Acupuncture Helps to Reduce Delayed Onset Muscle Soreness (DOMS)

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Acupuncture Helps to Reduce Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscles soreness (DOMS) is the term given to that ache and loss of strength you feel in the muscles for a couple of days after a good workout. It is believed that DOMS occurs as a result of high muscle tension exerted during eccentric contractions during movement (1). This causes mechanical disruption of the connective tissues and microscopic muscle structures called myofibrils which then triggers the inflammatory response (2). For experienced and recreational athletes alike, DOMS is common at the start of sporting season or during the progression from low-intensity to high-intensity training or when new types of exercises are introduced into the training program (3). Unlike previously thought, this is not as a result of lactic acid accumulation, but rather a side effect of the repair process of the microscopic muscle damage as a result of novel stresses during exercise (4).

DOMS differs from acute pain during exercise which develops due to the immediate stress on the area used (5), and as long as the body is being pushed past its regular limits to increase its performance capacity, all people including pro athletes are susceptible to DOMS (6). To avoid putting too much strain on your body in the initial stages, it is advised that you work your way up gradually in your exercise regimen (7), however like all things in life, pain is a natural part of the process of growth and development. Fortunately though our bodies do grow accustomed to each incremental increase in exercise, and as your body grows stronger, soreness actually tends to decrease the more you perform the same exercise (8).

“Since recent research provides evidence for the efficacy of acupuncture on pain and dysfunction in various musculoskeletal and inflammatory disorders, it is conceivable that acupuncture could also be a potential treatment option in DOMS.”(9)

DOMS is essentially a Type 1 muscle strain (10), and as there is substantial evidence to support the efficacy of acupuncture reducing pain and increasing function for many musculoskeletal and inflammatory disorders (11), it was wondered whether DOMS would respond in a similar way.

22 healthy, physically active sports students participated in a randomized, controlled, observer and subject blinded trial to determine the efficacy of acupuncture for reducing the duration and intensity of DOMS (12). They were randomised into 3 treatment groups of either real acupuncture, sham (fake) acupuncture, and a control group who received no treatment (13). They were advised to perform no exercise for at least one week prior to or for the entire duration of the study and then DOMS was induced through eccentric contractions of the elbow flexors of the non-dominant hand until exhaustion (14). Treatment was administered immediately, 24 and 48 hours after DOMS induction followed by outcomes measures at 72 hours (15).

“Seventy-two (72) hours after DOMS induction, only the acupuncture group nearly attained full recovery, and reported significant less pain than the other groups.” (16)

At the 72 hour mark, it was only the acupuncture group that had gained almost full recovery with significantly less pain than either the sham or control group (17). These groups experienced their highest pain levels at the 48 hour mark of the observational period, whereas by this time, the pain experienced by participants in the real acupuncture group had already started to diminish greatly in comparison (18). Muscular performance was greatly decreased by DOMS, and while at 72 hours on partial recovery had occurred in all three groups, levels for both the sham and real acupuncture groups maintained a higher strength capacity compared to the control (19). As the sham treatment in this study still consisted of inserting acupuncture needles into areas of the ares though not specifically tailored to treating the soreness(20), it implies that a needle inserted into non-specific points will still elicit a healing response. Another trial performed by Itoh et al. found that inserting needles directly into tender points associated with DOMS provided analgesic effects that relieved symptoms (21). It is suggested that this is  due to previously sensitised nociceptors (pain receptors) responding to further stimulation by the acupuncture needle which then relieves pain (22). This provides reason for the difference in results of needling specific and non-specific points during treatments, and the inherent difficulty of comparing real acupuncture to sham when trying to prove its efficacy.

“Significant differences in visual analog scores for pain were found between the control group and tender point group immediately after treatment and three days after exercise.” (23)

Considering these results, it suggests the possibility that acupuncture not only helps to reduce the soreness associated with increased training load, but that it also may help to maintain strength capacity and muscle performance, possibly indicating faster recovery in the days that follow. While DOMS is a natural part of the development process of the body during training, reducing its presence following activity may help to prevent minor alterations that may affect joint structure and mobility (24). While more studies need to be performed for more conclusive evidence, the potential ability for acupuncture to reduce DOMS could have highly beneficial effects on improving many facets of training and exercise such as long-term competition performance, training capacity, and reduced incidence of sporting injuries (25).

As DOMS is such a common occurrence, prevention and treatment options have been sought in the avenues of supplements and anti-inflammatory drugs with little success (26). While anti-inflammatories help to reduce the immediate muscle soreness, the fact that they may slow the ability of the muscle to repair makes their use highly counterproductive for muscle function in the weeks that follow (27). Given that acupuncture has been shown in other studies to be effective for producing anti-inflammatory processes in the body, as well as treating a wide range of musculoskeletal disorders (28), it seems to be the one of the more safer and effective options for the relief of DOMS when starting out again this training season.


  1. Hübscher, M, Vogt, L, Bernhörster, M, Rosenhagen, A, & Banzer, W 2008, Effects of Acupuncture on Symptoms and Muscle Function in Delayed-Onset Muscle Soreness, The Journal of Alternative and Complementary Medicine, Volume 14, Number 8, 2008, pp. 1011 – 1016, http://s3.amazonaws.com/academia.edu.documents/44239697/Effects_of_acupuncture_on_symptoms_and_m20160330-22457-15wpnd5.pdf?AWSAccessKeyId=AKIAJ56TQJRTWSMTNPEA&Expires=1470113003&Signature=K7s4VYUfcD3VJg5cOSEguUdqB8s%3D&response-content-disposition=inline%3B%20filename%3DEffects_of_Acupuncture_on_Symptoms_and_M.pdf, (viewed 2 August 2016), p. 1011
  2. ibid
  3. idid
  4. American College of Sports Medicine 2011, Delayed Onset Muscle Soreness (DOMS), American College of Sports Medicine website, https://www.acsm.org/docs/brochures/delayed-onset-muscle-soreness-(doms).pdf, (viewed 2 August 2016), p. 1
  5. ibid
  6. ibid
  7. ibid, p. 7
  8. ibid
  9. Hübscher et al. op. cit. p. 1012
  10. ibid, p. 1011
  11. ibid, p. 1012
  12. ibid
  13. ibid
  14. ibid
  15. ibid
  16. ibid, p. 1014
  17. ibid
  18. ibid
  19. ibid
  20. ibid, p. 1012
  21. Itoh, K, Ochi, H & Kitakoji, H 2008, Effects of tender point acupuncture on delayed onset muscle soreness (DOMS) – a pragmatic trial, Chinese Medicine, Vol. 3 No. 14, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607277/, (viewed 3 August 2016), p. 4
  22. ibid
  23. ibid, p. 1
  24. Hübscher et al. op. cit. p. 1014
  25. ibid
  26. Roth, S 2006, Why does lactic acid build up? And why does it cause soreness? Scientific American, http://www.scientificamerican.com/article/why-does-lactic-acid-buil/, (viewed 3 August 2016)
  27. ibid
  28. Hübscher et al. op. cit. p. 1012
By |2017-07-18T04:09:59+00:00August 2nd, 2016|Categories: Acupuncture, Research|Tags: , , , |0 Comments

About the Author:

Chris Fehres lives in Brisbane and holds a Bachelor of Health Science majoring in acupuncture. Chris completed his degree in 2015 at Endeavour College of Natural Health where he graduated with distinction and was awarded the medal of academic excellence for highest achievement Australia-wide for acupuncture. He currently holds positions at Endeavour College as a contract tutor for higher education and alumni representative for the Course Advisory Committees for both the Acupuncture and Biosciences departments, as well as having been chosen as the focus for their 2017 - 18 Graduate Stories write up.

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