[From fascial tension abnormality to myofascial chain: modern anatomical and biomechanical interpretation of "taking painful points as acupoints" in acupuncture and moxibustion].

"Taking painful points as acupoints" is an important principle of acupoint selection in acupuncture and moxibustion. But its traditional connotation and modern mechanism have long been controversial. In this paper, the principle of "taking painful points as acupoints" is reinterpreted in light of anatomical and biomechanical studies of fascial system. Fascia, as a tension network covering the whole body, plays a crucial role in the onset and persistence of pain. The abnormal fascial tension may form tender points and myofascial trigger points (MTrPs), which are highly consistent with the distribution of ashi points. The continuity of myofascial chain can partially explain meridian pathways and distal effect of acupuncture and moxibustion in mechanistic studies. The mechanotransmission and mechanotransduction induced by acupuncture acting on the fascia-neural network provide a potential biological basis for deqi and analgesic effect. Based on the above understandings, this study further investigates the correlation between mechanical nature of ashi points, tender points and MTrPs in fascial tension field and their clinical practice, as well as the relationship of them with meridian pathways and distal effect. Therefore, it is concluded that "taking painful points as acupoints" not only represents the refinement of practical experience of acupuncture and moxibustion, but also serves as the surface mapping of abnormal fascial states. Such understanding provides new theoretical support for the transition from empirical acupoint selection to precise acupoint selection in acupuncture and moxibustion, and also expands new research and practical approaches for the comprehensive management of chronic pain.