Acupuncture for neck pain
Evidence Summaries Level of Evidence = C
Acupuncture may relieve chronic neck pain better than sham or no treatment at least in the short term.
A Cochrane review 1 [withdrawn from publication] included 10 studies on acupuncture for chronic neck pain, with a total of 661 subjects. No trials on acupuncture for acute or subacute neck pain were found. For chronic mechanical neck disorders, there was moderate evidence that acupuncture was more effective for pain relief than some types of sham controls, measured immediately post-treatment. There was moderate evidence that acupuncture was more effective than inactive, sham treatments measured immediately post-treatment and at short-term follow-up (pooled standardized mean difference [SMD] –0.37, 95% confidence interval [CI] –0.61 to –0.12). There was limited evidence that acupuncture was more effective than massage at short-term follow-up. For chronic neck disorders with radicular symptoms, there was moderate evidence that acupuncture was more effective than a wait-list control at short-term follow-up.
A systematic review 1 including 14 studies with a total of 724 subjects was abstracted in DARE. Of the 8 studies with better quality (3 or more on the Jadad score), 5 reported no difference between treatment arms, and 3 favoured acupuncture. Acupuncture was significantly better than waiting list in one study (Jadad score 3). Of 3 studies on acupuncture versus physiotherapy, 2 reported no differences and 1 favoured acupuncture.
Comment: The quality of evidence is downgraded by study limitations (mainly inadequate concealment of allocation) and inconsistency of results (heterogeneity in interventions and outcomes).
1. Trinh K, Graham N, Irnich D et al. WITHDRAWN: Acupuncture for neck disorders. Cochrane Database Syst Rev 2016;(11):CD004870. [PMID:27852100].
2. White AR, Ernst E. A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology (Oxford) 1999 Feb;38(2):143-7. [PMID:10342627]
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