Acupuncture is as Effective as Exercise for Improvement of Chronic Neck Pain: A Randomized Clinical Trial

Nejati, Parisa; Mousavi, Reza; Angoorani, Hooman

doi:10.5812/semj.97497

Cited by 3 publications

(10 citation statements)

References 33 publications

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“…Forty-two RCTs were rated as having a low risk of bias in random sequence generation: Of them, 26 [ 25 , 30 – 33 , 35 – 38 , 40 , 41 , 45 , 47 , 51 , 53 , 54 , 60 , 62 – 64 , 67 , 71 , 74 , 79 , 87 , 88 ] used various computerized randomization programs, 11 [ 43 , 44 , 50 , 55 , 58 , 66 , 68 , 72 , 78 , 81 , 85 ] used random number tables, 3 [ 27 – 29 ] used coin tossing, and 2 [ 24 , 39 ] used block randomization. In terms of allocation in the RCTs, 19 studies [ 24 , 26 , 30 – 32 , 38 – 41 , 45 , 58 , 62 , 64 , 67 , 71 , 79 , 84 , 87 , 88 ] described proper allocation concealment (the use of sealed envelopes or independent researchers). Because of the nature of the interventions, performance bias was high in most studies; only 2 studies [ 41 , 47 ] were assessed as having a low risk of bias in participant blinding due to the use of nonpenetrating SA.…”

Section: Resultsmentioning

confidence: 99%

“…The 65 selected RCTs included a total of 5266 participants and had sample sizes varying from 17 to 220 patients. Most were conducted in China; of the others, 6 were conducted in Iran, [24][25][26][27][28][29] 3 in Spain, [30][31][32] 2 in Turkey, [33,34] and 1 each from Taiwan, [35] Japan, [36] Germany, [37] Korea, [38] Belgium, [39] and the United States. [40] Sixty-two were 2-arm trials and the remaining 3 were 3-arm trials.…”

Section: Characterization Of the Included Rctsmentioning

confidence: 99%

“…Forty-two RCTs were rated as having a low risk of bias in random sequence generation: Of them, 26 [25,[30][31][32][33][35][36][37][38]40,41,45,47,51,53,54,60,[62][63][64]67,71,74,79,87,88] used various computerized randomization programs, 11 [43,44,50,55,58,66,68,72,78,81,85] used random number tables, 3 [27][28][29] used coin tossing, and 2 [24,39] used block randomization. In terms of allocation in the RCTs, 19 studies [24,26,[30][31][32][38][39][40]…”

Section: Risk Of Bias and Quality Assessmentmentioning

confidence: 99%

“…Because of the nature of the interventions, performance bias was high in most studies; only 2 studies [41,47] were assessed as having a low risk of bias in participant blinding due to the use of nonpenetrating SA. The detection bias had low risk in 12 RCTs [26,[30][31][32][33][37][38][39][40][41]47,52] that used independent assessors. Six RCTs [33,37,39,43,45,84] were rated as high risk for attrition bias because they had large amounts of missing data, and 6 RCTs [27,34,51,59,61,86] were rated as having unclear risk of bias for attrition because the reasons for the missing data were not stated.…”

Section: Risk Of Bias and Quality Assessmentmentioning

confidence: 99%

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Comparative effectiveness of different acupuncture therapies for neck pain

Noh

et al. 2022

Medicine

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Background: Neck pain is a common musculoskeletal symptom that has negative effects on quality of life and work productivity. Acupuncture has been widely used for neck pain, and a number of randomized controlled trials (RCTs) and systematic reviews (SRs) have evaluated its effectiveness. However, previous studies have obtained inconsistent results regarding the effects of acupuncture for neck pain, and there is no SR for the comparative efficacy and safety of various types of acupuncture. Therefore, we herein conducted a SR and network meta-analysis to compare and rank different types of acupuncture with respect to their effectiveness in treating neck pain.Methods: We searched 9 electronic databases for relevant RCTs published from their inception to July 1, 2021. Pairwise metaanalyses and network meta-analysis were performed with R software using the frequentist framework. Change of pain intensity was assessed as the primary outcome, and change of pain-related disability and efficacy rate were assessed as secondary outcomes. The Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) instrument were used to evaluate the quality of the included RCTs and the certainty of the evidence.Results: A total of 65 RCTs involving 5266 participants and 9 interventions were included. Three network meta-analyses were constructed for the following: pain intensity (42 RCTs, 3158 participants), pain-related disability (21 RCTs, 1581 participants), and efficacy rate (40 RCTs, 3512 participants). The results indicated that fire acupuncture, electroacupuncture, and warm acupuncture were more effective than manual acupuncture in terms of pain intensity reduction and efficacy rate, and that electroacupuncture decreased pain-related disability more effectively than manual acupuncture. Fire acupuncture ranked first among the 9 interventions. The overall q of evidence was very low according to the GRADE assessment. The reported adverse events were not serious. Conclusion:Fire acupuncture, warm acupuncture, acupoint catgut embedding, and electroacupuncture ranked higher than other interventions (usual care, sham acupuncture, no treatment) in reducing the pain and disability index scores and the efficacy rate. However, the included trials were evaluated as being of low quality; thus, we recommend additional well-designed RCTs with larger sample sizes to confirm these findings.

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Section: Resultsmentioning

confidence: 99%

Section: Characterization Of the Included Rctsmentioning

confidence: 99%

Section: Risk Of Bias and Quality Assessmentmentioning

confidence: 99%

Section: Risk Of Bias and Quality Assessmentmentioning

confidence: 99%

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Comparative effectiveness of different acupuncture therapies for neck pain

Noh

et al. 2022

Medicine

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“…Evidence suggests that exercise therapy plays a role in improving neck pain and disability of patients with cervical spondylosis. Besides, thanks to being non-invasive and profitable, exercise therapy is commonly used in patient rehabilitation [2,5].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of isometric exercises on disability and pain of cervical spondylosis: a randomized controlled trial

Sadeghi

Rostami

Ameri

et al. 2022

BMC Sports Sci Med Rehabil

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Background Neck pain and disability is a significant public health problem with only very few evidence-based treatment option. The aim of this study was to evaluate the effect of isometric exercise on pain and disability of cervical spondylosis. Methods Twenty four patients with cervical osteoarthritis and neck pain (22 females and 2 males; mean age, 46.70 ± 13.71 years) were recruited and randomly allocated into 2 arms: neck isometric exercises (n = 12) and conservative management without exercise (n = 12). The Neck Disability Index (NDI) and Neck Pain and Disability Scale (NPAD) were used to assess participants at baseline and after 4 weeks. Results Basic characteristics, NDI score and NPAD score were not significantly different between groups at baseline. The exercise arm demonstrated significantly lower scores regarding NDI (mean, 17.41 vs. 25.58; P-value = 0.035) and NPAD (mean, 25.33 vs. 66.67; P < 0.001), compared to the control arm after 4 weeks. The exercise arm also showed significant within group reduction considering NDI and NPAD scores after 4 weeks (Both, P < 0.001). Conclusion Our findings suggested that isometric exercises might be a beneficial treatment for improving pain and disability caused by cervical spondylosis. Trial registration This study was registered at irct.ir (Iranian Registry of Clinical Trials) with the code IRCT20220206053950N1, 07.05.2022, retrospectively registered.

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Durable Effect of Acupuncture for Chronic Neck Pain: A Systematic Review and Meta-Analysis

Fang,

Shi,

Wang

et al. 2024

Curr Pain Headache Rep

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Objective Chronic neck pain, a prevalent health concern characterized by frequent recurrence, requires exploration of treatment modalities that provide sustained relief. This systematic review and meta-analysis aimed to evaluate the durable effects of acupuncture on chronic neck pain. Methods We conducted a literature search up to March 2024 in six databases, including PubMed, Embase, and the Cochrane Library, encompassing both English and Chinese language publications. The main focus of evaluation included pain severity, functional disability, and quality of life, assessed at least 3 months post-acupuncture treatment. The risk of bias assessment was conducted using the Cochrane Risk of Bias 2.0 tool, and meta-analyses were performed where applicable. Results Eighteen randomized controlled trials were included in the analysis. Acupuncture as an adjunct therapy could provide sustained pain relief at three (SMD: − 0.79; 95% CI − 1.13 to − 0.46; p < 0.01) and six (MD: − 18.13; 95% CI − 30.18 to − 6.07; p < 0.01) months post-treatment. Compared to sham acupuncture, acupuncture did not show a statistically significant difference in pain alleviation (MD: − 0.12; 95% CI − 0.06 to 0.36; p = 0.63). However, it significantly improved functional outcomes as evidenced by Northwick Park Neck Pain Questionnaire scores 3 months post-treatment (MD: − 6.06; 95% CI − 8.20 to − 3.92; p < 0.01). Although nine studies reported an 8.5%–13.8% probability of adverse events, these were mild and transitory adverse events. Conclusion Acupuncture as an adjunct therapy may provide post-treatment pain relief lasting at least 3 months for patients with chronic neck pain, although it is not superior to sham acupuncture, shows sustained efficacy in improving functional impairment for over 3 months, with a good safety profile.

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Acupuncture is as Effective as Exercise for Improvement of Chronic Neck Pain: A Randomized Clinical Trial

Cited by 3 publications

References 33 publications

Comparative effectiveness of different acupuncture therapies for neck pain

Comparative effectiveness of different acupuncture therapies for neck pain

Effectiveness of isometric exercises on disability and pain of cervical spondylosis: a randomized controlled trial

Durable Effect of Acupuncture for Chronic Neck Pain: A Systematic Review and Meta-Analysis

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