THERAPIES & TRADITIONS · GUIDE
Trigger Point Acupuncture and Ashi Points in Traditional Practice
Ashi points are tender spots used in traditional Chinese acupuncture. Learn how they relate to myofascial trigger points and where researchers disagree.
Content last updated . This page has not been medically reviewed.
Back to AcupunctureWhat this page covers
Acupuncture literature describes a kind of point that is found by tenderness rather than by a map. These are called ashi points (also spelled a shi or ah shi). Modern pain medicine describes tender muscle spots called myofascial trigger points. People often ask whether these are the same thing. This page sets out the traditional description, what researchers have compared, and where they disagree. It is information only. It does not tell you how to locate or needle any point, and it is not a guide to treating pain yourself.
The traditional description
A review of the history of ashi points traces them to the Neijing (Internal Classic), where points were located by palpation, meaning by feeling for a tender response.[1] The same review says the ashi concept took shape in the Qianjin Yaofang (Prescriptions Worth a Thousand Gold) and gradually became a kind of point alongside the regular and extra points.[1] Regular points are located by proportional measurement along bones, while an ashi point is located by palpation.[1] The author also argues that the method is not limited to local tenderness.[1]
In traditional terms, one Chinese review says ashi points arise from the theory of the "muscle region of the meridian."[2] These are traditional frameworks, not anatomical findings. For background, see Meridians and Channels in Acupuncture and Acupuncture Points Explained.
The modern concept: myofascial trigger points
A myofascial trigger point is described as a hyperirritable painful spot involving a limited number of muscle fibers.[3] One review says the trigger point phenomenon has good face validity and is clinically relevant.[3] Other work questions how reliably the points can be found: a meta-analysis of six studies concluded that manual palpation for trigger points is unreliable.[4] See Trigger Point Injections and Dry Needling Compared for more on that problem.
Are ashi points and trigger points the same?
| Source | What it said | How to weigh it |
|---|---|---|
| Melzack and colleagues, 1977 | Found a 71% correspondence between trigger points and acupuncture points for pain, and proposed they represent the same phenomenon.[5] | An early, widely cited comparison, not a trial of treatment. |
| Birch, 2003 | Said the 71% figure is conceptually not possible and found that closer to 18%-19% of the points matched, but did find a probable match with ashi points.[6] | A reanalysis based on acupuncture textbooks. |
| 2008 response | Argued the correspondence is likely 95% or higher.[7] | A direct disagreement with Birch's reading. |
| 2016 review | Reported that trigger points are significantly correlated with channel points, extra points and ashi points, and suggested trigger point research could inform study of ashi points.[8] | A narrative review, not a measurement of outcomes. |
| 2017 Chinese review | Described ashi points, tender points and trigger points as related but different: by its account ashi points sit in muscle regions on boundaries between muscles, while trigger points sit on motor points.[2] | A conceptual comparison. |
The honest summary is that the overlap between the two ideas is a matter of dispute, and the answer depends on how each is defined. These studies compare locations and descriptions. They do not show that needling a given spot works better than another.
What treatment trials show
Proper evidence not found that treating ashi points is better than treating other points. I searched PubMed for randomized trials comparing ashi or trigger-point sites with classical points and found mostly small or non-English studies and protocols.
One trial did compare laser applied to trigger points with laser at classical acupoints in 100 people with neck muscle pain. Immediate pain relief was seen in the trigger point group and improved neck movement in the same group, but not in the acupoint group.[9] That is a single trial of a needle-free method, so it cannot be generalized to needling. For the broader evidence on needling for muscle pain, see Dry Needling: What Research Shows by Condition. For why sham comparisons matter, see Sham Acupuncture and Placebo Controls.
Practical pointers
If a practitioner says they will treat "ashi points" or "trigger points," it is reasonable to ask which tradition they work in, what training they have, and how you will both judge whether it is helping. See How to Choose an Acupuncturist.
Frequently asked questions
What does ashi mean in acupuncture?
It names points found by feeling for tenderness rather than by a measured map.[1]
Are ashi points the same as trigger points?
Researchers disagree. One 1977 study reported 71% overlap, and later reanalyses reached very different figures.[5][6][7]
Do ashi points work better than regular points?
Proper evidence not found. The comparisons found are about location, not treatment results.[8]
Is needling tender spots risky?
It can be, if done wrongly or in the wrong area. Serious harms include infection, punctured organs and nerve injury.[10]
Can I find my own ashi points?
This site gives no point-finding or needling guidance. Seek a trained, regulated practitioner for assessment.
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Safety
Needling any tender muscle, especially around the neck, chest and upper back, can injure nearby organs and nerves if done wrongly. NCCIH says that when acupuncture is not delivered properly it can cause serious adverse effects, including infections, punctured organs and injury to the central nervous system.[10] The laser trial authors themselves pointed to the risk of pneumothorax (collapsed lung) from acupuncture in people with neck muscle pain.[9] See Serious Complications of Acupuncture. Do not use needling to delay care for sudden severe pain, chest or breathing symptoms, or new weakness. In the US, call 911 for emergencies.
References
- Origin and development of Ashi point locating method (abstract in English; article in Chinese). Zhongguo Zhen Jiu 2013. Read 2026-10-22.
- Discussing the relationship among the ashi point, tender point and myofascial trigger point (abstract in English; article in Chinese). Zhongguo Zhen Jiu 2017. Read 2026-10-22.
- Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain. Curr Opin Support Palliat Care 2019. Read 2026-10-22.
- Interrater Agreement of Manual Palpation for Identification of Myofascial Trigger Points: A Systematic Review and Meta-Analysis. Clin J Pain 2017. Read 2026-10-22.
- Melzack R, Stillwell DM, Fox EJ. Trigger points and acupuncture points for pain: correlations and implications. Pain 1977. Read 2026-10-22.
- Birch S. Trigger point--acupuncture point correlations revisited. J Altern Complement Med 2003. Read 2026-10-22.
- Can classical acupuncture points and trigger points be compared in the treatment of pain disorders? Birch's analysis revisited. J Altern Complement Med 2008. Read 2026-10-22.
- Traditional Chinese Medicine acupuncture and myofascial trigger needling: The same stimulation points? Complement Ther Med 2016. Read 2026-10-22.
- Comparison of the effects between lasers applied to myofascial trigger points and to classical acupoints for patients with cervical myofascial pain syndrome. Biomed J 2021. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH), Acupuncture: Effectiveness and Safety. Read 2026-10-22.