Individualized Acupuncture Provides Moderate Relief for Chronic Neck Pain: JAMA

A new study published in the Annals of Internal Medicine evaluated the long-term effectiveness of individualized acupuncture for individuals with chronic neck pain (CNP) and found that specific acupuncture techniques provided moderate pain relief, though the improvement fell short of the clinically significant threshold. The 24-week, multicenter randomized controlled trial, conducted across four clinical centers in China between May 2018 and March 2020, sought to assess the efficacy and safety of acupuncture based on pressure pain and sensory responses.

The trial included a total of 716 participants diagnosed with chronic neck pain and were randomly divided into 4 groups. 3 groups received different acupuncture interventions as higher sensitive acupoints (HSA), lower sensitive acupoints (LSA), and sham acupoints (SA), while the fourth group, a waiting list (WL) control group, did not receive any immediate treatment. Each intervention consisted of 10 acupuncture sessions over 4 weeks. The primary outcome measured was the change in the visual analogue scale (VAS) score for neck pain. The VAS score ranged from 0 to 100, with a reduction of 10 points considered the minimum threshold for a clinically significant difference.

Of the 716 participants, 683 completed the trial with the mean baseline VAS score for neck pain across the groups being around 50. The findings of the study revealed that acupuncture at both high- and low-sensitivity acupoints resulted in moderate improvements in neck pain, with the HSA group by experiencing the most observed pain relief.

By the end of week 4, the HSA group showed an average decrease of 12.16 points in their VAS score when compared to a 10.19-point reduction in the LSA group. Meanwhile, the SA group (which received sham acupuncture) and the WL control group had smaller improvements of 6.11 and 2.24 points, respectively. These outcomes suggest that HSA and LSA acupuncture were more effective than the sham and no-treatment options in reducing neck pain.

While the reductions in pain were statistically significant, the difference in outcomes between the acupuncture groups and the sham or waiting list groups did not reach the minimum clinically important threshold of a 10-point improvement. This suggests that, despite the acupuncture providing some relief, it might not be substantial enough to be considered a clinically meaningful improvement. The benefits observed in the acupuncture groups persisted throughout the 24-week follow-up period. Overall, individualized acupuncture at higher sensitivity acupoints offered moderate pain relief for individuals with chronic neck pain. Further research is imperative to determine its long-term clinical relevance and general applicability.

Source:

Zhao, L., Sun, M., Yin, Z., Cui, J., Wang, R., Ji, L., Geng, G., Chen, J., Cai, D., Liu, Q., Zheng, H., & Liang, F. (2024). Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain. In Annals of Internal Medicine. American College of Physicians. https://doi.org/10.7326/m23-2425