Relief of chronic neck and shoulder pain by manual acupuncture to tender points—a sham-controlled randomized trial

https://doi.org/10.1016/S0965-2299(02)00082-1Get rights and content

Abstract

Objectives: To compare the effects of real acupuncture to tender points for neck and shoulder pain and stiffness (Japanese: katakori) with those of sham acupuncture. Design: Randomized-controlled trial. Methods: Thirty-four volunteers from an acupuncture school with complaints of chronic pain and stiffness, who had no arm symptoms and gave informed consent, were randomly allocated to acupuncture or sham groups. Acupuncture or sham acupuncture was applied to the tender points once a week for 3 weeks. In the acupuncture group the acupuncture needle was inserted to the muscle, then the sparrow pecking technique was applied five times. Sham acupuncture was done without insertion of the needle. Dull pain and stiffness were evaluated by visual analog scale (VAS) before, and every 2 days after the first needling for 1 month. Pressure pain threshold on the tender points was measured before and after each treatment. Results: There was no statistical difference of VAS scores between acupuncture and sham groups 9 days after the last treatment. However, the acupuncture group showed significant reduction of VAS scores immediately after and/or 1 day after the real acupuncture treatments (P<0.01). The effect tended to be prolonged after repeated treatment. Pressure pain thresholds tended to increase after real acupuncture treatment but not after sham acupuncture. Conclusions: Acupuncture applied to tender points appears to have short-term effects on neck and shoulder pain and stiffness, but this study was unable to demonstrate any long-term superiority over sham acupuncture.

Section snippets

INTRODUCTION

Chronic dull pain and stiffness of the neck and shoulder are very common symptoms. Acupuncture treatment has been used for pain relief for a long time. Several studies have examined the efficacy of acupuncture treatment for such conditions, however, the results are mixed. Positive results were obtained in studies that used nonacupuncture control groups,1., 2., 3., 4. and negative results tended to be reported in those that used sham acupuncture or mock transcutaneous electrical nerve

Patients

Patients were recruited from the students of an acupuncture school in Japan who complained of chronic dull pain and stiffness of the neck and shoulder without any arm symptoms. Thirty-four subjects who gave written informed consent were enrolled and randomly allocated to acupuncture group (AG) or sham group (SG) by use of a computerized randomization program. Ethical approval for this protocol was given by the ethics committee of Meiji School of Oriental Medicine.

Intervention

Five well-trained licensed

RESULTS

Thirty-four subjects (age range 20–63 years) were enrolled. There were 5 male and 12 female (mean age 34.2±10.8 years) in AG, and 5 male and 12 female (mean age 30.8±12.0) in SG. Two subjects in AG and five subjects in SG missed the third treatment as a result of traffic delays due to bad weather. Adverse effects were not the cause of drop out in this study.

DISCUSSION

In the present sham-controlled RCT, there was no overall statistically significant difference between the real and sham acupuncture to the tender points, 9 days after the third treatment. However, real acupuncture produced statistically significant short-term improvements. The assessment of the blinding procedure indicated that the subjects could not discriminate sham from real acupuncture.

Acknowledgements

We are grateful to the staff of the Meiji School of Oriental Medicine and subjects.

Dr. Kenji Kawakita, Department of Physiology, Meiji University of Oriental Medicine, Hiyoshi-cho, Funai-gun, Kyoto 629-0392, Japan. Tel.: +81 771 72 1289; Fax: +81 771 72 1289; E-mail: [email protected]

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    Dr. Kenji Kawakita, Department of Physiology, Meiji University of Oriental Medicine, Hiyoshi-cho, Funai-gun, Kyoto 629-0392, Japan. Tel.: +81 771 72 1289; Fax: +81 771 72 1289; E-mail: [email protected]

    Funding This study was partly supported by the Japan Society for the Promotion of Science, the Japan Society of Acupuncture and Moxibustion and the Foundation for training and licenser examination in anma-massage-acupressure, acupuncture, and moxibustion.

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