Acupuncture Therapy for Chronic Neck Pain

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Acupuncture Therapy for Chronic Neck Pain by Dr. Anne D. Walling MD,

American Family Physician magazine

Up to one half of adults report at least one episode of neck pain during their

lifetime. For many persons, such pain is chronic or recurrent, causing

difficulties in work and daily activities. Although many treatments have been

suggested, including medications, massage and local injections, the

outcomes have frequently been unsatisfactory, and interest in alternative

therapies has grown. Irnich and colleagues studied acupuncture in patients

with chronic neck pain.

The authors recruited patients from three university outpatient departments in

Germany for the controlled clinical trial. Patients were required to have

painful

restriction of the cervical spine for at least one month and not to have

participated in any active treatment during the two weeks before the start of

the study. Patients were excluded if they had undergone relevant surgery or

had local dislocations, fractures, or other conditions underlying their neck

symptoms. Patients with neurologic deficits, systemic illnesses, or

contraindications to the interventions were also excluded.

The 177 patients were randomly allocated to treatment with acupuncture,

massage, or sham laser acupuncture. Each treatment was provided five times

during the three-week study, and analgesic use was not permitted during the

study.

Patients in the acupuncture group received traditional Chinese acupuncture,

including diagnostic palpation, ear acupuncture, and dry needling. The

patients assigned to massage received conventional Western massage

techniques but no spinal manipulation. The remaining patients were treated

with a deactivated laser acupuncture pen that emitted red light and acoustic

signals. The diagnostic palpation and points of treatment with the pen were

identical to those used in the acupuncture group. Patients were assessed

before the first treatment, immediately following the first treatment, and again

three days later. They were reassessed immediately following the final

treatment, one week after the final treatment, and three months after the final

treatment. Change in pain was the principal outcome, but range of motion,

global complaints, and quality-of-life indicators were also measured.

The average age of the patients was 52 years. About one half of the patients

in each group reported pain duration of more than five years. Almost all

patients had been treated previously for neck pain, and many had used

chiropractic, acupuncture, and other alternative therapies.

Patients treated with acupuncture reported the greatest reduction in pain one

week after the end of the study. The improvement was significantly greater

than that in patients treated with massage, but the difference was not

statistically significant compared with patients treated with sham laser.

Patients with myofascial pain syndrome and those with pain of more than five

years' duration had the greatest benefit from acupuncture. The acupuncture

group also reported the best results in the secondary outcomes but, at the

three-month follow-up, the differences in benefit between the groups was not

significant. One third of the acupuncture patients experienced reactions

sufficiently severe as to require brief cessation of therapy. Similar reactions

occurred in 7 percent of massage patients and 21 percent of sham-laser

patients.

The authors conclude that while all patients improved during therapy, the

greatest benefit occurred following acupuncture treatment. The short courses

of treatment produced improvements in pain, range of motion, and quality of

life immediately following therapy, but evidence of long-term benefit is

limited.