Effectiveness of acupuncture and myofascial release in analgesia of women with tensional neck pain: Systematic review

This systematic review investigated the effectiveness of acupuncture and myofascial release in the treatment of tension-type cervical pain, a condition affecting 30-50% of the general population, with a female predominance. Tension-type cervical pain is characterized by the presence of pain in the posterior or posterolateral region of the neck, frequently associated with emotional factors, stress, and postural alterations. The authors performed a comprehensive search across databases including Medline, BVS, Lilacs, SciELO, and Google Scholar, analyzing publications from 2005 to 2019. Thirty studies meeting the inclusion criteria were selected, with approximately half on acupuncture and half on myofascial release.

The acupuncture results demonstrated remarkable efficacy, with studies showing improvement in approximately 90% of treated cases. The research by Kim et al. identified that cervical pain represents 23.9% of all conditions treated with acupuncture in a Korean university hospital, being the second most common cause after low back pain. The Nakajima study showed favorable results in nearly 90% of 15 patients treated with weekly acupuncture for 4 weeks.

Comparatively, the Figueroa study demonstrated superiority of acupuncture over pharmacological treatment, with 48% of patients in the acupuncture group showing immediate pain relief, compared to 0% in the medication group. Electroacupuncture was particularly effective, providing rapid symptom relief and improving function in patients with cervical radiculopathy. Regarding myofascial release, the reviewed studies indicated significant effectiveness in pain reduction and functional improvement. The technique is based on the application of low-load, long-duration pressure to promote muscle relaxation and pain reduction.

Rodriguez et al. compared myofascial release with a multimodal physical therapy program and found superiority of the former in short-term pain relief. The authors observed that the efficacy of myofascial release is enhanced when combined with other therapeutic modalities. Both techniques demonstrated the ability to significantly improve quality of life and cervical range of motion.

Acupuncture showed advantages in response time, providing faster pain relief, while myofascial release demonstrated lasting benefits, especially in combined programs. From a pathophysiological standpoint, tension-type cervical pain is closely related to myofascial trigger points, particularly in the trapezius and sternocleidomastoid muscles. The associated postural alterations create a vicious cycle of muscle shortening, tension, and pain. Both acupuncture and myofascial release act by interrupting this cycle through distinct but complementary mechanisms.

Identified limitations include the methodological heterogeneity of the reviewed studies and the absence of research directly comparing the two modalities. The authors emphasize the need for more controlled studies to establish standardized protocols and determine which technique is most effective for different subtypes of cervical pain.