Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. The natural history of neck pain is unclear. It is thought that neck pain is a benign and self-limited condition—26 per cent to 71 per cent of the adult population can recall experiencing an episode of neck pain or stiffness in their lifetime.
Treatments for neck pain are varied, as are the perceptions of benefits. Acupuncture has been used as an alternative to more traditional treatments for musculoskeletal pain. It is defined as the stimulation of a certain point or points on the body, by the insertion of needles, to achieve a desirable effect. It is thought to prevent or modify the perception of pain or to alter physiological functions, including pain control for the treatment of certain diseases or dysfunctions of the body.
Acupuncture typically includes manual stimulation of needles, but there are variations commonly used, such as electrical stimulation and heat stimulation of needles, which is called moxibustion.
We included 10 acupuncture trials (661 participants) on chronic mechanical neck pain, one of which recruited patients with pain of at least six weeks duration but considered them to be chronic.
There are two studies in pain intensity post treatment category. Both studies are low quality and positive. Both studied chronic Motor Neurone Disease. One study is on Japanese style acupuncture with shallow needling over relevant points and the other on needling into tissues and muscles with electrical stimulation. The Birch et al study involved a sham treatment over irrelevant points, the White et al study involved a sham with minimal stimulation (insertion only with no stimulation), and another control with electrical stimulation over non-segmental area, numbers needed to treat and treatment benefit values.
The results of this review found that the specific effects of acupuncture are short-term but have important clinical treatment benefits. This is consistent with other reviews on acupuncture for elbow pain and back pain.
In our reviews of other therapies for neck disorders, the results are disappointing.
The number of acupuncture treatment sessions was found to be associated with outcome. Ideally, there should be at least six or more acupuncture sessions.
For mechanical neck disorders, there is moderate evidence that acupuncture is more effective than some types of sham controls for pain relief, measured at the end of the treatment. There is also moderate evidence that acupuncture is more effective than inactive treatment for pain relief, measured at the end of the treatment. Acupuncture is also more effective than a wait-list control for pain relief at short-term follow-up. Acupuncture treatment appears to be relatively safe.
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