Does Individualized Acupuncture for Chronic Neck Pain Provide Long-Term Relief?

Compared with sham treatment, patients who receive individualized acupuncture for chronic neck pain report symptom relief; however, relief is not at clinically significant levels. These are the findings of a study published in the Annals of Internal Medicine.

The American Physical Therapy Association estimates that up to 20% of the population experiences neck problems. Chronic neck pain can be treated with therapeutic interventions; however, they are associated with adverse effects with long-term use.

To assess the effect of acupuncture for chronic neck pain, researchers from Chengdu University of Traditional Chinese Medicine conducted a randomized controlled trial at 4 sites in China between 2018 and 2020.

Patients (N=683) with chronic neck pain lasting 3 months or longer were randomly assigned to receive personalized acupuncture targeting higher sensitive acupoints (HSA; n=169; mean age, 38.6; women, 70.4%), lower sensitive acupoints (LSA; n=168; mean age, 40.2; women, 74.4%), sham acupuncture (SA; n=170; mean age, 40.2; women, 75.3%) or waitlist (n=176; mean age, 38.6; women, 69.9%). Acupuncture was delivered in 10 sessions over 2 weeks. The targeted acupoints were individualized in a session that measured the pressure pain threshold of 15 acupoints in 5 regions assessed twice at 5-minute intervals.

The primary outcome was the change in 100-mm Visual Analogue Scale (VAS) pain scores from baseline to 4 weeks. A clinically meaningful change in neck pain was defined as a 10-mm change.

From baseline to week 4, ccupuncture targeted in the HSA decreased VAS neck pain scores decreased by -12.16 (95% CI, -14.45 to -9.87); LSA decreased pain by -10.19 (95% CI, -12.43 to -7.95). SA decreased pain score by -6.11 (95% CI, -8.31 to -3.91) and no treatment led to a decrease of -2.24 (95% CI, -4.10 to -0.38). These effects continued through 24 weeks.

No clear group differences were observed for the secondary outcomes of quality of life, functional outcomes, and analgesic use.

A total of 9 adverse events were reported in this study, including 2 reports of feeling cold during treatment, 2 reports of dizziness during treatment, 2 instances of subcutaneous hemorrhage at the needle insertion area, a urinary tract infection, diarrhea, and urticaria.

This study was limited by the low amount of diversity among the study population, in which these findings may not be generalizable for older patients or those with severe chronic neck pain.

“Our results suggest that the selection of pressure pain, sensory-based objective acupoints could be considered as a treatment of CNP [chronic neck pain].”

This article originally appeared on Clinical Pain Advisor