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Ci-dessous, les différences entre deux révisions de la page.

--- acupuncture:evaluation:rhumatologie - orthopedie:03. douleurs musculo-squelettiques [11 Dec 2020 07:36]
Nguyen Johan Replacement automatique de '⊕ positive recommendation' par '⊕ positive recommendation '
+++ acupuncture:evaluation:rhumatologie - orthopedie:03. douleurs musculo-squelettiques [24 Oct 2025 11:38] (Version actuelle)
Nguyen Johan [1.2.1.1. Yu 2023]
@@ Ligne 1: / Ligne 1: @@
-====== Douleurs musculo-squelettiques : évaluation de l'acupuncture ======
+/*English:Musculoskeletal Pain*/
+=======  Musculoskeletal Pain  =======
+====== Douleurs musculo-squelettiques  ======
 ===== Systematic Reviews and Meta-Analysis=====
-|☆☆☆ |Evidence for effectiveness and a specific effect of acupuncture. |
-|☆☆| Evidence for effectiveness of acupuncture.|
-| ☆ |Preuves limitées qualitativement et/ou quantitativement en faveur d’une efficacité de l’acupuncture.|
-|Ø |No evidence or insufficient evidence.|
-==== Acupuncture générique  ====
+==== Generic Acupuncture ====
+=== Xiong 2024 ===
+Xiong J, Zhou X, Luo X, Gong X, Jiang L, Luo Q, Zhang S, Jiang C, Pu T, Liu J, Zhang J, Li B, Chi H. Acupuncture therapy on myofascial pain syndrome: a systematic review and meta-analysis. Front Neurol. 2024 May 3;15:1374542.  https://doi.org/10.3389/fneur.2024.1374542
+^Purpose| Traditional Chinese medicine (TCM) therapies, especially acupuncture, have received increasing attention in the field of pain management. This meta-analysis evaluated the effectiveness of acupuncture in the treatment of myofascial pain syndrome.|
+^Methods| A comprehensive search was conducted across a number of databases, including PubMed, Cochrane Library, WOS, CNKI, WANFANG, Sinomed, and VIP. Furthermore, articles of studies published from the inception of these databases until November 22, 2023, were examined. This systematic review and meta-analysis encompassed all randomized controlled trials (RCTs) on acupuncture for myofascial pain syndromes, without language or date restrictions. Based on the mean difference (MD) of symptom change, we critically assessed the outcomes reported in these trials. The quality of evidence was assessed using the Cochrane Risk of Bias Tool. The study is registered with PROSPERO under registration number CRD42023484933.|
+^Results| Our analysis included **10 RCTs in which 852 patients** were divided into two groups: an acupuncture group (427) and a control group (425). The results of the study showed that acupuncture was significantly more effective than the control group in treating myofascial pain syndromes, which was reflected in a greater decrease in VAS scores (MD = -1.29, 95% [-1.65, -0.94], p < 0.00001). In addition, the improvement in PRI and PPI was more pronounced in the acupuncture group (PRI: MD = -2.04, 95% [-3.76, -0.32], p = 0.02) (PPI: MD = -1.03, 95% [-1.26, -0.79], p < 0.00001) compared to the control group. |
+^Conclusions|These results suggest that acupuncture is effective in reducing myofascial pain. It is necessary to further study the optimal acupoints and treatment time to achieve the best therapeutic effect.|
+=== Lenoir 2020 ★★★ ===
+Lenoir D, De Pauw R, Van Oosterwijck S, Cagnie B, Meeus M. Acupuncture Versus Sham Acupuncture: A Meta-Analysis on Evidence for Longer-term Effects of Acupuncture in Musculoskeletal Disorders. Clin J Pain. 2020;36(7):533-549.   [221040]. #https://doi.org/10.1097/ajp.0000000000000812
+^Objective| Acupuncture is a common modality in the therapy of musculoskeletal disorders. The evidence for acupuncture has been examined frequently, but a clear synthesis of previous research is currently lacking. This meta-analysis aimed to summarize the evidence for nonimmediate effects of acupuncture on pain, functionality, and quality of life in patients with musculoskeletal disorders, when compared with sham acupuncture. |
+^Methods| Search results from PubMed and Web of Science were brought together. All screening procedures were executed twice by 2 independent researchers. The pooled standardized mean difference (SMD) with its confidence interval (CI) was estimated at follow-up at <1 month, 1 to 3 months, 3 to 6 months, and >6 months. |
+^Results|For pain, the SMD equalled respectively -0.47 (CI -0.76 to -0.19), -0.27 (CI -0.44 to -0.11), -0.32 (CI -0.51 to -0.13) and -0.12 (CI -0.36 to 0.11) for <1 month, 1 to 3 months, 3 to 6 months, and >6 months follow-up. For functionality, the pooled SMD equalled -0.43 (CI -0.76 to -0.10), -0.41 (CI -0.76 to -0.05), 0.07 (CI -0.22 to 0.36), and -0.13 (-0.46 to 0.19). In the area of QOL, pooled SMD of respectively 0.20 (CI 0.04 to 0.35), 0.19 (CI -0.01 to 0.39), 0.02 (CI -0.09 to 0.14) and -0.04 (CI -0.25 to 0.16) were obtained. |
+^Discussion| A significant difference in therapy effect, favoring acupuncture, was found for pain at <1 month, 1 to 3 months, and 3 to 6 months, as well as on quality of life at <1 month, and on functionality at <1 month and 1 to 3 months. |
@@ Ligne 32: / Ligne 50: @@
-=== Yuan 2016 ★ ===
+=== Yuan 2016 ★★★ ===
 Yuan QL, Wang P, Liu L, Sun F, Cai YS, Wu WT, Ye ML, Ma JT, Xu BB, Zhang YG. Acupuncture for musculoskeletal pain: A meta-analysis and meta-regression of sham-controlled randomized clinical trials. Sci Rep. 2016. {{:medias securises:acupuncture:evaluation:rhumatologie - orthopedie:yuan-164489.pdf|[164489].}}
@@ Ligne 56: / Ligne 74: @@
-=== Pfefer 2009 (tendinopathies) ★ ===
+=== Pfefer 2009 (tendinopathy) ★ ===
@@ Ligne 77: / Ligne 95: @@
 </wrap>
-==== Techniques particulières  ====
+==== Special Acupuncture Techniques  ====
-=== Acupotomie ===
+=== Sham Acupuncture ===
+== Yu 2023 ==
+Yu C, Zhang R, Shen B, Li X, Fang Y, Jiang Y, Jian G. Effects of sham acupuncture for chronic musculoskeletal pain syndrome: A systematic review and network meta-analysis of randomized controlled trials. Medicine (Baltimore). 2023 Nov 17;102(46):e35275.  https://doi.org/10.1097/MD.0000000000035275
+^Background| Acupuncture has been widely used for chronic musculoskeletal pain syndrome (MPS). Due to the strong influence of sham acupuncture (SA) in clinical trials, the treatment of MPS by acupuncture remains controversial. Different types of SA procedures might produce different responses. The purpose of this systematic review was to assess the effect of SA on MPS.|
+^Methods| We searched 8 literature databases for randomized controlled trials (RCTs) on acupuncture for chronic MPS with SA as a control from database inception to November 29, 2022. SA included superficial acupuncture on non-acupoints (SANAs), non-penetration on acupoints (NPAs), and non-penetration on non-acupoints (NPNAs). Two independent reviewers assessed the risk of bias and conducted the research selection, data extraction, and quality assessment of the included RCTs. We conducted data analysis using the RevMan 5.3 and STATA 14 software packages, and traditional meta-analysis was adopted for direct comparison. A network meta-analysis (NMA) was executed using frequency models in which we combined all available direct and indirect evidence from RCTs. The pain-related indicators were set as primary outcomes, and GRADEpro online was implemented for the assessment of evidence quality.|
+^Results| Forty-two RCTs were included in this study, encompassing a total of 6876 patients and incorporating 3 types of SA procedures. In our traditional meta-analysis, true acupuncture (TA) was more effective than SANAs, NPAs, and NPANAs concerning MPS. In the NMA, TA was the most effective modality, followed by SANAs, NPAs and NPANAs, and then the blank control (BC). In this NMA and according to the therapeutic effects in the pain indicators, the rankings of SA were as follows: SANA (surface under the cumulative ranking curve [SUCRA], 65.3%), NPA (SUCRA, 46.2%), and NPANA (SUCRA, 34.2%). The quality of the evidence for outcomes ranged from "low" to "moderate."|
+^Conclusions| Compared with SA, TA was effective in treating MPS. The effects produced by different SA procedures were different, and the order of effects from greatest to least was as follows: SANA, NPA, and NPANA.|
+=== Comparison of Acupuncture techniques ===
+== Liu 2025 ==
+Liu Z, Cheng Z, Zhang K, Lin X, Fu Y, Wang L, Zhang Q, Zhang F, Wu X, Dong B. Comparison of the efficacy of acupoint stimulation therapy in the treatment of pain in musculoskeletal diseases: A network meta-analysis based on randomized controlled trials. J Back Musculoskelet Rehabil. 2025 Jul 15:10538127251358729. https://doi.org/10.1177/10538127251358729
+^Background|Orthopedic patients often present with significant pain symptoms, which can impact both the physical and mental well-being of patients, emerging as a significant concern. Given its safety, effectiveness, and absence of side effects, acupoint therapy is being increasingly utilized in the pain management of orthopedic patients. This study conducted a network meta-analysis to compare analgesic efficacy, safety, and effectiveness of acupuncture (AP), electroacupuncture (EA), moxibustion, and acupressure, so as to provide a reference for the clinical application of acupoint therapies in managing orthopedic pain.|
+^Methods|Eight databases, including PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, and VIP, were searched for clinical randomized controlled trials (RCTs) investigating the effects of AP, EA, moxibustion, and acupressure on orthopedic pain. The quality of the included documents was evaluated using the Cochrane Risk of Bias Tool, and graphs regarding the risk of bias and network meta-analysis were drawn by Revman 5.2, Stata 18.0 and R software (v4.3.2). Intervention ranking probabilities were quantified using SUCRA values derived from a Bayesian random-effects model.|
+^Results|1) For decreasing Visual Analogue Scale (VAS) scores in patients with orthopedic pain, moxibustion therapy was identified as the optimal intervention (SUCRA=94.84%); 2) For decreasing VAS scores in patients with orthopedic pain undergoing surgical intervention, AP therapy was identified as the optimal intervention (SUCRA=76.99%); 3) For decreasing VAS scores in patients with orthopedic pain not undergoing surgical intervention, moxibustion therapy was identified as the optimal intervention (SUCRA=90.26%); 4) AP therapy (SUCRA=83.73%) demonstrated the most favorable safety profile; 5) Acupressure therapy (SUCRA=77.93%) was identified as the most effective therapeutic method.|
+^Conclusion|It is recommended to select differentiated acupoint therapies tailored to the type of orthopedic pain. Specifically, post-operative patients with orthopedic pain should prioritize AP, while moxibustion is advised for non-surgical patients.|
+=== Acupotomy ===
@@ Ligne 91: / Ligne 132: @@
 ^ Conclusion|This review shows that **MSN might have the effect on MPS**, even though there were some limitations in the studies included in the review. Studies with robust methodology are warranted to further test its pain-relieving effect on MPS.|
-=== Api-acupuncture ===
+=== Bee Acupuncture ===
@@ Ligne 105: / Ligne 146: @@
 ^ Results     | A total of 626 possibly relevant articles were identified, of which **11 RCTs** met our inclusion criteria. Four. RCTs that tested the effects of BVA plus classic acupuncture compared with saline injection plus classic acupuncture were included in the main meta-analysis. Pain was significantly lower with BVA plus classic acupuncture than with saline injection plus classic acupuncture (weighted mean difference: 100-mm visual analog scale, 14.0 mm, 95% Cl = 9.5-18.6, P < .001, n = 112; heterogeneity: 72 = 0, x2 = 1.92, P = .59, 12 = 0%). |
 ^ Conclusion  | Our results provide suggestive evidence for the effectiveness of BVA in treating musculoskeletal pain. However, the total number of RCTs included in the analysis and the total sample size were too small to draw definitive conclusions. |
 === Laser acupuncture ===
+== Hung 2021 ==
+Hung YC, Lin PY, Chiu HE, Huang PY, Hu WL. The Effectiveness of Laser Acupuncture for Treatment of Musculoskeletal Pain: A Meta-Analysis of Randomized Controlled Studies. J Pain Res. 2021:1707-1719. [219489]. [[https://doi.org/10.2147/jpr.s308876|doi]]
+^ Objective| To evaluate the treatment effectiveness of laser acupuncture (LA) in patients with musculoskeletal pain. |
+^ Methods| Major electronic databases, including Medline, PubMed, Embase, Cochrane Library, CINAHL, and Scopus were searched to identify double-blind, randomized controlled trials of LA in musculoskeletal disorders. The primary outcome was the treatment efficacy for pain. The secondary outcomes included the comparison of disability, functional impairment, and dropout rate between LA and sham treatment, as well as the effect of sham treatment for pain. The results from included studies were synthesized with the random effects model. |
+^ Results| In total, **20 articles** comprising 568 patients receiving LA and 534 patients receiving sham treatment were included in the current study. Our analysis showed LA significantly reduced pain (g=0.88, 95% confidence interval [CI]=0.35 to 1.42, p=0.001), disability (g=0.68, 95% CI=0.29 to 1.08, p<0.001), and functional impairment (g=0.67, 95% CI=0.32 to 1.03, p<0.001). Through meta-regression analysis, we found these effects were not moderated by mean age, the percentage of females, or treatment duration. Additionally, there was no significant difference between the two groups in dropout rate (risk ratio=0.73, p=0.08), and the sham treatment significantly reduced only pain intensity (g=0.54, 95% CI=0.32 to 0.77, p<0.001).|
+^Conclusion| Our findings supported that LA significantly reduced pain, disability, and functional impairment in patients with musculoskeletal disorders. Further researches are required to determine the optimal therapeutic parameters and the suitable patients for receiving LA.|
@@ Ligne 122: / Ligne 172: @@
 === Dry needling ===
+== Charles 2024 ==
+Charles D, Hudgins T, MacNaughton J, Newman E, Tan J, Wigger M. A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points. J Bodyw Mov Ther. 2019 Jul;23(3):539-546.  https://doi.org/10.1016/j.jbmt.2019.04.001
+^Introduction| Myofascial pain with myofascial triggers are common musculoskeletal complaints. Popular treatments include manual therapy, dry needling, and dry cupping. The purpose of this systematic review was to compare the efficacy of each treatment in the short-term relief of myofascial pain and myofascial trigger points.|
+^Methods| Search engines included Google Scholar, EBSCO Host, and PubMed. Searches were performed for each modality using the keywords myofascial pain syndrome and myofascial trigger points. The inclusion criteria included English-language, peer-reviewed journals; a diagnosis of myofascial pain syndrome or trigger points; manual therapy, dry needling, or dry cupping treatments; retrospective studies or prospective methodology; and inclusion of outcome measures.|
+^Results| Eight studies on manual therapy, twenty-three studies on dry needling, and two studies on dry cupping met the inclusion criteria. The Physiotherapy Evidence Database (PEDro) was utilized to assess the quality of all articles.|
+^Discussion|While there was a moderate number of randomized controlled trials supporting the use of manual therapy, the evidence for dry needling ranged from very low to moderate compared to control groups, sham interventions, or other treatments and there was a paucity of data on dry cupping. Limitations included unclear methodologies, high risk for bias, inadequate blinding, no control group, and small sample sizes.|
+^Conclusion| While there is moderate evidence for manual therapy in myofascial pain treatment, the evidence for dry needling and cupping is not greater than placebo. Future studies should address the limitations of small sample sizes, unclear methodologies, poor blinding, and lack of control groups.|
+== Griswold 2024 ==
+Griswold D, Learman K, Ickert E, Clewley D, Donaldson MB, Wilhelm M, Cleland J. Comparing dry needling or local acupuncture to various wet needling injection types for musculoskeletal pain and disability. A systematic review of randomized clinical trials. Disabil Rehabil. 2024 Feb;46(3):414-428.  https://doi.org/10.1080/09638288.2023.2165731
+^Purpose| Systematically evaluate the comparative effectiveness of dry needling (DN) or local acupuncture to various types of wet needling (WN) for musculoskeletal pain disorders (MPD).|
+^Methods| Seven databases (PubMed, PEDro, SPORTDiscus, CINAHL, Scopus, Embase, and Cochrane Central Register of Controlled Trials) were searched following PROSPERO registration. Randomized clinical trials were included if they compared DN or local acupuncture with WN for MPD. Primary outcomes were pain and/or disability. The Revised Cochrane Collaboration tool (RoB 2.0) assessed the risk of bias.|
+^Results| **Twenty-six studies** were selected. Wet Needling types included cortisone (CSI) (N = 5), platelet-rich plasma (PRP) (N = 6), Botox (BoT) (N = 3), and local anesthetic injection (LAI) (N = 12). Evidence was rated as low to moderate quality. Results indicate DN produces similar effects to CSI in the short-medium term and superior outcomes in the long term. In addition, DN produces similar outcomes compared to PRP in the short and long term and similar outcomes as BoT in the short and medium term; however, LAI produces better pain outcomes in the short term.|
+^Conclusion| Evidence suggests the effectiveness of DN to WN injections is variable depending on the injection type, outcome time frame, and diagnosis. In addition, adverse event data were similar but inconsistently reported.|
+== Khan 2021 ==
+Khan I, Ahmad A, Ahmed A, Sadiq S, Asim HM. Effects of dry needling in lower extremity myofascial trigger points. J Pak Med Assoc. 2021 Nov;71(11):2596-2603.  [[https://doi.org/10.47391/JPMA.01398]]
+== Sousa Filho 2021 ==
+Sousa Filho LF, Barbosa Santos MM, Dos Santos GHF, da Silva Júnior WM. Corticosteroid injection or dry needling for musculoskeletal pain and disability? A systematic review and GRADE evidence synthesis. Chiropr Man Therap. 2021 Dec 2;29(1):49. [[https://doi.org/10.1186/s12998-021-00408-y]]
 == Gattie 2017 ★★ ==
@@ Ligne 208: / Ligne 286: @@
 ^ Conclusion  | In conclusion, **there is limited evidence deriving from one study that deep needling directly into myofascial trigger points has an overall treatment effect when compared with standardised care**. Whilst the result of the meta-analysis of needling compared with placebo controls does not attain statistically significant, the overall direction could be compatible with a treatment effect of dry needling on myofascial trigger point pain. However, the limited sample size and poor quality of these studies highlights and supports the need for large scale, good quality placebo controlled trials in this area. |
-=== Cummings 2002 ★ ===
+== Cummings 2002 ★ ==
 Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil. 2001;82(7):986-92.  {{:medias securises:acupuncture:evaluation:rhumatologie - orthopedie:cummings-70878.pdf|[70878].}}
 ^Objective|To establish whether there is evidence for or against the  efficacy of needling as a treatment approach for myofascial trigger  point pain.|
@@ Ligne 217: / Ligne 295: @@
+=== Auricular acupuncture ===
+== Choi 2022 ==
-==== Formes cliniques particulières ====
+Choi SY, Kim YJ, Kim B. [Effect of Auriculotherapy on Musculoskeletal Pain: A Systematic Review and Meta-Analysis]. J Korean Acad Nurs. 2022 Feb;52(1):4-23. Korean.  https://doi.org/10.4040/jkan.21121
-=== Douleurs musculo-squelettiques de la tête et du cou ===
+^Purpose|The aim of this study was to evaluate the effect of auriculotherapy on musculoskeletal pain in adults.|
+^Methods| A total of 885 studies were retrieved from nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS). Sixteen studies were selected for meta-analysis, which satisfied the inclusion criteria and the evaluation of risk of bias. Demographic data, auriculotherapy types, intervention characteristics, auricular points, and outcomes related to pain (subjective pain scale, and amount of analgesic) were extracted from all included studies. The effect size of auriculotherapy was analyzed through comprehensive meta analysis 3.0, and the presence of publication bias was analyzed through a funnel plot and Egger's regression.|
+^Results| The results of the meta-analysis (**n = 16**) revealed that the auriculotherapy was significantly superior to the control group on present pain in adults (Hedges' g = -0.35, 95% Confidence Interval [CI] = -0.55~-0.15). According to the results of subgroup analysis, the effect size of auricular acupuncture therapy (Hedges' g = 0.45, 95% CI = -0.75~-0.15) was higher than the auricular acupuncture (Hedges' g = 0.27, 95% CI = -0.53~0.00): the longer the intervention period, the greater the effect size.|
+^Conclusion| In this study, auriculotherapy demonstrates a significant reduction in musculoskeletal pain in adults. Therefore, it is necessary to refine the curriculum to include auriculotherapy as a nursing intervention to relieve musculoskeletal pain in adults and encourage its use in clinical settings.|
+=== Cupping ===
+== Charles 2024 ==
+Charles D, Hudgins T, MacNaughton J, Newman E, Tan J, Wigger M. A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points. J Bodyw Mov Ther. 2019 Jul;23(3):539-546.  https://doi.org/10.1016/j.jbmt.2019.04.001
+^Introduction| Myofascial pain with myofascial triggers are common musculoskeletal complaints. Popular treatments include manual therapy, dry needling, and dry cupping. The purpose of this systematic review was to compare the efficacy of each treatment in the short-term relief of myofascial pain and myofascial trigger points.|
+^Methods| Search engines included Google Scholar, EBSCO Host, and PubMed. Searches were performed for each modality using the keywords myofascial pain syndrome and myofascial trigger points. The inclusion criteria included English-language, peer-reviewed journals; a diagnosis of myofascial pain syndrome or trigger points; manual therapy, dry needling, or dry cupping treatments; retrospective studies or prospective methodology; and inclusion of outcome measures.|
+^Results| Eight studies on manual therapy, twenty-three studies on dry needling, and two studies on dry cupping met the inclusion criteria. The Physiotherapy Evidence Database (PEDro) was utilized to assess the quality of all articles.|
+^Discussion|While there was a moderate number of randomized controlled trials supporting the use of manual therapy, the evidence for dry needling ranged from very low to moderate compared to control groups, sham interventions, or other treatments and there was a paucity of data on dry cupping. Limitations included unclear methodologies, high risk for bias, inadequate blinding, no control group, and small sample sizes.|
+^Conclusion| While there is moderate evidence for manual therapy in myofascial pain treatment, the evidence for dry needling and cupping is not greater than placebo. Future studies should address the limitations of small sample sizes, unclear methodologies, poor blinding, and lack of control groups.|
+== Mohamed 2023 ==
+Mohamed AA, Zhang X, Jan YK. Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: A systematic and evidence-based review. J Back Musculoskelet Rehabil. 2023;36(1):3-19.  https://doi.org/10.3233/BMR-210242
+^Backgound| Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence to support its use in managing musculoskeletal and sports conditions remains unknown.|
+^Objective| To evaluate the evidence level of the effect of cupping therapy in managing common musculoskeletal and sports conditions.|
+^Methods| 2214 studies were identified through a computerized search, of which **22 met the inclusion criteria**. The search involved randomized and case series studies published between 1990 and 2019. The search involved five databases (Scopus, MEDLINE (PubMed), Web of Science, Academic Search Complete PLUS (EBSCO), and CrossRef) and contained studies written in the English language. Three analyses were included: the quality assessment using the PEDro scale, physical characteristic analysis, and evidence-based analysis.|
+^Results| The results showed that most studies used dry cupping, except five which used wet cupping. Most studies compared cupping therapy to non-intervention, the remaining studies compared cupping to standard medical care, heat, routine physiotherapy, electrical stimulation, active range of motion and stretching, passive stretching, or acetaminophen. Treatment duration ranged from 1 day to 12 weeks. The evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low. The incidence of adverse events is very low.|
+^Conclusion| This study provides the first attempt to analyze the evidence level of cupping therapy in musculoskeletal and sports rehabilitation. However, cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation and might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area with low adverse effects.|
+== Woods 2020 ==
+Wood S, Fryer G, Tan LLF, Cleary C. Dry cupping for musculoskeletal pain and range of motion: A systematic review and meta-analysis. J Bodyw Mov Ther. 2020 Oct;24(4):503-518.  https://doi.org/10.1016/j.jbmt.2020.06.024
+^Objectives| This review evaluated the efficacy and safety of western dry cupping methods for the treatment of musculoskeletal pain and reduced range of motion.|
+^Methods| A systematic literature search was performed until April 2018 for randomised controlled trials (RCTs) pertaining to musculoskeletal pain or reduced range of motion, treated with dry cupping. Outcomes were pain, functional status, range of motion and adverse events. Risk of bias and quality of evidence was assessed using the modified Downs & Black (D&B) checklist and GRADE.|
+^Results| A total of **21 RCTs with 1049 participants** were included. Overall, the quality of evidence was fair, with a mean D&B score of 18/28. Low-quality evidence revealed dry cupping had a significant effect on pain reduction for chronic neck pain (MD, -21.67; 95% CI, -36.55, to -6.80) and low back pain (MD, -19.38; 95%CI, -28.09, to -10.66). Moderate-quality evidence suggested that dry cupping improved functional status for chronic neck pain (MD, -4.65; 95%CI, -6.44, to -2.85). For range of motion, low quality evidence revealed a significant difference when compared to no treatment (SMD, -0.75; 95%CI, -0.75, to -0.32).|
+^Conclusion| Dry cupping was found to be effective for reducing pain in patients with chronic neck pain and non-specific low back pain. However, definitive conclusions regarding the effectiveness and safety of dry cupping for musculoskeletal pain and range of motion were unable to be made due to the low-moderate quality of evidence. Further high-quality trials with larger sample sizes, long-term follow up, and reporting of adverse events are warranted.|
+==== Specific outcomes ====
+=== Neuroimaging studies ===
+=== Ha 2022 ===
+Ha G, Tian Z, Chen J, Wang S, Luo A, Liu Y, Tang J, Lai N, Zeng F, Lan L. Coordinate-based (ALE) meta-analysis of acupuncture for musculoskeletal pain. Front Neurosci. 2022 Jul 22;16:906875.  https://doi.org/10.3389/fnins.2022.906875
+^Background|Neuroimaging studies have been widely used to investigate brain regions' alterations in musculoskeletal pain patients. However, inconsistent results have hindered our understanding of the central modulatory effects of acupuncture for musculoskeletal pain. The main objective of our investigation has been to obtain comprehensive evidence of acupuncture for musculoskeletal pain diseases.|
+^Methods| The PubMed, Web of Science, Google Scholar, Embase, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine disc Database, Clinical Trial Registration Platform, and Wanfang Database were searched for neuroimaging studies on musculoskeletal pain diseases published from inception up to November 2021. Then, the relevant literature was screened to extract the coordinates that meet the criteria. Finally, the coordinate-based meta-analysis was performed using the activation likelihood estimation algorithm.|
+^Results| A total of **15 neuroimaging studies** with 183 foci of activation were included in this study. The ALE meta-analysis revealed activated clusters in multiple cortical and sub-cortical brain structures in response to acupuncture across studies, including the thalamus, insula, caudate, claustrum, and lentiform nucleus.|
+^Conclusions| The studies showed that acupuncture could modulate different brain regions, including the thalamus, insula, caudate, claustrum, and lentiform nucleus. The findings offer several insights into the potential mechanisms of acupuncture for musculoskeletal pain and provide a possible explanation for the observed clinical benefit of this therapy.|
+==== Special Clinical Forms ====
+=== Myofascial Head and Neck Pain ===
 == Farag 2020 ==
@@ Ligne 235: / Ligne 369: @@
-=== Douleurs musculo-squelettiques des extrémités ===
+=== Musculoskeletal Disorders of the Extremities ===
 == Cox 2016 ★ ==
@@ Ligne 245: / Ligne 379: @@
 ^Results| The search revealed 5180 articles; **15 were included** (10 with a low risk of bias, 5 with a high risk of bias). The studies with a low risk of bias suggested that (1) traditional needle acupuncture was superior to oral steroids (1 RCT, n = 77) and may be superior to vitamin B1/B6 supplements (1 RCT, n = 64) for carpal tunnel syndrome (CTS), and was superior to exercise for Achilles tendinopathy (1 RCT, n = 64). Traditional needle acupuncture did not provide important benefit over placebo for upper extremity pain (1 RCT, n = 128), or no intervention for patellofemoral pain (1 RCT, n = 75), and was inconclusive for shoulder pain (2 RCTs, n = 849), suggesting no important benefit; (2) electroacupuncture may be superior to placebo for shoulder injuries (1 RCT, n = 130) and may not be superior to night splinting for persistent CTS (1 RCT, n = 78); and (3) dry needling may be superior to placebo for plantar fasciitis (1 RCT, n = 84). Sensitivity analysis suggests that including studies with a high risk of bias might have impacted the evidence synthesis in support of managing shoulder pain with traditional needle acupuncture, and that would suggest traditional needle acupuncture may be effective for lateral epicondylitis and piriformis syndrome. |
 ^Conclusion| **Evidence for the effectiveness of acupuncture for musculoskeletal disorders of the extremities was inconsistent**. Traditional needle acupuncture may be beneficial for CTS and Achilles tendinopathy, but not for nonspecific upper extremity pain and patellofemoral syndrome. Electroacupuncture may be effective for shoulder injuries and may show similar effectiveness to that of night wrist splinting for CTS. The effectiveness of dry needling for plantar fasciitis is equivocal. Level of Evidence Therapy, 1a-.|
+=== Hand and Wrist Pain ===
+== Trinh 2022 ==
-===== Overview of Systematic Reviews =====
-== Lorenc 2018 (association à pathologie mentale) ==
+Trinh K, Zhou F, Belski N, Deng J, Wong CY. The Effect of Acupuncture on Hand and Wrist Pain Intensity, Functional Status, and Quality of Life in Adults: A Systematic Review. Med Acupunct. 2022 Feb 1;34(1):34-48.  https://doi.org/10.1089/acu.2021.0046
+^Objective| This systematic review examined the effects of acupuncture on hand-and-wrist pain intensity, functional status, quality of life, and incidence of adverse effects in adults. |
+^Methods| Searches of 6 databases and previous reviews for randomized controlled trials (RCTs) were performed. Each outcome was analyzed for participant conditions, interventions, controls, and follow-up times determined a priori. Active controls were excluded. Follow-up periods were based on Cochrane 5.1.0 guidelines. The results were tabulated and described narratively.|
+^ Results| In the **10 included RCTs (622 participants)**, 6 had a low risk of bias. For cryotherapy-induced pain, 1 trial showed significant pain reduction post treatment. For rheumatoid arthritis, 1 trial shown significant pain reduction and function improvements post treatment and short-term. For carpal tunnel syndrome, 1 trial showed significant pain reduction and functional improvements intermediate-term, while 3 trials suggested no significant difference. For tenosynovitis, 1 trial showed significant pain reduction and function improvements short-term. For poststroke impairments, 1 trial showed significant function improvements post treatment and at short-term, while another trial suggested no significant difference. No significant improvements were noted for trapezio-metacarpal joint osteoarthritis. In 2 trials, adverse effects occurred in patients with carpal tunnel syndrome; yet acupuncture appeared to be relatively safe. |
+^Conclusions |Acupuncture may be effective and safe for short-term pain reduction and functional improvement in hand-and-wrist conditions. Clinicians should interpret the results with caution due to small sample sizes and clinical heterogeneity. Future research is warranted.|
+===== Overviews of Systematic Reviews =====
+== Lorenc 2018 (Musculoskeletal and Mental Health Condition) ==
@@ Ligne 263: / Ligne 406: @@
-===== Guidelines =====
+===== Clinical Practice Guidelines =====
+| ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) |
+==== American Psychological Association (APA, USA) 2024 ⊕ ====
-| ⊕ positive recommendation (quel que soit le niveau de preuve annoncé) \\ Ø recommandation négative (ou absence de preuve) |
+American Psychological Association (2024). Guideline for Psychological and Other Nonpharmacological Treatment of Chronic Musculoskeletal Pain in Adults. Retrieved from https://www.apa.org/practice/guidelines/nonpharmacological-treatment-chronic-musculoskeletal-pain.pdf
+| For patients with //chronic LBP//, the panel suggests offering patients the following interventions over usual care, attention control, or another intervention (Strength/Direction: Conditional For) : Acupuncture for short-term pain management. \\ For patients //with chronic neck pain//, the panel suggests offering patients acupuncture over sham, placebo, or usual care for shortand intermediate-term pain relief (Strength/Direction: Conditional For).|
 ==== Institute for Clinical Systems Improvement. (ICSI, USA) 2017 ⊕ ====
@@ Ligne 306: / Ligne 454: @@
 | The evidence for the effectiveness of acupuncture is most convincing for the treatment of chronic neck and shoulder pain. In terms of other injuries, the evidence is either inconclusive or insufficient. The state of the evidence on the effectiveness of acupuncture is not dissimilar to other physical therapies such as physiotherapy, chiropractic and osteopathy. \\ // General // \\ - There is insufficient evidence to make a recommendation for the use of acupuncture in the management of acute neck, back or shoulder pain \\ - There is emerging evidence that acupuncture may enhance/facilitate other conventional therapies (including physiotherapy & exercise-based therapies) \\ - There is a paucity of research for the optimal dosage of acupuncture treatment for treating shoulder, knee, neck and lower back pain \\ - Studies comparing effective conservative treatments (including simple analgesics, physical therapy, exercise, heat & cold therapy) for (sub) acute and chronic non-specific low back pain (LBP) have been largely inconclusive. \\ //Lower back// \\ - The evidence for the use of acupuncture in (sub)acute LBP is inconclusive \\ - There is limited evidence to support the use of acupuncture for pain relief in chronic LBP in the short term (up to 3 months) \\ - The evidence is inconclusive for the use of acupuncture for long term (beyond 3 months) pain relief in chronic LBP \\ - There is no evidence to recommend the use of acupuncture for lumbar disc herniation related radiculopathy (LDHR)  \\ //Neck// \\ - There is good evidence that acupuncture is effective for short term pain relief in the treatment of chronic neck pain \\ - There is moderate evidence that real acupuncture is more effective than sham acupuncture for the treatment of chronic neck pain \\ - There is limited evidence that acupuncture has a long term effect on chronic neck pain \\ Shoulder \\ - There is good evidence from one pragmatic trial that acupuncture improves pain and mobility in chronic shoulder pain \\ - There is limited evidence for the efficacy of acupuncture for frozen shoulder \\ - There is contradictory evidence for the efficacy of acupuncture for subacromial impingement syndrome \\ //Knee// \\ - There is no evidence to recommend the use of acupuncture for injury-related knee pain. \\ //Ankle:// \\ - There is no evidence to recommend the use of acupuncture for ankle pain |
+===== Overviews of Clinical Practice Guidelines =====
+==== Ho 2025 ====
+Ho L, Lai CNT, Chen H, Law SW, Yu ECL, Lam FPY, Cheung YC, Wu IX, Wong SYS, Sit RWS. Systematic review of clinical practice guidelines on acupuncture for chronic musculoskeletal pain. BMC Complement Med Ther. 2025 Sep 1;25(1):322. https://doi.org/10.1186/s12906-025-05070-y
+^Background|Acupuncture is increasingly utilised in primary care to manage chronic musculoskeletal pain, supported by a growing body of evidence. This rising adoption has driven demand for clinical practice guidelines (CPGs). We summarised the characteristics of recent acupuncture CPGs for osteoarthritis, low back pain, neck pain, and shoulder pain, and critically appraised their methodological quality.|
+^Methods|We searched nine databases to identify acupuncture CPGs published from January 2014 to November 2024. Eligible CPGs were required to be developed by guideline committees and to include evidence-informed recommendations linked to clearly defined levels of evidence. Two independent reviewers extracted CPG characteristics and assessed methodological quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.|
+^Results|Of the 1,999 records screened, **17 CPGs were included, encompassing 35 recommendations**. Shoulder pain was the most addressed condition (n = 14), followed by low back pain (n = 11), osteoarthritis (n = 8), and neck pain (n = 2). Various types of acupuncture were considered, with manual acupuncture featuring in most (n = 26) recommendations. Overall, 60% of the recommendations supported the use of acupuncture, comprising 5.7% strong recommendations and 54.3% weak or conditional recommendations. In contrast, 22.9% of recommendations offered no explicit guidance, while 17.1% advised against its use. Methodological assessment classified 10 CPGs as high quality, while seven were of moderate quality.|
+^Conclusion|Contradictions exist among the included CPGs regarding whether acupuncture should be recommended for routine practice, potentially reflecting differences in clinical and cultural contexts. Local CPGs should be developed using rigorous methodology, ensuring the involvement of local stakeholders. An AGREE II extension should be developed for the methodological quality assessment of acupuncture CPGs.|

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