP showed a significant increase in the pain perception threshold when compared to Gsham (p =0.021) and to CGRT (p<0.001) and after 24 hours, with CGRT (p=0.006). The results were coherent with the acupuncture theoretical foundations, suggesting the release of opioid analgesics and applicability in the recovery of post-exercise sore muscles.

CONCLUSION: A single acupuncture intervention was able to increase the Pain Perception Threshold immediately and after 24 hours.


Acupuncture, Algometry, Muscle pain, Pain perception threshold


JUSTIFICATIVA E OBJETIVOS: A dor muscular é uma das causas de afastamento de práticas de atividades físicas e fator limitante no desempenho desportivo. O objetivo deste estudo foi avaliar a resposta imediata e tardia do limiar de percepção dolorosa após estímulo de acupuntura em uma única aplicação, em sujeitos submetidos a esforço repetitivo.

MÉTODOS: Ensaio clínico-experimental, quantitativo, com grupo controle e encoberto, 47 mulheres sadias, com idades entre 18 e 55 anos (36,3±10,6), separadas por alocação determinista por alternância sequencial em grupos: acupuntura (GACP n=16), Sham (Gsham n=16) e controle (GCRT n=15). Realizou-se o esforço repetitivo no equipamento Reformer do método Pilates, antes e após a intervenção com agulhas 0,25x40mm. O GACP recebeu agulhamento no ponto E36 (Zusanli). O Gsham agulhamento superficial, fora do ponto de estímulo de acupuntura e o GCRT só realizou o exercício. Todos permaneceram 20 min com agulhas e o GCRT só em repouso. Utilizou-se um algômetro de pressão digital no ponto B57 (Chengshan). A algometria foi realizada antes da intervenção e do exercício, imediatamente após, e após 24 horas.

RESULTADOS: O GACP teve aumento significativo do limiar de percepção dolorosa no momento imediato, quando comparado ao Gsham (p=0,021) e ao GCRT (p<0,001), e após 24 horas com o GCRT (p=0,006). Houve coerência dos resultados com as bases teóricas do estímulo da acupuntura, sugerindo liberação de opioides analgésicos e aplicabilidade em recuperação de dores musculares pós-exercícios.

CONCLUSÃO: Uma única intervenção de acupuntura foi capaz de aumentar o limiar de percepção dolorosa de imediato e após 24 horas.


Acupuntura, Algometria, Dor muscular, Limiar de percepção dolorosa


Hsu CL, Best JR, Davis JC, Nagamatsu LS, Wang S, Boyd LA. Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment. Br J Sports Med. 2018;52(3):184-91.

McMahon EM, Corcoran P, O'Regan G, Keeley H, Cannon M, Carli V. Physical activity in European adolescents and associations with anxiety, depression and well-being. Eur Child Adolesc Psychiatry. 2017;26(1):111-22.

Knapen J, Vancampfort D, Moriën Y, Marchal Y. Exercise therapy improves both mental and physical health in patients with major depression. Disabil Rehabil. 2015;37(16):1490-5.

Bishop FL, Fenge-Davies AL, Kirby S, Geraghty AW. Context effects and behaviour change techniques in randomised trials: a systematic review using the example of trials to increase adherence to physical activity in musculoskeletal pain. Psychol Health. 2015;30(1):104-21.

Lewis BA, Napolitano MA, Buman MP, Williams DM, Nigg CR. Future directions in physical activity intervention research: expanding our focus to sedentary behaviors, technology, and dissemination. J Behav Med. 2017;40(1):112-26.

Nigg CR, Borrelli B, Maddock J, Dishman RK. A theory of physical activity maintenance. Appl Psychol. 2008;57(4):544-60.

Floegel TA, Giacobbi Jr PR, Dzierzewski JM, Aiken-Morgan AT, Roberts B, McCrae CS. Intervention markers of physical activity maintenance in older adults. Am J Health Behav. 2015;39(4):487-99.

Kawakita K, Okada K. Acupuncture therapy: mechanism of action, efficacy, and safety: a potential intervention for psychogenic disorders?. Biopsychosoc Med. 2014;8(1):4.

Barros TL, Angeli G, Barros LF. Preparação do atleta de esportes competitivos. Rev Soc Cardiol. 2005;15(2):114-20.

Foschini D, Prestes J, Charro MA. Relationship between physical exercise, muscle damage and delayed-onset muscle soreness. Rev Bras Cineantropom Desempenho Hum. 2007;9(1):101-6.

Byrne C, Twist C, Eston R. Neuromuscular function after exercise-induced muscle damage: theoretical and applied implications. Sports Med. 2004;34(1):49-69.

Qin W, Bai L, Jin L, Tian J. Findings of Acupuncture Mechanisms Using EEG and MEG. Multi-Modality Neuroimaging Study on Neurobiological Mechanisms of Acupuncture. 2018.

Chen X. Electric acupuncture analgesic action may differ between acupoint Zusanli and a point 0.2cm beside Zusanli in rats. J Integ Med. 2014;12(3):229.

Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ. Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain. 2018;19(5):455-74.

Zhu J, Arsovska B, Kozovska K. Acupuncture treatment for sports injury - hamstring muscles group. Inter J Clin Exper Med Sci. 2017;3(6):71-3.

Fong DT, Chan YY, Mok KM, Yung PS, Chan KM. Understanding acute ankle ligamentous sprain injury in sports. Sports Med Arthrosc Rehabil Ther Technol. 2009;1:14.

Hübscher M, Vogt L, Bernhörster M, Rosenhagen A, Banzer W. Effects of acupuncture on symptoms and muscle function in delayed-onset muscle soreness. J Altern Complement Med. 2008;14(8):1011-6.

Lian YL, Chen CY, Hammes M, Kol BC. Pictorial atlas of acupuncture - An ilustrated manual of acupuncture points. 2012.

Elliott J, Marsh C. Exploring data: an introduction to data analysis for social scientists. 2008.

Lindenau JD, Guimarães LS. Calculando o tamanho de efeito no SPSS. Rev HCPA. 2012;32(3):363-81.

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2017;39(2):175-91.

Itoh K, Minakawa Y, Kitakoji H. Effect of acupuncture depth on muscle pain. Chin Med. 2011;6(1):24.

Paschalis V, Koutedakis Y, Jamurtas AZ, Mougios V, Baltzopoulos V. Equal volumes of high and low intensity of eccentric exercise in relation to muscle damage and performance. J Strength Cond Res. 2005;19(1):184-8.

Hsieh YL, Hong CZ, Liu SY, Chou LW, Yang CC. Acupuncture at distant myofascial trigger spots enhances endogenous opioids in rabbits: a possible mechanism for managing myofascial pain. Acupunct Med. 2016;34(4):302-9.

Schenk P, Laeubli T, Klipstein A. Validity of pressure pain thresholds in female workers with and without recurrent low back pain. Eur Spine J. 2007;16(2):267-75.

Melia M, Schmidt M, Geissler B, König J, Krahn U, Ottersbach HJ. Measuring mechanical pain: the refinement and standardization of pressure pain threshold measurements. Behav Res Methods. 2015;47(1):216-27.

Erthal V, Maria-Ferreira D, Werner MF, Baggio CH, Nohama P. Anti-inflammatory effect of laser acupuncture in ST36 (Zusanli) acupoint in mouse paw edema. Lasers Med Sci. 2016;31(2):315-22.

Chesterton LS, Barlas P, Foster NE, Baxter GD, Wright CC. Gender differences in pressure pain threshold in healthy humans. Pain. 2003;101(3):259-66.

Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Anesthesiol Clin. 2007;25(4):841-51.

Bonfim AE, Ré D De, Gaffuri J, Costal MM, Portolez JL, Bertolini GR. Uso do alongamento estático como fator interveniente na dor muscular de início tardio. Rev Bras Med Esporte. 2010;16(5):349-52.

Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE. Acupuncture for chronic pain individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444-53.

Toda S. Effect of acupuncture on carnitine for skeletal muscle fatigue. Chin Med. 2012;3:9-12.

Submitted date:

Accepted date:

5f1f778b0e88254446dc6779 brjp Articles


Share this page
Page Sections