| Author, Year, Followup,a Pain Duration, Study Quality | Intervention | Population | Function and Pain Outcomes | Other Outcomes |
|---|---|---|---|---|
Birch, 1998231 3 months Duration of pain, 7.5 years Poor | A. Relevant acupuncture, Japanese technique (n=15): using bilateral needles on hands and feet known to be associated with treatment for neck pain and followed by Infrared lamp. B. Irrelevant acupuncture (n=16): using bilateral needles on hands and feet in areas not associated with treatment for neck pain and followed by light. C. NSAIDs only (n=15): 500mg per day of Trilisate 30 minute treatment twice per week for 4 weeks, then once per week for 4 weeks, total 14 treatments | A vs. B vs. C Age: 41 vs. 38 vs. 39 years Female: 86% vs. 77% vs. 86% Employed: 86% vs. 69% vs. 77% Baseline pain (CPEQ, 0-10) 4.8 vs. 4.7 vs. 4.9 | A vs. B 3 months SF-MPQb (0-33): 9.0 vs. 15.1, p=NS A vs. C 3 months SF-MPQ: 9.0 vs. 18.0, p=NS | NR |
Cho, 2014254 1 month Duration of pain, NR Poor | A. Active acupuncture, traditional Chinese (n=15), 3x/week for 3 weeks.(length of time for each intervention not reported) B. Zaltoprofen (80mg) alone (n=15) 3x/day for 3 weeks. | A vs. B Age: 38 vs. 39 years Female: 60 vs. 80 Baseline NDI (0-50): 22.3 vs. 26.3 Baseline Pain (0-10 VAS): 6.1 vs. 7.1 | A vs. B 1 month NDI: 17.3 vs. 17.7, difference −0.40 (95% CI −4.6 to 3.8) Pain VAS: 4.5 vs. 3.8, difference 0.7 (95% CI −0.7 to 2.1) | A vs. B 1 month BDI (0-63) : 28.5 vs. 27.2, p=NS SF-36 (0-100): 88.6 vs. 84.3, p=NS EQ-5D (scale unclear): 7.3 vs. 6.7, p=NS |
Ho 2017232 1 month Duration of pain: 6 years Fair | A. Acupuncture (n=77): 30 sessions of abdominal acupuncture 3 times a week for 2 weeks. The acupuncture points CV12, CV4, KI17, and ST24 were needled for 30 minutes with infrared therapeutic lamp placed 30 cm above the naval. B. Sham acupuncture (n=77): 30 sessions of sham abdominal acupuncture 3 times a week for 2 weeks. Blunt sham needles were nonpenetrative and administered at nonacupuncture points. | A vs. B Age: 46 vs. 45 Female: 81% vs. 83% Use of pain medications: 15% vs. 13% Previous acupuncture use: 42% vs. 44% Baseline NPQ (0-100%): 41.3 vs. 41.0 Baseline pain (0-10 VAS): 6.4 vs. 6.1S | A vs. B 1 month NPQ, mean ∆ (95% CI): −11.9 (−14.6 to −9.2) vs. −3.3 (−5.5 to −1.0), difference −8.7 (95% CI −12.1 to −5.2) p<0.001 Pain VAS, mean ∆ (95% CI): −2.4 (−2.8 to −1.9) vs. −0.6 (−0.9 to −0.2), difference −1.8 (95% CI −2.4 to −1.2) p<0.001 | A vs. B 1 month SF-36 PCS, mean ∆ (95% CI): 4.1 (3.0 to 5.3) vs. 1.3 (0.1 to 2.5), difference 2.8 (95% CI 1.2 to 4.5), p=0.003 SF-36 MCS, mean ∆ (95% CI): 2.0 (0.5 to 3.5) vs. −0.3 (−2.0 to 1.4), difference 2.3 (95% CI −0.0 to 4.5) p=NR |
Liang, 2011233 3 months Duration of pain: NR Fair | A. Active acupuncture, traditional Chinese, (n=93) B. Sham acupuncture (n=97) Treatment was 3x/week for 3 weeks (9 treatments total) lasting 20 minutes after needling Both groups received infrared | A vs. B Age: 37 vs. 37 years Female: 72% vs. 73% Baseline NPQ (0-100%): 32.7 vs. 33.0 Baseline Pain (0-10 VAS): 5.3 vs. 5.5 | A vs. B 3 months NPQ: 19.1 vs. 25.5, difference −6.4 (95% CI −9.9 to −2.9) Pain VAS: 2.9 vs. 3.2, difference −0.3 (95% CI −0.75 to 0.15) | A vs. B 3 months SF-36 physical functioning (0-100): 84.3 vs. 85.9, p=0.447 SF-36 mental (0-100): 67.1 vs. 61.6, p=0.001 |
MacPherson, 2015213, Essex, 2017214 ATLAS trial 1, 7, and 12 months Duration of pain: 7 years Fair [Essex – New publication reporting healthcare utilization] | A. Active acupuncture, traditional Chinese, (n=173): plus usual care 2 weeks later. B. Usual care (n=172): including general and neck pain–specific treatments routinely provided to primary care patients, such as prescribed medications and visits to physical therapists and other healthcare professionals. Treatment was 12 sessions over 5 months lasting 50 minutes | A vs. B Age: 52 vs. 54 years Female: 69% vs. 69% White: 93% vs. 89% Employed: 61% vs. 62% Baseline NPQ (0-100%): 39.64 vs. 40.46 | A vs. B 1 month NPQ: 35.4 vs. 40.9, difference −5.6 (95% CI −8.3 to −2.8) 7 months NPQ: 37.07 vs. 41.0, difference −3.9 (95% CI −6.9 to −1.0) | A vs. B 1 month SF-12v2 physical: data NR, p=NS SF-12v2 mental: data NR, p=NS 7 months SF-12v2 physical (0-100): difference 0.7 (95% CI 1.1 to 2.4) SF-12v2 mental (0-100): difference 1.8 (95% CI 0.2 to 3.4) 12 monthsc Mean utilization of NHS resourcesd: p>0.05, data NR Mean utilization of private healthcare (additional sessions):
Mean total NHS cost (2012/13 UK £): 947 (95% CI 800 to 1094) vs. 484 (95% CI 371 to 598), adjusted difference,e 451 (95% CI 285 to 634); p<0.001 |
Sahin, 2010234 3 months Duration of pain: NR Fair | A. Electro-acupuncture (n=15) B. Sham acupuncture (n=16) Treatment was 10 sessions, 3 sessions per week, lasting 30 minutes | A vs. B Age: 39 vs. 35 years Female: 100% vs. 81% University graduate: 54% vs. 94% BMI: 23.9 vs. 24.6 Baseline pain with motion (0-10 VAS): 7.4 vs. 6.2 Baseline pain at rest (0-10 VAS): 4.0 vs. 5.3 | A vs. B 3 months Pain with motion VAS: 4.50 vs. 5.38, difference −0.9 (95% CI −2.7 to 0.9) Pain at rest VAS: 4.0 vs. 3.5, difference 0.5 (95% CI −1.9 to 2.8) | NR |
Vas, 2006235 6 months Duration of pain: 3.8 years Fair | A. Active acupuncture, traditional Chinese, (n=61) B. Sham TENS (n=62) Treatment was 5 sessions over 3 weeks lasting 30 minutes | A vs. B Age: 46 vs. 47 years Female: 75% vs. 89% Baseline pain with motion (0-10 VAS): 6.9 vs. 7.2 PQ (0-100%): 52.7 vs. 56.5 | A vs. B 6 months (Mean from baseline) Pain VAS with motion: 4.1 vs. 2.7, difference 1.4 (95% CI 0.3 to 2.6) | A vs. B 6 months SF-36 PCS: (0-100): 9.3 vs. 5.3, p=0.054 SF-36 MCS: (0-100): 8.0 vs. 5.2, p=0.351 Rescue medication (none or occasional): 87% (39/45) vs. 68% (27/40), RR 1.28 (95% CI 1.01 to 1.64) |
White, 2004236 2, 6, 12 months Duration pain: 6 years Fair | A. Active acupuncture, Western technique based on tender local and distal points (n=70) B. Sham electro-acupuncture (n=65) Treatment was 8 sessions over 4 weeks lasting 20 minutes | A vs. B Age: 54 vs. 53 years Female: 66% vs. 63% Baseline NDI (0-50): 16.8 vs. 17.2 Baseline pain (0-10 VAS): 5.0 vs. 5.4 | A vs. B 2 months NDI: 11.0 vs. 12.7, difference −1.7 (95% CI −4.3 to 0.9) Pain VAS: 1.7 vs. 2.3, difference −0.6 (95% CI −1.3 to 0.1) 6 months NDI: 9.9 vs. 10.6, difference −0.7 (95% CI −3.6 to 2.2) Pain VAS: 1.9 vs. 2.1, difference −1.8 (95% CI −1.1 to 0.7) 12 months NDI: 8.9 vs. 10.7, difference −1.8 (95% CI −4.84 to 1.24) Pain VAS: 2.1 vs. 2.4, difference −0.3 (95% CI −1.4 to 0.6) | A vs. B 2 months SF-36 PCS (0-100): 42.5 vs. 43.8, p=NS SF-36 MCS (0-100): 52.5 vs. 50.3, p=NS |
Zhang, 2013237 3 and 6 months Duration of pain: 6.3 years Fair | A. Electro-acupuncture, traditional Chinese (n=103) B. Sham laser acupuncture (n=103): via a mock laser pen 2 minutes, with the pen at a distance of 0.5 to 1 cm from the skin. Treatment 3x/week for 3 weeks, 45 min for electro-acupuncture and 2 min per point for sham laser | A vs. B Age: 46 years (whole population) Female: 70% (whole population) Baseline NPQ (0-100%): 40.7 vs. 41.1 Baseline pain with motion (0-10 NPS): 5.5 vs. 5.2 | A vs. B 3 months NPQ: mean 32.9 (95% CI 30.3 to 35.4) vs. mean 33.3 (95% CI 30.1 to 36.5), p=0.664 Pain with motion VAS: mean 4.7 (95% CI 4.2 to 5.1) vs. mean 4.5 (95% CI 4.1 to 5.0), p=0.617 6 months NPQ: mean 33.6 (95% CI 30.7 to 36.4) vs. mean 34.3 (95% CI 31.1 to 37.6), p=0.808 Pain with motion: mean 4.7 (95% CI 4.2 to 5.2) vs. mean 4.4 (95% CI 3.9 to 4.8), p=0.813 | A vs. B 3 months SF-36 PCS (0-100): mean 52.8 (95% CI 53.0 to 53.7) vs. mean 53.3 (95% CI 52.4 to 54.2), p=0.982 SF-36 MCS (0-100): mean 45.9 (95% CI 46.0 to 46.8) vs. mean 45.3 (95% CI 44.2 to 46.4), p=0.444 6 months SF-36 PCS: mean 53.0 (95% CI 52.0 to 53.9) vs. mean 53.2 (95% CI 52.3 to 54.0), p=0.559 SF-36 MCS: mean 45.4 (95% CI 44.5 to 46.3) vs. mean 44,4 (95% CI 43.4 to 45.4), p=0.246 |
∆ = change; BDI = Beck Depression Inventory; CI = confidence interval; CPEQ = Comprehensive Pain Evaluation Questionnaire; EQ-5D = Euroqol 5-D; NDI = Neck Disability Index; NHS = National Health Service; NPQ = Northwick Park Neck Pain Questionnaire; NR = not reported; NS = not statistically significant; NSAID = nonsteroidal anti-inflammatory drug; SF-36 MCS = Short Form-36 questionnaire Mental Component Score; SF-36 PCS = Short Form-36 questionnaire Physical Component Score; SF-MPQ = McGill Pain Questionnaire Short Form; TENS = Transcutaneous electrical nerve stimulation; VAS = visual analog scale
Unless otherwise noted, followup time is calculated from the end of the treatment period
12 month data are health utilization data only from a subset of patients from the ATLAS trial (publication Essex 2017) who had full economic data N=293 (57%) [to include the acupuncture arm; details in the Acupuncture section]; no demographic data provided for the subset
Across all appointment types and prescription medications; National Health Services (NHS) appointment types to include, general practitioner appointments, physiotherapy visits, hospital outpatient visits, accident and emergency admissions, hospital day case admissions, other hospital admissions. NHS prescription medication included all prescription medication and prescription items specifically for neck pain. Neck pain prescriptions t-test comparing usual care and acupuncture borderline significance (p=0.06).
For baseline NHS healthcare costs and practice size.
From: Results
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