Negative effects acupuncture neck pain
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Acupuncture is a complementary therapy used for many medical conditions.
An increasing number of patients, are starting to use acupuncture as a means of ameliorating neck pain.
The premise of acupuncture is that the body contains patterns or channels of energy flow. The vital energy or life force of the body is referred to as qi (pronounced "chee"), and proper flow of qi is considered to be necessary to maintain health.
The theory of acupuncture is that there are more than 2,000 points on the human body that connect with 20 channels (meridians). These pathways conduct the qi throughout the body. In acupuncture, needles are inserted into specific points to maintain a normal flow of qi.
During an acupuncture treatment session, anywhere from 1 to 20 needles are inserted into the body. In certain instances, needles are warmed or electrically charged after insertion.
Some practitioners also use moxibustion. Here, an herb compound is attached to the top of the needle and is burned on the needles during insertion. “Cupping” is another addition to acupuncture. Cups are heated and applied to the skin to create suction and bring blood close to the surface.
Acupuncture is thought to operate by:
•Release of pain relieving peptides. There has been considerable evidence to support that acupuncture stimulates the central nervous system, releasing these chemicals.
•Alteration in the secretion of neurotransmitters and neural-mediated hormones. Acupuncture is said to activate the hypothalamus and pituitary gland and thereby alter secretion of chemical neurotransmitters.
Acupuncture is considered a safe medical treatment.
In 1998, the National Institutes of Health (NIH) released a statement that said there is enough evidence to demonstrate that acupuncture had beneficial pain-relieving qualities in adults experiencing postoperative dental pain, as well as nausea from chemotherapy. The NIH also found that acupuncture might be useful as a treatment for low back pain, as well as many other conditions, such as headache, myofascial pain, osteoarthritis, and carpal tunnel syndrome.
However, as with any treatment option acupuncture is not without its risks and costs.
As with any medical treatment, there are certain contraindications for acupuncture treatments, including:
• Drug or alcohol intoxication
• Use of a pacemaker
• A seizure disorder
• Bleeding disorder such as hemophilia or use of blood thinners
• Infections skin disorder or disease
• If pregnant, needling in the abdominal area or lumbosacral region should be avoided. It is also advisable to avoid any acupuncture that might stimulate the early delivery of the fetus or even lead to abortion.
Compared to other treatments, acupuncture is quite safe.
Side effects reported include:
Infection from non-sterilized needles
Pain or bruising at the site of needle insertion
Feeling faint or tired after a session
Pneumothorax (punctured lung)
Cardiac tamponade (Sack around the heart fills with blood)
Endocarditis (infection of the heart)
Damage to the spinal cord or peripheral nerves
There have also been negative studies reported. For instance...
A study in the British Medical Journal [2001; 322(7302); 1574-78], as reported in The Back Letter Vol. 16, Number 8, 2001, compared traditional Chinese acupuncture, massage therapy and sham laser therapy administered to 177 people aged 18 to 85 (with an average age of 52). The patients were randomly divided between one group that received five 30-minute sessions of acupuncture; another group that got five 30-minute sessions with a deactivated laser which had, in effect, been turned off to simulate acupuncture; and a third group having five 30-minute session of massage by experienced therapists.
The study concluded that “Acupuncture was an effective short-term treatment for patients with chronic neck pain, but there is only limited evidence for long-term effects after five treatments.” In other words, acupuncture works as long as it was being applied.
The massage group fared the poorest in both short-term and long-term benefits in this study and in quality of life measurements. All three groups failed miserably over the long-term. Fully two-thirds of the patients went on to seek other types of therapy in the period following up on the study.
This study showed no evidence that any of these treatments were beneficial for chronic neck pain.
Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain.
Smith LA, Oldman AD, McQuay HJ, Moore RA.
Pain Research, Nuffield Department of Anaesthetics, University of Oxford, The Churchill, Oxford Radcliffe Hospital, Headington, UK.
The objectives of the study were (1) to carry out a systematic review to assess the analgesic efficacy and the adverse effects of acupuncture compared with placebo for back and neck pain and (2) to develop a new tool, the Oxford Pain Validity Scale (OPVS), to measure validity of findings from randomized controlled trials (RCTs), and to enable ranking of trial findings according to validity within qualitative reviews. Published RCTs (of acupuncture at both traditional and non-traditional points) were identified from systematic searching of bibliographic databases (e.g. MEDLINE) and reference lists of retrieved reports. Pain outcome data were extracted with preference given to standardized outcomes such as pain intensity. Information on adverse effects was also extracted. All included trials were scored using a five-item 0-16 point validity scale (OPVS). The individual RCTs were ranked according to their OPVS score to enable more weight to be placed on the trials of greater validity when drawing an overall conclusion about the efficacy of acupuncture for relieving neck and back pain. Statistical analyses were carried out on the OPVS scores to assess the relationship between trial finding (positive or negative) and validity. Thirteen RCTs met the inclusion criteria. Five trials concluded that acupuncture was effective, and eight concluded that it was not effective for relieving back or neck pain. There was no obvious difference between the findings of trials using traditional and non-traditional points. Using the new OPVS scale, the validity scores of the included trials ranged from 4 to 14. There was no significant relationship between OPVS score and trial finding (positive versus negative). Authors' conclusions did not always agree with their data. We drew our own conclusions (positive/negative) based on the data presented in the reports. Re-analysis using our conclusions showed a significant relationship between OPVS score and trial finding, with higher validity scores associated with negative findings. OPVS is a useful tool for assessing the validity of trials in qualitative reviews. With acupuncture for chronic back and neck pain, we found that the most valid trials tended to be negative. There is no convincing evidence for the analgesic efficacy of acupuncture for back or neck pain.
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