Efficacy of chronic neck pain self-treatment using press needles: a randomized controlled clinical trial

Kaori Horike, Masatoshi Ukezono
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Abstract

Chronic neck pain is common among Japanese individuals, but few receive treatment. This randomized controlled trial aimed to evaluate the efficacy of acupuncture using press needles in the self-treatment of chronic neck pain and preliminarily identify the characteristics of patients likely to benefit from this treatment.Fifty participants with chronic neck pain were allocated to receive either press needle or placebo treatment for 3 weeks. The visual analogue scale (VAS) and motion-related VAS (M-VAS) scores for neck pain, Neck Disability Index score, and pressure pain threshold were measured at baseline, after the first session, at the end of the last session, and 1 week after the last session. Changes in the outcomes were analyzed using analysis of variance, and the relationships between the variables were evaluated using structural equation modeling.Intervention results as assessed by VAS score revealed no significant differences in the ANOVA. A between-groups comparison of M-VAS scores at the end of the last session and baseline showed a significant difference (press needle: −21.64 ± 4.47, placebo: −8.09 ± 3.81, p = 0.025, d = −0.65). Structural equation modeling revealed a significant pain-reducing effect of press needle treatment (β = −0.228, p = 0.049). Severity directly affected efficacy (β = −0.881, p < 0.001). Pain duration, baseline VAS and Neck Disability Index scores were variables explaining severity, while age and occupational computer use were factors affecting severity.Self-treatment with press needles for chronic neck pain did not significantly reduce the VAS score compared to placebo but reduced the motion-related pain as assessed by M-VAS score. A direct association was observed between pain severity and the effectiveness of press needles, and the impact of age and computer were indirectly linked by pain severity.Identifier UMIN-CTR, UMIN000044078.
使用按压针自我治疗慢性颈痛的疗效:随机对照临床试验
慢性颈部疼痛在日本人中很常见,但很少有人接受治疗。这项随机对照试验旨在评估使用按压针进行针灸自我治疗慢性颈部疼痛的疗效,并初步确定可能从这种治疗中受益的患者的特征。50 名慢性颈部疼痛患者被分配接受按压针或安慰剂治疗,为期 3 周。在基线、第一次治疗后、最后一次治疗结束时和最后一次治疗后一周,分别测量了颈部疼痛的视觉模拟量表(VAS)和运动相关VAS(M-VAS)评分、颈部残疾指数评分和压痛阈值。采用方差分析对结果的变化进行分析,并采用结构方程模型对变量之间的关系进行评估。最后一次疗程结束时的 M-VAS 评分与基线的组间比较显示存在显著差异(按压针:-21.64 ± 4.47,安慰剂:-8.09 ± 3.81,p = 0.025,d = -0.65)。结构方程模型显示,按压针治疗具有显著的镇痛效果(β = -0.228,p = 0.049)。严重程度直接影响疗效(β = -0.881,p < 0.001)。疼痛持续时间、基线 VAS 和颈部残疾指数评分是解释严重程度的变量,而年龄和职业计算机使用是影响严重程度的因素。与安慰剂相比,使用按压针进行慢性颈部疼痛的自我治疗并不能显著降低 VAS 评分,但却能降低用 M-VAS 评分评估的运动相关疼痛。疼痛严重程度与按压针的有效性之间存在直接联系,而年龄和电脑的影响则与疼痛严重程度间接相关。
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