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Table 2.4Neck Pain - Acupuncture - Chronic - Non-Specific Pain

Study ID Year CountryTotal sample sizePopulation (Gender, Age)EligibilityRandomized Groups (no. of patients)Frequency and Treatment durationOutcomes and post-treatment follow-upQuality score
Abernathy, AP (2008)214123% male: NR, majority female

Mean age: 46.5 years
Patients ≥ 18 years with uncomplicated NP for at least 3 months with motion-included pain of at least 30 on 100 mm VAS
  1. Acupuncture by an acupuncturist, n = NR
  2. TENS, n = NR
5 sessions

3 weeks
  1. Pain: VAS (0-100 mm) motion
  2. Quality of Life: SF-36 improvement
  3. Medication used (no data provided)
  4. ADVERSE EVENTS: mild but not described

Data measured at 1 week post treatment and 6 months post randomization
0/13
Itoh, K (2007)215

Japan
40 (cross over design)% male: 27.5

Mean age: 62.3 years
Patients age at least 45 years, no radiation of neck pain, and no major trauma or systemic disease
  1. Trigger point acupuncture, n = 10
  2. Acupoint acupuncture (standard), n = 10
  3. Non trigger point acupuncture, n = 10
  4. Sham acupuncture, n = 10

All treatments by acupuncturist with 2 – 7 years experience and 4 years training
A pre-cross over period followed by 18 acu treatments

3 weeks
  1. Pain (VAS)
  2. Disability (Neck Disability Index)
  3. ADVERSE EVENTS: reported
6/13
Salter GC (2006)216

US
24% male: 25.5

Mean age: 48.2 years
Patients with chronic neck pain aged 18 yrs or older who had consulted the neck pain practice in the previous 12 mo
  1. Acupuncture + standard treatment by acupuncturists and general practitioner, n = 10
  2. general practitioner, n = 14
3 months
  1. Pain and disability: NPQ
  2. Drug utilization
  3. ADVERSE EVENTS: aggravation of symptoms, dizziness, tiredness

Data measured immediately post intervention
6/13
Seidel (2002)217218

Germany
51% male: 9.8

Mean age: 49.5 years
Patients with cervical pain for at least 6 months aged 20-72 years; no AP treatment for past 6 mo; consent
  1. Low-level laser therapy (LLLT) on AP by a “therapist”, n = 13
  2. LLLT 7 mW, n = 12
  3. LLLT 30 mW, n = 13
  4. Conventional Acupuncture, n = 13
8 treatments

4 weeks
  1. Pain: pain intensity VAS (0-10); pain sensation PPT;
  2. Disability: Cervical movement function
  3. Physical Measures: cervical mobility; mental health questionnaire
  4. ADVERSE EVENTS: no harms reported

Data measured immediately post intervention and 1 mo
10/13
Petrie, J (1986)219

United Kingdom
25% male: 36.5

Mean age: 50.5 years
Chronic neck pain (at least 6 months)
  1. Acupuncture + analgesic, n = 13
  2. Sham transcutaneous nerve stimulation (TNS) + analgesic, n = 12

Treatment provider: NR (author administered the treatment)
8 sessions

4 weeks
  1. Pain: MPQ-PRI based on word rank; Daily pain score-VAS (0-10)-
  2. ADVERSE EVENTS: no harms reported

Data measured at 4 weeks
5/13
Petrie, JP (1983)220

New Zealand
13% male: 32.2

Mean age: 65 years
Chronic cervical pain (> 2 yrs) defined as NP radiating to the occipital and/or shoulders with some limitations in movement
  1. Acupuncture, n = 7
  2. TENS-placebo

Treatment provider: NR
8 sessions

4 weeks
  1. Pain: pain relief: 5-pt simple scale (no relevant outcome reported)
  2. ADVERSE EVENTS: no harms reported

Data measured immediately post intervention
6/13
Gallacchi G (1983)221,222

Switzerland
113% male: NR

Mean age: NR
Tendomyotical cervical and lumbar syndrome were under medical and/or physical treatment for number of months before volunteered for acupuncture study (data reported for cervical pain)
  1. AP conventional needle AP at classical acupuncture points by a physician, n = 15
  2. PN conventional needle AP at classical acupuncture points with placebo needles, n = 14
  3. PP needle acupuncture at placebo points, n = 14
  4. Laser AP at classical acupuncture points- laser light, n = 15
  5. Laser AP at classical a acupuncture points-no emission of rays, n = 14
  6. Laser AP at classical a acupuncture points-mixed light, n = 14
  7. Laser AP at classical a acupuncture points-red light, n = 13
  8. Laser AP at classical a acupuncture points-infrared light, n = 14
8 treatments

4 weeks
  1. Pain: VAS (Scale NR)
  2. VAS muscle tension
  3. ADVERSE EVENTS: no harms reported
5/13
Coan RM (1982)223

US
30% male: 26.7

Mean age: 49.3 years
chronic Neck pain and/or radicular arm and hand pain ≥6 mo
  1. Acupuncture + electroacupuncture or Moxibustion was used on some subjects, n = 15
  2. wait list control, n = 15

Treatment provider: NR
3-4 times/week

8 weeks
  1. Pain: VAS (0-10); mean number of hrs with pain/day
  2. mean number of pain pills used
  3. ADVERSE EVENTS: no harms reported

Data measured at 3 mo
4/13
Giles, LGF (1999)129

Australia
40% male: 35.7

Mean age: 41.3 years
Patients suffering from NP for at least 13 weeks, at least 18 years of age
  1. Acupuncture, n = 10
  2. Manipulation, n = 20
  3. Medication [tenoxicam (NSAID) with ranitidine], n = 10

Treatment provider: NR
6 treatments

3-4 weeks
  1. Pain: VAS (0-10)
  2. Disability: NDI (0-50)
  3. ADVERSE EVENTS: no side effects occurred for acupuncture or manipulation

Data measured immediately post intervention
1/13
David, J (1998)224

UK
70% male: 28.6

Mean age: 46 years
Patients aged 18-75 years with chronic neck pain (> 6 weeks) and WAD
  1. Acupuncture by general practitioners registered with the BMAS, n = 35
  2. PT (Maitland mobilization) by a senior physiotherapist, n = 35
6 sessions

6 weeks
  1. Pain: VAS (0-100); NPQ
  2. Quality of Life: GHQ
  3. ADVERSE EVENTS: no harms reported

No numerical data given, data measured at 6 weeks and 6 mo
4/13
Vas, J (2006)225

Spain
123% male: 18

Mean age: 46.7 yrs
17 yrs and over with uncomplicated NP over 3 months duration; symptomatic at examination; motion-related NP intensity 30 and over on 100mm VAS, no treatment during past week
  1. Acupuncture by a doctor with over 15 years of clinical experience, n = 61
  2. TENS placebo, unclear who administered the treatment, n = 62
5 sessions

3 weeks
  1. Pain: VAS(0-100 mm); NPQ (Spanish)
  2. Disability: ACM (Active Cervical Mobility; PCM (Passive Cervical Mobility)
  3. Quality of Life: SF-36 physical score
  4. Utility of conventional care: N of doctor visits in past 3 mo
  5. ADVERSE EVENTS: swelling of the hand, bruising, pain, ulcer of the ear; cephalea, aggravation of symptoms

Data measured at 3 weeks and 3 mo
7/13
White P (2004)226,227135
123 of 235 were analyzed
% male: 35.6

Mean age: 53.4 years
Patients aged 18-80 years with chronic mechanical neck pain (> 2 months) and a pain score > 30 mm on VAS (0-100 mm) for 5 of 7 pre-treatment days
  1. Acupuncture by an acupuncturist with 7 years of experience, n = 70
  2. TENS-Placebo by the same therapist, n = 65
8 sessions

4 weeks
  1. Pain: VAS (0-100)
  2. Disability: NDI
  3. Quality of Life: PCS/SF-36
  4. Healthcare utilization: daily consumption of acetaminophen tablets
  5. ADVERSE EVENTS: increase in symptoms, faintness, swelling of the hand, bruising, mild headache, euphoria and enhanced vision, dizziness

Data measured immediately post treatment, 8 weeks and 6 mo, 12 mo
9/13
Sator-Katzenschlager SM (2003)228

Austria
21% male: 28.5

Mean age: 52 years
Chronic cervical pain (≥ 6 mo), normal neurologic function, of cervical nerves with no pain radiation, neural or spinal structure pathology, VAS≥5
  1. M-Au-Acupuncture, n = 11
  2. EI-Au-Acupuncture, n = 10

Treatment provider: NR
Once/week

6 weeks
  1. Pain: VAS (no numerical data)
  2. Quality of Life: well-being(no numerical data)
  3. Utility of conventional care: utilization of rescue medication
  4. ADVERSE EVENTS: no harms reported

Data measured at 3 mo
4/13
Nabeta, T (2002)229

Japan
34% male: 29.4

Mean age: 32.5 years
Patients with chronic pain/stiffness in neck and shoulder without arm symptoms
  1. Acupuncture by well- trained acu instructors, n = 17
  2. Sham-Acupuncture by the same instructors, n = 17
3 treatments at weekly intervals

3 weeks
  1. Pain: VAS (0-10); PPT
  2. ADVERSE EVENTS: no harms reported

Data measured at 3 weeks and 3 mo
5/13

From: Appendix I, Summary Tables

Cover of Complementary and Alternative Therapies for Back Pain II
Complementary and Alternative Therapies for Back Pain II.
Evidence Reports/Technology Assessments, No. 194.
Furlan AD, Yazdi F, Tsertsvadze A, et al.

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