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


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.

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Description/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.

Item Type: Article
ISSNs: 1539-3704 (print)
Related URLs:
Keywords: chronic pain
Subjects: R Medicine > RZ Other systems of medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RM Therapeutics. Pharmacology
Divisions: University Structure - Pre August 2011 > School of Mathematics > Statistics
University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
University Structure - Pre August 2011 > Superseded (SOHPRS)
ePrint ID: 18101
Date Deposited: 27 Oct 2005
Last Modified: 27 Mar 2014 18:07
Contact Email Address: pjw1@soton.ac.uk
URI: http://eprints.soton.ac.uk/id/eprint/18101

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