Comparative effectiveness of different acupuncture therapies for neck pain

Abstract

Background: Neck pain is a common musculoskeletal symptom that has negative effects on quality of life and work productivity. Acupuncture has been widely used for neck pain, and a number of randomized controlled trials (RCTs) and systematic reviews (SRs) have evaluated its effectiveness. However, previous studies have obtained inconsistent results regarding the effects of acupuncture for neck pain, and there is no SR for the comparative efficacy and safety of various types of acupuncture. Therefore, we herein conducted a SR and network meta-analysis to compare and rank different types of acupuncture with respect to their effectiveness in treating neck pain.Methods: We searched 9 electronic databases for relevant RCTs published from their inception to July 1, 2021. Pairwise metaanalyses and network meta-analysis were performed with R software using the frequentist framework. Change of pain intensity was assessed as the primary outcome, and change of pain-related disability and efficacy rate were assessed as secondary outcomes. The Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) instrument were used to evaluate the quality of the included RCTs and the certainty of the evidence.Results: A total of 65 RCTs involving 5266 participants and 9 interventions were included. Three network meta-analyses were constructed for the following: pain intensity (42 RCTs, 3158 participants), pain-related disability (21 RCTs, 1581 participants), and efficacy rate (40 RCTs, 3512 participants). The results indicated that fire acupuncture, electroacupuncture, and warm acupuncture were more effective than manual acupuncture in terms of pain intensity reduction and efficacy rate, and that electroacupuncture decreased pain-related disability more effectively than manual acupuncture. Fire acupuncture ranked first among the 9 interventions. The overall q of evidence was very low according to the GRADE assessment. The reported adverse events were not serious. Conclusion:Fire acupuncture, warm acupuncture, acupoint catgut embedding, and electroacupuncture ranked higher than other interventions (usual care, sham acupuncture, no treatment) in reducing the pain and disability index scores and the efficacy rate. However, the included trials were evaluated as being of low quality; thus, we recommend additional well-designed RCTs with larger sample sizes to confirm these findings.

Immediate efficacy of acupuncture combined with active exercise as 10 min rapid therapy for pain and movement disorders in patients suffering from acute stiff neck: protocol for a randomised controlled trial

“…A recent meta-analysis indicated that electroacupuncture was more effective than other interventions (usual care, sham acupuncture or no treatment) in reducing pain and disability index scores. 35 Similarly, several other reviews support acupuncture’s role in treating neck pain, highlighting its potential as a non-pharmacological treatment option. 36 37 For the treatment of acute phase, prioritising simple and straightforward procedures is essential.…”

Acupoint catgut embedding for chronic non-specific low back pain: A protocol of randomized controlled trial

“…Chronic non-specific low back pain, one of the most common conditions in orthopaedics, rehabilitation, and pain medicine, accounts for 1/3 ( Wang et al, 2015 ) of daily outpatient visits, and is a major cause of increase in years of life lived with disability, in both developed and developing countries ( Diseases and Injuries, 2020 ). Recently, evidence has been published for ACE being beneficial in relieving pain from patients ( Jo et al, 2022 ). However, the evidence for clinical studies targeting ACE in CNLBP treatment is lacking.…”

“…In recent years, a growing body of clinical evidence supports the use of ACE for the management of painful conditions. For example, a meta-analysis showed that ACE is beneficial for the relief of neck pain ( Jo et al, 2022 ). However, to our knowledge, no clinical study on ACE for the treatment of CNLBP has been reported.…”

A comprehensive practical review of acupoint embedding as a semi-permanent acupuncture: A mini review

“…A Korean survey on the effects of AEM on neck pain showed that AEM alleviated the pain, reduced disability index scores, and showed higher efficacy rate compared to control. [ 27 ] Moreover, in patients with carpal tunnel syndrome Korean method of AEM showed remarkable effects on finger tingling, Phalen test, and pain severity. [ 11 ] Mexican TCM scientists compared the effects of AEM with fluoxetine in depressed rat model and showed antidepressant effects of AEM and its potential to remodel the hippocampus.…”