Trigger Points vs Acupuncture Points: different maps of the same territory?

You press into a tender knot in your shoulder and feel pain shoot up your neck. Your massage therapist calls it a trigger point, but your acupuncturist might describe it as a blockage along a meridian. These appear to be two completely different explanations — but could they be describing the same biological phenomenon through different lenses?

Modern pain science and Traditional Chinese Medicine (TCM) developed independently, yet an intriguing overlap exists between myofascial trigger points and acupuncture or acupressure points. Let’s explore where they converge, where they differ, and why it matters.

What Are Trigger Points?

Trigger points are hyperirritable spots within skeletal muscle, typically found inside taut bands of muscle fibres. When stimulated, they can produce local tenderness, referred pain, motor dysfunction, and autonomic responses (Travell and Simons, 1983; Simons, Travell and Simons, 1999).

They are central to the concept of Myofascial Pain Syndrome, extensively described by Janet Travell and David Simons in their foundational work Myofascial Pain and Dysfunction (Travell and Simons, 1983; Simons, Travell and Simons, 1999). Travell’s interest in skeletal muscle pain defined her career, and she notably became the first female physician to serve as personal doctor to President John F. Kennedy.

From a Western biomedical perspective, although trigger points are often described as “knots,” they are actually small areas where muscle fibres and nerves become irritated. Researchers suggest that communication between nerves and muscle may become overactive, causing a small portion of muscle to remain stuck in contraction (Simons, 2004). This sustained tension can compress nearby blood vessels, reducing blood flow and oxygen to the area, which may lead to aching, burning, or fatigue sensations.

At the same time, local pain receptors may become unusually sensitive, meaning that even mild pressure or movement feels disproportionately painful. Studies have shown that trigger points contain elevated levels of chemicals associated with pain and inflammation, including substance P and CGRP (Shah et al., 2005). Trigger points can also disrupt how muscles coordinate and function, contributing to stiffness, weakness, and restricted movement. Together, these factors may create a self-perpetuating cycle of tension, reduced circulation, chemical irritation, and pain — which is why therapies such as manual trigger point release, dry needling, movement retraining, and acupuncture aim to interrupt this loop.

What Are Acupuncture / Acupressure Points?

In Traditional Chinese Medicine (TCM), acupuncture points are specific locations along pathways known as meridians, through which Qi — often described as the body’s vital energy — is believed to circulate. The concept of energy flow is central to Eastern medical philosophy, where health is associated with balance and smooth movement of Qi, and illness or pain is thought to arise when this flow becomes blocked or disrupted. By stimulating these points, practitioners aim to restore balance and support the body’s natural healing processes.

Stimulation can be applied using fine needles (acupuncture), manual pressure (acupressure), or heat (moxibustion). Within TCM theory, these points are considered capable of influencing pain modulation, organ function, emotional well-being, and overall systemic health.

While the conceptual framework differs from Western anatomy, acupuncture’s clinical effects — particularly in pain management — have been widely studied (Vickers et al., 2012; Zhang et al., 2014). Research suggests acupuncture can influence endorphin release, serotonin levels, and central pain-regulating pathways (Han, 2004).

The Fascinating Overlap

Here’s where things become especially interesting. Multiple studies have reported that a large proportion of myofascial trigger points correspond anatomically with classical acupuncture points (Melzack, Stillwell and Fox, 1977; Dorsher, 2006). Some analyses have suggested overlap estimates ranging from approximately 70% to 90%, depending on criteria used (Melzack, Stillwell and Fox, 1977).

How Could This Overlap Exist?

Several hypotheses attempt to explain this crossover.

Scientists have observed that both trigger points and acupuncture points are frequently located near areas where nerves interact closely with muscles. These regions tend to be highly sensitive and may play an important role in how the body processes pain (Melzack, Stillwell and Fox, 1977).

Research has shown that trigger points contain increased levels of biochemicals associated with pain and inflammation (Shah et al., 2005). Similarly, stimulating acupuncture points has been shown to activate the body’s natural pain-relief mechanisms, including endorphin release and modulation of pain pathways within the central nervous system (Han, 2004).

Some researchers have also proposed that the meridians described in Traditional Chinese Medicine may correspond to connective tissue or fascial planes recognised in Western anatomy (Langevin and Yandow, 2002). Together, these findings raise the possibility that both systems — despite using different language and theoretical frameworks — may be identifying similar biologically significant regions.

Notably, both traditions developed their maps through careful palpation and clinical observation. Traditional Chinese Medicine charted sensitive therapeutic points, while Travell and Simons documented reproducible patterns of referred pain. Independent discovery of similar sensitive “hotspots” is therefore plausible.

Why This Matters Clinically

This overlap matters in clinical practice because it can encourage a more integrative approach to care. When therapists, acupuncturists, and other practitioners recognise that they may be working with similar sensitive areas, communication improves and treatment options expand. It also helps move away from rigid “either/or” thinking.

In reality, many patients benefit from combining techniques such as hands-on manual therapy, needling approaches, movement-based rehabilitation, and strategies that reduce stress.

It is important to keep some perspective, however. Not every trigger point directly matches an acupuncture point, diagnostic systems differ, and the strength of scientific evidence varies depending on the condition being treated (Birch, 2003). Researchers continue to investigate the underlying mechanisms, including neurochemical effects, connective tissue signalling, and central nervous system modulation (Shah et al., 2005; Langevin and Yandow, 2002).

Conclusion

Whether described as dysfunctional motor endplates, myofascial trigger points, or blocked Qi along meridians, both perspectives highlight predictable, sensitive regions in the body that influence pain and physiology. Rather than viewing these explanations as competing, we might consider them different maps of the same complex biological territory.

For patients in pain, what ultimately matters most is not the model — but the relief.

References

Melzack, R., Stillwell, D.M. and Fox, E.J. (1977) ‘Trigger points and acupuncture points for pain: correlations and implications’, Pain, 3(1), pp. 3–23.

Travell, J.G. and Simons, D.G. (1983) Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore: Williams & Wilkins.

Simons, D.G., Travell, J.G. and Simons, L.S. (1999) Myofascial Pain and Dysfunction: The Trigger Point Manual. Volume 1: Upper Half of Body. 2nd edn. Baltimore: Williams & Wilkins.

Shah, J.P., Phillips, T.M., Danoff, J.V. and Gerber, L.H. (2005) ‘An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle’, Archives of Physical Medicine and Rehabilitation, 86(3), pp. 576–583.

Langevin, H.M. and Yandow, J.A. (2002) ‘Relationship of acupuncture points and meridians to connective tissue planes’, The Anatomical Record, 269(6), pp. 257–265.

Vickers, A.J., Cronin, A.M., Maschino, A.C., Lewith, G., MacPherson, H., Foster, N.E., Sherman, K.J., Witt, C.M. and Linde, K. (2012) ‘Acupuncture for chronic pain: individual patient data meta-analysis’, Archives of Internal Medicine, 172(19), pp. 1444–1453.

Han, J.S. (2004) ‘Acupuncture and endorphins’, Trends in Neurosciences, 27(1), pp. 17–22.

Birch, S. (2003) ‘Trigger point–acupuncture point correlations revisited’, Journal of Alternative and Complementary Medicine, 9(1), pp. 91–103.