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Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial

Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial
Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial
BACKGROUND: Despite substantial increases in its popularity and use, the efficacy of acupuncture for chronic mechanical neck pain remains unproved.
OBJECTIVE: To compare acupuncture and placebo for neck pain.
DESIGN: A randomized, single-blind, placebo-controlled, parallel-arm trial with 1-year follow-up.
SETTING: The outpatient departments of 2 major hospitals in the United Kingdom, 1999 to 2001.
PATIENTS: 135 patients 18 to 80 years of age who had chronic mechanical neck pain. Eleven patients withdrew from treatment, and 124 completed the primary end point.
MEASUREMENTS: The primary outcome was pain 1 week after treatment, according to a visual analogue scale. Secondary outcomes were pain at other time points, score on the Neck Disability Index and the Short Form-36, and use of analgesic medications.
INTERVENTIONS: Patients were randomly assigned to receive, over 4 weeks, 8 treatments with acupuncture or with mock transcutaneous electrical stimulation of acupuncture points using a decommissioned electroacupuncture stimulation unit.
RESULTS: Both groups improved statistically from baseline, and acupuncture and placebo had similar credibility. For the primary outcome (weeks 1 to 5), a statistically significant difference in visual analogue scale score in favor of acupuncture (6.3 mm [95% CI, 1.4 to 11.3 mm] P = 0.01) was observed between the 2 study groups, after adjustment for baseline pain and other covariates. However, this difference was not clinically significant because it demonstrated only a 12% (CI, 3% to 21%) difference between acupuncture and placebo. Secondary outcomes showed a similar pattern.
LIMITATIONS: All treatments were provided by 1 practitioner. Although the control was credible, it did not mimic the process of needling. A nonintervention group was not present to control for regression to the mean.
CONCLUSION: Acupuncture reduced neck pain and produced a statistically, but not clinically, significant effect compared with placebo. The beneficial effects of acupuncture for pain may be due to both nonspecific and specific effects.
chronic pain
0003-4819
911 - 919
White, Peter
f33829fd-24c9-4b44-a148-24eca9d52253
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Prescott, Phil
cf0adfdd-989b-4f15-9e60-ef85eed817b2
Conway, Joy
bbe9a2e4-fb85-4d4a-a38c-0c1832c32d06
White, Peter
f33829fd-24c9-4b44-a148-24eca9d52253
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Prescott, Phil
cf0adfdd-989b-4f15-9e60-ef85eed817b2
Conway, Joy
bbe9a2e4-fb85-4d4a-a38c-0c1832c32d06

White, Peter, Lewith, George, Prescott, Phil and Conway, Joy (2004) Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial. Annals of Internal Medicine, 141 (12), 911 - 919.

Record type: Article

Abstract

BACKGROUND: Despite substantial increases in its popularity and use, the efficacy of acupuncture for chronic mechanical neck pain remains unproved.
OBJECTIVE: To compare acupuncture and placebo for neck pain.
DESIGN: A randomized, single-blind, placebo-controlled, parallel-arm trial with 1-year follow-up.
SETTING: The outpatient departments of 2 major hospitals in the United Kingdom, 1999 to 2001.
PATIENTS: 135 patients 18 to 80 years of age who had chronic mechanical neck pain. Eleven patients withdrew from treatment, and 124 completed the primary end point.
MEASUREMENTS: The primary outcome was pain 1 week after treatment, according to a visual analogue scale. Secondary outcomes were pain at other time points, score on the Neck Disability Index and the Short Form-36, and use of analgesic medications.
INTERVENTIONS: Patients were randomly assigned to receive, over 4 weeks, 8 treatments with acupuncture or with mock transcutaneous electrical stimulation of acupuncture points using a decommissioned electroacupuncture stimulation unit.
RESULTS: Both groups improved statistically from baseline, and acupuncture and placebo had similar credibility. For the primary outcome (weeks 1 to 5), a statistically significant difference in visual analogue scale score in favor of acupuncture (6.3 mm [95% CI, 1.4 to 11.3 mm] P = 0.01) was observed between the 2 study groups, after adjustment for baseline pain and other covariates. However, this difference was not clinically significant because it demonstrated only a 12% (CI, 3% to 21%) difference between acupuncture and placebo. Secondary outcomes showed a similar pattern.
LIMITATIONS: All treatments were provided by 1 practitioner. Although the control was credible, it did not mimic the process of needling. A nonintervention group was not present to control for regression to the mean.
CONCLUSION: Acupuncture reduced neck pain and produced a statistically, but not clinically, significant effect compared with placebo. The beneficial effects of acupuncture for pain may be due to both nonspecific and specific effects.

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Published date: 1 December 2004
Keywords: chronic pain
Organisations: Statistics

Identifiers

Local EPrints ID: 18101
URI: http://eprints.soton.ac.uk/id/eprint/18101
ISSN: 0003-4819
PURE UUID: 0ae01d21-091f-4fed-a3ee-db3b68c733ee
ORCID for Joy Conway: ORCID iD orcid.org/0000-0001-6464-1526

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Date deposited: 27 Oct 2005
Last modified: 15 Mar 2024 06:02

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Contributors

Author: Peter White
Author: George Lewith
Author: Phil Prescott
Author: Joy Conway ORCID iD

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