Durable Effect of Acupuncture for Chronic Neck Pain: A Systematic Review and Meta-Analysis

Overview

Journal Curr Pain Headache Rep

Date 2024 Jun 10

PMID 38856887

Authors

Jiufei Fang

Hangyu Shi

Weiming Wang

He Chen

Min Yang

Shuai Gao

Hao Yao

Lili Zhu

Yan Yan

Zhishun Liu

Affiliations

Soon will be listed here.

Abstract

Objective: Chronic neck pain, a prevalent health concern characterized by frequent recurrence, requires exploration of treatment modalities that provide sustained relief. This systematic review and meta-analysis aimed to evaluate the durable effects of acupuncture on chronic neck pain.

Methods: We conducted a literature search up to March 2024 in six databases, including PubMed, Embase, and the Cochrane Library, encompassing both English and Chinese language publications. The main focus of evaluation included pain severity, functional disability, and quality of life, assessed at least 3 months post-acupuncture treatment. The risk of bias assessment was conducted using the Cochrane Risk of Bias 2.0 tool, and meta-analyses were performed where applicable.

Results: Eighteen randomized controlled trials were included in the analysis. Acupuncture as an adjunct therapy could provide sustained pain relief at three (SMD: - 0.79; 95% CI - 1.13 to - 0.46; p < 0.01) and six (MD: - 18.13; 95% CI - 30.18 to - 6.07; p < 0.01) months post-treatment. Compared to sham acupuncture, acupuncture did not show a statistically significant difference in pain alleviation (MD: - 0.12; 95% CI - 0.06 to 0.36; p = 0.63). However, it significantly improved functional outcomes as evidenced by Northwick Park Neck Pain Questionnaire scores 3 months post-treatment (MD: - 6.06; 95% CI - 8.20 to - 3.92; p < 0.01). Although nine studies reported an 8.5%-13.8% probability of adverse events, these were mild and transitory adverse events.

Conclusion: Acupuncture as an adjunct therapy may provide post-treatment pain relief lasting at least 3 months for patients with chronic neck pain, although it is not superior to sham acupuncture, shows sustained efficacy in improving functional impairment for over 3 months, with a good safety profile.

References

MacPherson H, Tilbrook H, Richmond S, Woodman J, Ballard K, Atkin K . Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial. Ann Intern Med. 2015; 163(9):653-62. DOI: 10.7326/M15-0667. View

Witt C, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich S . Acupuncture for patients with chronic neck pain. Pain. 2006; 125(1-2):98-106. DOI: 10.1016/j.pain.2006.05.013. View

Whitfield-Cargile C, Cohen N, Chapkin R, Weeks B, Davidson L, Goldsby J . The microbiota-derived metabolite indole decreases mucosal inflammation and injury in a murine model of NSAID enteropathy. Gut Microbes. 2016; 7(3):246-61. PMC: 4939928. DOI: 10.1080/19490976.2016.1156827. View

Hershman D, Unger J, Greenlee H, Capodice J, Lew D, Darke A . Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA. 2018; 320(2):167-176. PMC: 6583520. DOI: 10.1001/jama.2018.8907. View

Cerezo-Tellez E, Torres-Lacomba M, Fuentes-Gallardo I, Perez-Munoz M, Mayoral-Del-Moral O, Lluch-Girbes E . Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain. 2016; 157(9):1905-1917. DOI: 10.1097/j.pain.0000000000000591. View

Stieven F, Ferreira G, Wiebusch M, Xavier de Araujo F, Telles da Rosa L, Silva M . Dry Needling Combined With Guideline-Based Physical Therapy Provides No Added Benefit in the Management of Chronic Neck Pain: A Randomized Controlled Trial. J Orthop Sports Phys Ther. 2020; 50(8):447-454. DOI: 10.2519/jospt.2020.9389. View

Yuan Q, Guo T, Liu L, Sun F, Zhang Y . Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis. PLoS One. 2015; 10(2):e0117146. PMC: 4339195. DOI: 10.1371/journal.pone.0117146. View

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M . Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015; 4:1. PMC: 4320440. DOI: 10.1186/2046-4053-4-1. View

Ma C, Wu S, Li G, Xiao X, Mai M, Yan T . Comparison of miniscalpel-needle release, acupuncture needling, and stretching exercise to trigger point in myofascial pain syndrome. Clin J Pain. 2010; 26(3):251-7. DOI: 10.1097/AJP.0b013e3181b8cdc8. View

10.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009; 339:b2535. PMC: 2714657. DOI: 10.1136/bmj.b2535. View

11.

Coutaux A . Non-pharmacological treatments for pain relief: TENS and acupuncture. Joint Bone Spine. 2017; 84(6):657-661. DOI: 10.1016/j.jbspin.2017.02.005. View

12.

Fu L, Li J, Wu W . Randomized controlled trials of acupuncture for neck pain: systematic review and meta-analysis. J Altern Complement Med. 2009; 15(2):133-45. DOI: 10.1089/acm.2008.0135. View

13.

MacPherson H, Vertosick E, Foster N, Lewith G, Linde K, Sherman K . The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain. 2016; 158(5):784-793. PMC: 5393924. DOI: 10.1097/j.pain.0000000000000747. View

14.

Cote P, Wong J, Sutton D, Shearer H, Mior S, Randhawa K . Management of neck pain and associated disorders: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur Spine J. 2016; 25(7):2000-22. DOI: 10.1007/s00586-016-4467-7. View

15.

Franca D, Senna-Fernandes V, Cortez C, Jackson M, Bernardo-Filho M, Guimaraes M . Tension neck syndrome treated by acupuncture combined with physiotherapy: a comparative clinical trial (pilot study). Complement Ther Med. 2008; 16(5):268-77. DOI: 10.1016/j.ctim.2008.02.006. View

16.

Bronfort G, Evans R, Nelson B, Aker P, Goldsmith C, Vernon H . A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine (Phila Pa 1976). 2001; 26(7):788-97; discussion 798-9. DOI: 10.1097/00007632-200104010-00020. View

17.

Bakkum M, Tichelaar J, Wellink A, Richir M, van Agtmael M . Digital Learning to Improve Safe and Effective Prescribing: A Systematic Review. Clin Pharmacol Ther. 2019; 106(6):1236-1245. PMC: 6896235. DOI: 10.1002/cpt.1549. View

18.

Sim J, Jordan K, Lewis M, Hill J, Hay E, Dziedzic K . Sensitivity to change and internal consistency of the Northwick Park Neck Pain Questionnaire and derivation of a minimal clinically important difference. Clin J Pain. 2006; 22(9):820-6. DOI: 10.1097/01.ajp.0000210937.58439.39. View

19.

Lv Z, Shen L, Zhu B, Zhang Z, Ma C, Huang G . Effects of intensity of electroacupuncture on chronic pain in patients with knee osteoarthritis: a randomized controlled trial. Arthritis Res Ther. 2019; 21(1):120. PMC: 6518678. DOI: 10.1186/s13075-019-1899-6. View

20.

Irnich D, Behrens N, Molzen H, Konig A, Gleditsch J, Krauss M . Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain. BMJ. 2001; 322(7302):1574-8. PMC: 33515. DOI: 10.1136/bmj.322.7302.1574. View