Acupuncture for Treatment of Chronic Neck Pain

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The summary below is from the full report titled "Acupuncture versus Placebo for the Treatment of Chronic Mechanical Neck Pain. A Randomized, Controlled Trial." It is in the 21 December 2004 issue of Annals of Internal Medicine (volume 141, pages 911-919). The authors are P. White, G. Lewith, P. Prescott, and J. Conway.

What is the problem and what is known about it so far?

Chronic neck pain is a common problem that can interfere with a person's daily activities. Most often, chronic neck pain is due to nonspecific problems with the muscles, tendons, and bones of the neck. Common treatments include medications to reduce pain and inflammation and physical therapy or exercise to improve movement of the neck. Unfortunately, these treatments can have side effects and do not always help. Consequently, many people with chronic neck pain seek alternative treatments, such as acupuncture. Acupuncture is a medical treatment that was developed in China thousands of years ago. It involves putting special needles into specific points of the body to treat medical conditions. Increasingly, mainstream medicine is recognizing acupuncture as an effective treatment for a variety of disorders. Unfortunately, no studies prove that acupuncture helps patients with chronic neck pain.

Why did the researchers do this particular study?

To find out if acupuncture is an effective treatment for chronic neck pain.

Who was studied?

135 patients 18 to 80 years of age who had chronic neck pain.

How was the study done?

The researchers assigned patients to receive 8 treatment sessions over 4 weeks, either acupuncture or placebo therapy from the same therapist. During placebo therapy, the therapist placed a nonworking electrical device on the same acupuncture points where the acupuncture patients got needles. The researchers then measured pain 1 week after completion of treatment by having patients rate their pain along a scale from 0 (no pain) to 100 (worst pain imaginable). The researchers told patients in both groups to use the pain medication acetaminophen for neck pain if necessary but no other neck pain treatments.

What did the researchers find?

Pain improved in both the acupuncture and placebo groups. However, the degree of improvement between the groups was too small to be clinically meaningful (6 points on a 100-point scale) according to the definition that the researchers established before beginning the study.

What were the limitations of the study?

This study did not compare acupuncture with usual treatment for neck pain (physical therapy, exercise, and pain and anti-inflammatory medications). It also looked at 8 sessions of acupuncture over a 4-week period; more frequent sessions over a longer period might show different results.

What are the implications of the study?

Acupuncture delivered in 8 sessions over 4 weeks decreased pain but did not perform any better than placebo from a clinical perspective.