office (902)
444-3111
Study: Acupuncture Better than Massage for
Chronic Neck Pain
Researchers Find "Clear Clinical Advantages"
in Reducing Pain and Improving Motion
For most people, a quick visit to a massage
therapist has been traditionally considered the best way to provide
temporary relief of chronic neck pain.
Study: Acupuncture Better than Massage for
Chronic Neck Pain
Researchers Find "Clear Clinical Advantages"
in Reducing Pain and Improving Motion
For most people, a quick visit to a massage
therapist has been traditionally considered the best way to provide
temporary relief of chronic neck pain.
The
results of a randomized trial of neck pain patients published in a
recent issue of the British Medical
Journal, however, appear to suggest otherwise. According to a
team of German and Swedish researchers, acupuncture provides greater
short-term pain relief and increases range of motion better than
traditional massage techniques.
"Our study shows that acupuncture can be an
effective treatment for chronic neck pain, if the objective is to
relieve pain and to improve mobility of the cervical spine," said
Dr. Dominik Irnick of Ludwig-Maximilians University in Germany, one
of three settings in which the trial was conducted.
In the study, 177 patients with chronic neck pain
were randomly assigned to an acupuncture, massage or placebo group.
Patients in the acupuncture group were treated at local, remote and
ear acupoints, along with myofascial trigger points. The most
commonly used points were SI3; UB10; UB60; Liv3; GB20; GB34; TE5;
and the "cervical spine" ear point. In the massage group, patients
were treated with a variety of Western techniques, including
effleurage; petrissage; friction; tapotement and vibration. In the
placebo group, sham laser acupuncture was performed using an
inactivated laser pen on the same points as patients in the
acupuncture group.
A blinded observer assessed the effectiveness of
the treatments at six episodes during the course of care: at
baseline; immediately after the first treatment; three days after
the first treatment; immediately after the last treatment; one week
after the last treatment; and three months after treatment.
Researchers used a 100-point visual analogue scale to measure the
amount of pain a patient suffered related to head movement, along
with range of motion and tolerance to pressure. Spontaneous pain,
motion-related pain and global pain were also documented, and a
survey was administered to each patient to assess their quality of
life.
Results
Individuals treated with acupuncture reported
greater reductions in pain both immediately after the first and last
treatments, and one week after the last treatment, than those
treated with massage. Patients in the acupuncture group improved an
average of 24.22 points on pain related to motion one week after
treatment, compared to only 7.89 points for massage patients. These
differences were even more distinct among patients with myofascial
pain syndrome (a condition characterized by muscle pain in specific
areas of the neck that may be caused by physical or emotional
tension) and patients who reported pain lasting more than five
years.
|
Table I:
Improvement of pain related to motion one week after
treatment compared with baseline measurements. |
|
|
Patient
Group |
Mean
improvement on visual analogue scale |
|
All
participants |
|
|
Acupuncture (n = 51) |
24.22 points |
|
Massage (n = 57) |
7.89 |
|
Patients
with myofascial pain syndrome |
|
|
Acupuncture (n=34) |
30.05 points |
|
Massage (n=43) |
7.23 |
|
Patients
with pain >5 years |
|
|
Acupuncture (n=23) |
31.87 points |
|
Massage (n=23) |
13.52 |
Similar results were seen in related
measurements. For example, in assessments taken one week after the
last treatment, over half of those treated with acupuncture (29/51)
reported an improvement of more than 50% in pain related to motion,
compared to only 32% of patients treated with massage and less than
25% of patients in the sham acupuncture group. The researchers also
found that "significantly more patients in the acupuncture group
considered their pain (spontaneous, motion-related) and global
complaints improved" compared to patients given massage, with some
of these effects lasting as long as three months after treatment was
performed.
|
Table II:
Outcomes in chronic neck pain patients, acupuncture vs.
massage. |
||
|
Measurement |
Acupuncture |
Massage |
|
Increased
range of motion (in degrees) |
||
|
Immediately after last treatment |
19.6 |
6.2 |
|
One week after last treatment |
19.8 |
5.1 |
|
Three months after treatment |
8.9 |
5.5 |
|
Pain
related to direction (improvement on visual analogue
scale, 0-100 points) |
||
|
Immediately after last treatment |
16.9 |
5.6 |
|
One week after last treatment |
17.3 |
3.1 |
|
Three months after treatment |
15.0 |
8.1 |
|
Improvement in instances of spontaneous pain |
||
|
One week after last treatment |
35/51 (69%) |
28/56 (50%) |
|
Three months after treatment |
33/47 (70%) |
25/57 (44%) |
|
Improvement in instances of global pain |
||
|
One week after last treatment |
46/52 (88%) |
32/58 (55%) |
|
Three months after treatment |
39/48 (81%) |
32/57 (56%) |
The authors of the study were rather forthright
in their praise of acupuncture. "Our results show that acupuncture
is a safe form of treatment for people with chronic neck pain, and
offers clear clinical advantages over conventional massage in the
reduction of pain and improvement of mobility," they wrote. In
particular, it was suggested that acupuncture could be beneficial in
treating patients with myofascial pain syndrome, which is estimated
to be present in up to 90% of people with chronic neck pain and can
be easily recognized through a patient's case history or a detailed
physical exam.
The scientists were less kind in their opinion of
massage therapy. Even though it is one of the most common treatments
for chronic neck pain - in fact, 77% of the study participants had
used massage for pain relief before taking part in the trial - the
authors concluded that "conventional massage had only a weak effect"
in treating the condition effectively.
Some concerns were raised because the number of
treatments (five) given was relatively small, and that they were
delivered in a short amount of time. The scientists explained this
issue by stating that they "did not want to treat patients with
chronic pain with placebo for longer (than five sessions) for
ethical reasons." They also recommended that future research be
conducted to determine the optimum number of treatments for the
management of these patients.
"Acupuncture can be a safe form of treatment for
patients with chronic neck pain if the objective is to obtain relief
from pain related to motion and to improve cervical mobility," the
researchers concluded. "As neck pain may be a chronic condition with
considerable socioeconomic impact, single forms of treatment may be
inadequate, and acupuncture merits consideration."
The results of a randomized trial of
neck pain patients published in a recent issue of the
British Medical Journal, however,
appear to suggest otherwise. According to a team of German and
Swedish researchers, acupuncture provides greater short-term pain
relief and increases range of motion better than traditional massage
techniques.
"Our study shows that acupuncture can be an
effective treatment for chronic neck pain, if the objective is to
relieve pain and to improve mobility of the cervical spine," said
Dr. Dominik Irnick of Ludwig-Maximilians University in Germany, one
of three settings in which the trial was conducted.
In the study, 177 patients with chronic neck pain
were randomly assigned to an acupuncture, massage or placebo group.
Patients in the acupuncture group were treated at local, remote and
ear acupoints, along with myofascial trigger points. The most
commonly used points were SI3; UB10; UB60; Liv3; GB20; GB34; TE5;
and the "cervical spine" ear point. In the massage group, patients
were treated with a variety of Western techniques, including
effleurage; petrissage; friction; tapotement and vibration. In the
placebo group, sham laser acupuncture was performed using an
inactivated laser pen on the same points as patients in the
acupuncture group.
A blinded observer assessed the effectiveness of
the treatments at six episodes during the course of care: at
baseline; immediately after the first treatment; three days after
the first treatment; immediately after the last treatment; one week
after the last treatment; and three months after treatment.
Researchers used a 100-point visual analogue scale to measure the
amount of pain a patient suffered related to head movement, along
with range of motion and tolerance to pressure. Spontaneous pain,
motion-related pain and global pain were also documented, and a
survey was administered to each patient to assess their quality of
life.
Results
Individuals treated with acupuncture reported
greater reductions in pain both immediately after the first and last
treatments, and one week after the last treatment, than those
treated with massage. Patients in the acupuncture group improved an
average of 24.22 points on pain related to motion one week after
treatment, compared to only 7.89 points for massage patients. These
differences were even more distinct among patients with myofascial
pain syndrome (a condition characterized by muscle pain in specific
areas of the neck that may be caused by physical or emotional
tension) and patients who reported pain lasting more than five
years.
|
Table I:
Improvement of pain related to motion one week after
treatment compared with baseline measurements. |
|
|
Patient
Group |
Mean
improvement on visual analogue scale |
|
All
participants |
|
|
Acupuncture (n = 51) |
24.22 points |
|
Massage (n = 57) |
7.89 |
|
Patients
with myofascial pain syndrome |
|
|
Acupuncture (n=34) |
30.05 points |
|
Massage (n=43) |
7.23 |
|
Patients
with pain >5 years |
|
|
Acupuncture (n=23) |
31.87 points |
|
Massage (n=23) |
13.52 |
Similar results were seen in related
measurements. For example, in assessments taken one week after the
last treatment, over half of those treated with acupuncture (29/51)
reported an improvement of more than 50% in pain related to motion,
compared to only 32% of patients treated with massage and less than
25% of patients in the sham acupuncture group. The researchers also
found that "significantly more patients in the acupuncture group
considered their pain (spontaneous, motion-related) and global
complaints improved" compared to patients given massage, with some
of these effects lasting as long as three months after treatment was
performed.
|
Table II:
Outcomes in chronic neck pain patients, acupuncture vs.
massage. |
||
|
Measurement |
Acupuncture |
Massage |
|
Increased
range of motion (in degrees) |
||
|
Immediately after last treatment |
19.6 |
6.2 |
|
One week after last treatment |
19.8 |
5.1 |
|
Three months after treatment |
8.9 |
5.5 |
|
Pain
related to direction (improvement on visual analogue
scale, 0-100 points) |
||
|
Immediately after last treatment |
16.9 |
5.6 |
|
One week after last treatment |
17.3 |
3.1 |
|
Three months after treatment |
15.0 |
8.1 |
|
Improvement in instances of spontaneous pain |
||
|
One week after last treatment |
35/51 (69%) |
28/56 (50%) |
|
Three months after treatment |
33/47 (70%) |
25/57 (44%) |
|
Improvement in instances of global pain |
||
|
One week after last treatment |
46/52 (88%) |
32/58 (55%) |
|
Three months after treatment |
39/48 (81%) |
32/57 (56%) |
The authors of the study were rather forthright
in their praise of acupuncture. "Our results show that acupuncture
is a safe form of treatment for people with chronic neck pain, and
offers clear clinical advantages over conventional massage in the
reduction of pain and improvement of mobility," they wrote. In
particular, it was suggested that acupuncture could be beneficial in
treating patients with myofascial pain syndrome, which is estimated
to be present in up to 90% of people with chronic neck pain and can
be easily recognized through a patient's case history or a detailed
physical exam.
The scientists were less kind in their opinion of
massage therapy. Even though it is one of the most common treatments
for chronic neck pain - in fact, 77% of the study participants had
used massage for pain relief before taking part in the trial - the
authors concluded that "conventional massage had only a weak effect"
in treating the condition effectively.
Some concerns were raised because the number of
treatments (five) given was relatively small, and that they were
delivered in a short amount of time. The scientists explained this
issue by stating that they "did not want to treat patients with
chronic pain with placebo for longer (than five sessions) for
ethical reasons." They also recommended that future research be
conducted to determine the optimum number of treatments for the
management of these patients.
"Acupuncture can be a safe form of treatment for
patients with chronic neck pain if the objective is to obtain relief
from pain related to motion and to improve cervical mobility," the
researchers concluded. "As neck pain may be a chronic condition with
considerable socioeconomic impact, single forms of treatment may be
inadequate, and acupuncture merits consideration."
The “I Stop Pain” Acupuncture Center is owned by Registered Acupuncturists Tom Tian and Wei Yuan. Prior to moving to Halifax, we both worked as acupuncturists in hospitals in China and over many years have accumulated thousands of hours of clinical experience ?treating a wide variety of ailments. Upon immigrating to Canada we treated patients in our clinic in Vancouver, B.C. for two years until deciding to move to the east coast. We have been operating our new clinic in Halifax since 2007 and very much enjoy meeting and
treating new patients here in the Maritime Provinces.?