Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain.

OBJECTIVES

To compare the efficacy of acupuncture and conventional massage for the treatment of chronic neck pain.

DESIGN

Prospective, randomised, placebo controlled trial.

SETTING

Three outpatient departments in Germany.

PARTICIPANTS

177 patients aged 18-85 years with chronic neck pain.

INTERVENTIONS

Patients were randomly allocated to five treatments over three weeks with acupuncture (56), massage (60), or "sham" laser acupuncture (61).

PRIMARY OUTCOME MEASURE

maximum pain related to motion (visual analogue scale) irrespective of direction of movement one week after treatment.

SECONDARY OUTCOME MEASURES

range of motion (3D ultrasound real time motion analyser), pain related to movement in six directions (visual analogue scale), pressure pain threshold (pressure algometer), changes of spontaneous pain, motion related pain, global complaints (seven point scale), and quality of life (SF-36). Assessments were performed before, during, and one week and three months after treatment. Patients' beliefs in treatment were assessed.

RESULTS

One week after five treatments the acupuncture group showed a significantly greater improvement in motion related pain compared with massage (difference 24.22 (95% confidence interval 16.5 to 31.9), P=0.0052) but not compared with sham laser (17.28 (10.0 to 24.6), P=0.327). Differences between acupuncture and massage or sham laser were greater in the subgroup who had had pain for longer than five years (n=75) and in patients with myofascial pain syndrome (n=129). The acupuncture group had the best results in most secondary outcome measures. There were no differences in patients' beliefs in treatment.

CONCLUSIONS

Acupuncture is an effective short term treatment for patients with chronic neck pain, but there is only limited evidence for long term effects after five treatments.