Efficacy and safety of acupuncture for chronic uncomplicated neck pain: A randomised controlled study

Vas, Jorge; Perea-Milla, Emilio; Méndez, Camila; Navarro, Cayetana Sánchez; Rubio, José María León; Brioso, Mauricio; Obrero, Inmaculada García

doi:10.1016/j.pain.2006.07.002

Cited by 110 publications

(111 citation statements)

References 26 publications

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“…We excluded three trials by Vas et al [120][121][122] in a sensitivity analysis. As described in Meta-analysis, these trials had very much larger effect sizes than average and their exclusion resulted in heterogeneity becoming non-significant in the comparisons between acupuncture and sham acupuncture.…”

Section: Statistical Methods Related To Effect Of Control Groupmentioning

confidence: 99%

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Acupuncture for chronic pain and depression in primary care: a programme of research

MacPherson

Vickers

Bland

et al. 2017

Programme Grants Appl Res

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BackgroundThere has been an increase in the utilisation of acupuncture in recent years, yet the evidence base is insufficiently well established to be certain about its clinical effectiveness and cost-effectiveness. Addressing the questions related to the evidence base will reduce uncertainty and help policy- and decision-makers with regard to whether or not wider access is appropriate and provides value for money.AimOur aim was to establish the most reliable evidence on the clinical effectiveness and cost-effectiveness of acupuncture for chronic pain by drawing on relevant evidence, including recent high-quality trials, and to develop fresh evidence on acupuncture for depression. To extend the evidence base we synthesised the results of published trials using robust systematic review methodology and conducted a randomised controlled trial (RCT) of acupuncture for depression.Methods and resultsWe synthesised the evidence from high-quality trials of acupuncture for chronic pain, consisting of musculoskeletal pain related to the neck and low back, osteoarthritis of the knee, and headache and migraine, involving nearly 18,000 patients. In an individual patient data (IPD) pairwise meta-analysis, acupuncture was significantly better than both sham acupuncture (p < 0.001) and usual care (p < 0.001) for all conditions. Using network meta-analyses, we compared acupuncture with other physical therapies for osteoarthritis of the knee. In both an analysis of all available evidence and an analysis of a subset of better-quality trials, using aggregate-level data, we found acupuncture to be one of the more effective therapies. We developed new Bayesian methods for analysing multiple individual patient-level data sets to evaluate heterogeneous continuous outcomes. An accompanying cost-effectiveness analysis found transcutaneous electrical nerve stimulation (TENS) to be cost-effective for osteoarthritis at a threshold of £20,000 per quality-adjusted life-year when all trials were synthesised. When the analysis was restricted to trials of higher quality with adequate allocation concealment, acupuncture was cost-effective. In a RCT of acupuncture or counselling compared with usual care for depression, in which half the patients were also experiencing comorbid pain, we found acupuncture and counselling to be clinically effective and acupuncture to be cost-effective. For patients in whom acupuncture is inappropriate or unavailable, counselling is cost-effective.ConclusionWe have provided the most robust evidence from high-quality trials on acupuncture for chronic pain. The synthesis of high-quality IPD found that acupuncture was more effective than both usual care and sham acupuncture. Acupuncture is one of the more clinically effective physical therapies for osteoarthritis and is also cost-effective if only high-quality trials are analysed. When all trials are analysed, TENS is cost-effective. Promising clinical and economic evidence on acupuncture for depression needs to be extended to other contexts and settings. For the conditions we have investigated, the drawing together of evidence on acupuncture from this programme of research has substantially reduced levels of uncertainty. We have identified directions for further research. Our research also provides a valuable basis for considering the potential role of acupuncture as a referral option in health care and enabling providers and policy-makers to make decisions based on robust sources of evidence.Trial registrationCurrent Controlled Trials ISRCTN63787732.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Section: Statistical Methods Related To Effect Of Control Groupmentioning

confidence: 99%

“…We excluded a set of outlying trials, all by the same team [120][121][122] and which had very much larger effect sizes than other trials, as a pre-planned sensitivity analysis. Further details of the methods are reported separately.…”

Section: Statistical Methods For Analysis Of Characteristicsmentioning

confidence: 99%

Acupuncture for chronic pain and depression in primary care: a programme of research

MacPherson

Vickers

Bland

et al. 2017

Programme Grants Appl Res

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“…It is known that neck pain due to muscular tension is not a pathology in itself, but a symptom or a manifestation of muscle pain syndromes. Another relevant aspect in choosing this symptomatology was the fact that acupuncture has already shown good therapeutic results in neck pain (Qing et al,2000 ;Vas et al,2006 use in children and painful anatomical regions. Older equipments electrical stimulation used analog system and lasted until the decade of 90, being replaced by digital technology.…”

Section: Electrical Stimulation Equipments and Diagnosis For Acupuncturementioning

confidence: 99%

Electroacupuncture and Stimulatory Frequencies in Analgesia

Silvério-Lopes¹

2011

Acupuncture - Concepts and Physiology

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“…Another relevant aspect in choosing this symptomatology was the fact that acupuncture has already shown good therapeutic results in neck pain 15,20 and, as consequence, there is extensive literature on this symptom and the acupuncture application points [20][21][22][23][24][25] .…”

Section: Introductionmentioning

confidence: 99%

Influência da frequência estimulatória envolvida nos efeitos analgésicos induzidos por eletroacupuntura em cervicalgia tensional

Nohama¹,

Sm²

2009

Rev. bras. fisioter.

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Objective: To assess the influence of the stimulating frequency involved in analgesia induced by electroacupuncture for neck pain. Methods: The performance of the analgesia produced by 2Hz, 100Hz, 1000Hz and 2500Hz was compared with a group with acupuncture alone (without electrical stimulation), by means of pressure algometry, a visual analog scale (VAS) and heart rate. We used an electrical stimulator with a microprocessor yielding standard, single-phase, rectangular and asymmetrical balanced pulsed waveforms with a secondary phase decreasing exponentially. Stimulation periods were 4s, and resting periods were 3s. The sample included 66 volunteers with neck pain due to muscular tension, mean age 33.67±9.97 years, 89.5% female and 10.5% male. Results:There were no differences between the groups regarding the variables of degree of pain (according to the VAS) and heart rate, and all groups presented analgesic improvement. However, when comparing pressure algometry findings for the same individual before and after the treatment, within the same group, we found analgesic advantages in using 2500Hz (p=0.006 for the base of the occipital region, p=0.003 for the right trapezius and p=0.013 for the left trapezius), followed by 100Hz (p=0.035, p=0.016 and p=0.038 for the same regions, respectively). Conclusion: We preferentially recommend 2500Hz and 100Hz applications of electroacupuncture for analgesia of neck pain due to muscular tension.Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under the number 083456.Key words: electroacupuncture; electrical stimulation; analgesia; neck pain. ResumoObjetivo: Avaliar a influência da frequência estimulatória envolvida na analgesia induzida por eletroacupuntura em cervicalgia.Métodos: Comparou-se o desempenho da analgesia produzida em 2Hz, 100Hz, 1000Hz, 2500Hz e um grupo só com acupuntura, sem estímulo elétrico, avaliado por meio de algometria de pressão, Escala Visual Analógica (EVA) e frequência cardíaca. Utilizou-se um estimulador elétrico microprocessado, com forma de pulso em padrão pulsado, monofásico, retangular, balanceado assimétrico, com fase secundária em exponencial decrescente, com período de estimulação de 4 segundos e repouso de 3 segundos. A amostra contou com 66 voluntários com cervicalgia tensional, idade média de 33,67±9,97 anos, 89,5% do gênero feminino e 10,5% do masculino.Resultados: Não houve diferenças entre os grupos para as variáveis nota atribuída à dor pela EVA e frequência cardíaca, sendo que em todos os grupos houve melhoras analgésicas. No entanto, quando comparado o comportamento antes-depois, por meio da algometria de pressão, para um mesmo indivíduo, dentro de seu próprio grupo, houve vantagens analgésicas para o uso de 2500Hz (p=0,006 para a base da região occiptal; p=0,003 para o trapézio direito; e p=0,013 para o trapézio esquerdo), seguido de 100Hz (p=0,035, p=0,016 e p=0,038, para as mesmas regiões, respectivamente). Conclusão: Recomenda-se preferencialmente a aplicação de 2500Hz e 100Hz em eletro...

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Efficacy and safety of acupuncture for chronic uncomplicated neck pain: A randomised controlled study

Cited by 110 publications

References 26 publications

Acupuncture for chronic pain and depression in primary care: a programme of research

Acupuncture for chronic pain and depression in primary care: a programme of research

Electroacupuncture and Stimulatory Frequencies in Analgesia

Influência da frequência estimulatória envolvida nos efeitos analgésicos induzidos por eletroacupuntura em cervicalgia tensional

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