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To Oina, my wife, for her patience and forbearance during the writing of this book. The phenomena of pain belong to that borderland between the body and soul about which it is so delightful to speculate from the comfort of an armchair, but which offers such formidable obstacles to scientific inquiry. J. H. Kellgren (1948) Extracts from reviews of the first edition: ‘…I warmly recommend this book to anyone who wants to learn more about this often neglected area of common musculoskeletal pain conditions…’ Journal of the Royal College of Physicians of London ‘This is a book that should belong to physicians, neurologists, rheumatologists and teachers of medical students…’ Pain Endorsements of the new edition: ‘Peter Baldry is one of the most respected practitioners of Medical Acupuncture in the UK. This new edition is yet another first-class book, which adeptly combines the theory and practice of treatment of trigger points for musculoskeletal pain. An eminently readable and informative text; this is a tour du force and an essential acquisition for those practitioners who want a clear practical guide for the treatment of musculoskeletal pain using trigger point treatment and the scientific understanding that underpins the treatment.’ Jacqueline Filshie, Consultant in Anaesthesia and Pain Management, Royal Marsden Hospital, London and Surrey; Secretary of the British Medical Acupuncture Society ‘In this fine comprehensive book, Dr Baldry removes much of the mystique from acupuncture as a technique for musculoskeletal pain relief. Using a fully scientific integration of Eastern and Western knowledge, coupled with the relevant literature on clinical effectiveness of acupuncture, he provides an ideal, evidence-based text for the practitioner. From the beginner to the expert, anyone with an interest in the nature of muscle pain, its pathophysiology and treatment will be informed by this book: the entry-level therapist will gain a better understanding based on sound scientific evidence, while the experienced clinician will be rewarded with a well-written guide to what is significant in everyday clinical practice. Clinicians of several medical specialties (neurologists, orthopaedic surgeons, general practitioners, pain specialists, physiatrists) and other practitioners (acupuncturists, physiotherapists, nurses, occupational therapists) will find this book an indispensable reference in their daily work. For those who wish to implement acupuncture in the clinic, this textbook is an invaluable resource for responsible practice. In total, this book offers an innovative approach to the diagnosis, understanding and treatment of myofascial trigger point pain using acupuncture that integrates all current concepts of neurophysiology and neuroanatomy principles. Dr Peter Baldry is to be congratulated for conceptualizing, editing and writing such a truly valuable asset for every clinical practice.’ Dr George Georgoudis, Research Physiotherapist, University of Manchester, UK; Lecturer, Technological Educational Institute of Athens, Department of Physiotherapy, Greece; “Tzanio” General Hospital of Pireaus, Greece For Elsevier Ltd Commissionning Editor: Karen Morley Project Development Manager: Kerry McGechie Project Manager: Derek Robertson Distributed in the United States of America by Redwing Book Company, 44 Linden Street, Brookline, MA 02146. © Longman Group UK Limited 1993 © Harcourt Brace and Company Limited 1998 © Harcourt Publishers Limited 2000 © Elsevier Ltd 2005 No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP. Permissio