CHRONIC THORACOLUMBAR PAIN AND THE ROLE OF ACUPRESSURE AS A COMPLEMENTARY THERAPY
Keywords:
acupressure, thoracolumbar pain, chronic pain, spine, complementary therapyAbstract
Chronic thoracolumbar pain represents a common musculoskeletal condition that significantly affects functional capacity and quality of life. Acupressure, as a non-invasive complementary therapy, has gained increasing attention in the management of chronic pain conditions. The aim of this study is to evaluate the effectiveness of acupressure in reducing pain intensity and improving functional status in patients with chronic thoracolumbar pain, as well as to explain its underlying anatomical and neurophysiological mechanisms. The study is based on a descriptive-analytical review of relevant scientific literature, including clinical trials and systematic reviews. Results: The analyzed data indicate that acupressure stimulation leads to the activation of descending inhibitory services, continues to release endogenous opioids and serotonin, as well as a part of muscle spasm and improvement of local microcirculation. Clinical studies have shown a statistically significant effect on the negative effect of pain and improvement of functional mobility when acupressure is applied as part of a multimodal therapeutic protocol. Acupressure can reduce pain intensity by approximately 30-60%, improve spinal mobility by 20-40% and reduce muscle tension and spasm. These effects are associated with the activation of peripheral receptors, modulation of pain pathways in the spinal cord, and the release of endogenous opioids such as endorphins. The findings suggest that the combined use of local (Ashi) points and specific points such as BL23, BL25, and BL40 provides optimal therapeutic outcomes. In conclusion, acupressure is an effective, safe, and accessible complementary therapy for the management of chronic thoracolumbar pain, with significant clinical potential for integration into modern rehabilitation practice.
References
Василева, Д. (2023) Кинезиологија. COBISS.MK-ID 59239173, 1 (1). Универзитет „Гоце Делчев", Факултет за медицински науки, Штип. ISBN 978-608-244-951-7
Airaksinen, O., Brox, J. I., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., … & Mannion, A. F. (2006). Chapter 4: European guidelines for the management of chronic nonspecific low back pain. European Spine Journal, 15(2), S192–S300.
Bear, M. F., Connors, B. W., & Paradiso, M. A. (2020). Neuroscience: Exploring the brain (4th ed.). Wolters Kluwer.
Chen, Y. W., Wang, H. H., & Lin, Y. H. (2015). The effectiveness of acupressure on relieving pain: A systematic review. Evidence-Based Complementary and Alternative Medicine, 2015, 1–10.
Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture. Journal of Chinese Medicine Publications.
Fields, H. L. (2004). State-dependent opioid control of pain. Nature Reviews Neuroscience, 5(7), 565–575.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain. Psychological Bulletin, 133(4), 581–624.
Guyton, A. C., & Hall, J. E. (2021). Textbook of medical physiology (14th ed.). Elsevier.
Hodges, P. W. (2003). Core stability exercise in chronic low back pain. Journal of Manipulative and Physiological Therapeutics, 26(7), 505–512.
Hodges, P. W., & Richardson, C. A. (1996). Inefficient muscular stabilization of the lumbar spine. Spine, 21(22), 2640–2650.
Hoy, D., Bain, C., Williams, G., March, L., Brooks, P., Blyth, F., … & Buchbinder, R. (2014). A systematic review of the global prevalence of low back pain. Annals of the Rheumatic Diseases, 73(6), 968–974.
IASP. (2020). IASP terminology. International Association for the Study of Pain. https://www.iasp-pain.org.
Kaptchuk, T. J. (2000). The web that has no weaver: Understanding Chinese medicine. McGraw-Hill.
Krstev, T., Vasileva, D., Nikolovska, L., & Adziska, T. (2025). Evaluation of dry needling therapy in chronic lumbosacral pain. Journal of Neurosonology and Cerebral Hemodynamics, 21(2), 126–137.
Latremoliere, A., & Woolf, C. J. (2009). Central sensitization. The Journal of Pain, 10(9), 895–926.
Lee, E. J., Frazier, S. K., & Lee, J. Y. (2011). Effects of acupressure on pain and function. Journal of Pain Management, 4(1), 45–52.
Melzack, R., & Wall, P. D. (1965). Pain mechanisms: A new theory. Science, 150(3699), 971–979.
Millan, M. J. (2002). Descending control of pain. Progress in Neurobiology, 66(6), 355–474.
Namikoshi, T. (1974). Shiatsu therapy. Japan Shiatsu College.
Purves, D., Augustine, G. J., & Fitzpatrick, D. (2018). Neuroscience (6th ed.). Oxford University Press.
Schleip, R., Findley, T. W., Chaitow, L., & Huijing, P. A. (2012). Fascia: The tensional network of the human body. Churchill Livingstone.
Simons, D. G., Travell, J. G., & Simons, L. S. (1999). Myofascial pain and dysfunction: The trigger point manual. Lippincott Williams & Wilkins.
Snell, R. S. (2010). Clinical neuroanatomy (7th ed.). Lippincott Williams & Wilkins.
Treede, R. D., Rief, W., Barke, A., Aziz, Q., Bennett, M. I., Benoliel, R., … & Wang, S. J. (2015). Chronic pain classification. Pain, 156(6), 1003–1007.
Turk, D. C., & Okifuji, A. (2002). Psychological factors in chronic pain. Pain, 95(1–2), 1–4.
Vasileva, D., & Andovska, V. (2024). Средства на кинезитерапија кај лумбалгија. Knowledge – International Journal, 65(4), 431–436.
Vasileva, D., & Dimik, I. (2023). Влијание на кинезитерапијата кај лумбална дискус хернија. Knowledge – International Journal, 61(4), 665–670.
Vasileva, D., Pesevska, M., & Lyubenov, N. (2025). Effects of mechanical decompression in patients with degenerative changes of the intervertebral discs. Knowledge – International Journal, 72(4), 569–575.
Woolf, C. J. (2011). Central sensitization. Pain, 152(3), S2–S15.
