The role of acupuncture in the treatment of chronic neck pain.




British Medical Journal

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Acupuncture is an ancient Chinese practice that involves piercing strategic points on the body with needles. This is a relatively painless procedure and is performed by a licensed acupuncturist. While this practice has been used in China for over 2,000 years, its use in the United States is relatively new. Acupuncture is one element of Traditional Chinese Medicine, which includes other modalities such as herbal therapies and massage. It is difficult for people born and raised in a culture like the United States to understand how Traditional Chinese Medicine works because it is a complex and complicated medical system that uses theories and practices that Westerners are not used to. For this reason, acceptance by the medical profession has been slow. However, consistent reports of success using acupuncture for specific purposes have gained attention. One of these purposes is treatment of chronic pain.
In 1999, a medical school in the United Kingdom published a review of the existing literature available that reported treatment of chronic neck pain with acupuncture.1 The researchers reviewed 14 clinical studies and concluded that the efficacy of acupuncture was not based on sound clinical science. Another study compared acupuncture and hypnosis in treating neck pain. The authors concluded that both were effective, but that the practitioner must have more information to know which treatment would be effective for a specific patient.2
A study published in the British Medical Journal supports the use of acupuncture as a treatment for chronic neck pain and again identified short-term treatment as being more conclusive. This prospective, randomized, placebo controlled trial involved 177 chronic neck pain patients ranging in age from 18 to 85. Among the three treatment groups, each patient received 5 treatments over three weeks. Fifty-six received acupuncture, 60 received massage, and 61 received "sham" laser acupuncture. One week after the five treatments were completed, the patient groups were evaluated. Compared with massage, but not sham laser, the acupuncture group showed a significantly greater improvement in pain related to neck motion. Patients with myofacial pain syndrome and patients who had had pain for longer than five years, demonstrated greater differences between acupuncture and massage or sham laser. Also, the acupuncture group had the best results in most secondary outcomes, which included; range of motion, pressure pain threshold, changes of spontaneous pain, and quality of life. The study investigators concluded, "acupuncture is an effective short term treatment for patients with chronic neck pain, but there is only limited evidence for long term effects after five treatments."3


1. Lu DP, Lu GP, Kleinman L., Acupuncture and clinical hypnosis for facial and head and neck pain: a single crossover comparison. Am J Clin Hypn. 2001 Oct;44(2):141-8.
2. White AR, Ernst E., A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology. 1999 Feb;38(2):143-7.
3. Irnich D, Behrens N, Molzen H, K├Ânig A, Gleditsch J, Krauss M, et al. Randomized trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain. BMJ. June 2001;322:1574-9.