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| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:evaluation:rhumatologie - orthopedie:12. cervicalgies [06 Oct 2022 08:53] Nguyen Johan [1.2. Special Acupuncture Techniques] |
acupuncture:evaluation:rhumatologie - orthopedie:12. cervicalgies [23 Oct 2025 07:59] (Version actuelle) Nguyen Johan [3. Clinical Practice Guidelines] |
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| ===== Systematic Reviews and Meta-Analysis===== | ===== Systematic Reviews and Meta-Analysis===== | ||
| - | |☆☆☆ |Evidence for effectiveness and a specific effect of acupuncture. | | + | |
| - | |☆☆| Evidence for effectiveness of acupuncture.| | + | |
| - | | ☆ |Evidence for effectiveness of acupuncture mais limitées qualitativement et/ou quantitativement.| | + | |
| - | |Ø |No evidence or insufficient evidence.| | + | |
| ==== Generic Acupuncture ==== | ==== Generic Acupuncture ==== | ||
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| + | === Fang 2024 === | ||
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| + | Fang J, Shi H, Wang W, Chen H, Yang M, Gao S, Yao H, Zhu L, Yan Y, Liu Z. Durable Effect of Acupuncture for Chronic Neck Pain: A Systematic Review and Meta-Analysis. Curr Pain Headache Rep. 2024 Sep;28(9):957-969. https://doi.org/10.1007/s11916-024-01267-x | ||
| + | ^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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| + | === Yu 2024 === | ||
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| + | Yu B, Yang Y, Fang J, Guo Y, Qiu Y, Yang S, Ran S, Zheng K, Wang T, Huang Y. Efficacy and safety of acupuncture treatment for stiff neck: A systematic review and meta-analysis. Medicine (Baltimore). 2024 Nov 8;103(45):e40415. https://doi.org/10.1097/MD.0000000000040415 | ||
| + | ^Backgound| Stiff neck is a common acute musculoskeletal condition that significantly affects the quality of life of patients. Acupuncture is recommended as an effective method for alleviating pain and restoring neck mobility in patients with stiff neck, but there is currently a lack of scientific evidence supporting its efficacy and safety. The purpose of this study was to investigate the efficacy and safety of acupuncture in the treatment of stiff neck.| | ||
| + | ^Method| This study searched 8 Chinese and English electronic medical databases, including China Biology Medicine disc, VIP database, Wanfang Data, China National Knowledge Infrastructure, Web of Science, PubMed, Embase, and the Cochrane Library, with a search period up to May 13, 2024. The focus was on clinical randomized controlled trials evaluating acupuncture treatment for stiff neck. The primary outcome measures were the total effective rate and visual analog scale scores. The quality of evidence and methodology of the included studies were assessed according to the GRADEpro guidelines. Meta-analysis was conducted to assess the results, with heterogeneity analysis, sensitivity analysis, subgroup analysis, trial sequential analysis, and publication bias analysis performed to verify the robustness of the combined results and explore potential sources of heterogeneity.| | ||
| + | ^Result| This study evaluated **10 clinical randomized controlled trials** comparing acupuncture therapy with conventional treatment, involving **754 patients**. The treatment group received acupuncture alone or in combination with conventional treatment, whereas the control group received only conventional treatment. The analysis results showed that the treatment group was significantly superior to the control group in improving the total effective rate (risk ratio = 1.12, 95% confidence interval [CI] [1.04, 1.21], P = .002), reducing visual analog scale scores (mean difference [MD] = -0.93, 95% CI [-1.29, -0.57], P < .001), reducing neck disability index scores (MD = -6.39, 95% CI [-6.79, -6.00], P < .001), and restoring cervical range of motion (cervical lateral flexion: MD = 4.29, 95% CI [3.15, 5.43], P < .001; cervical rotation: MD = 6.08, 95% CI [4.46, 7.70], P < .001).| | ||
| + | ^Conclusion| Acupuncture is an effective and safe method for treating stiff neck. However, to validate this conclusion, more rigorously designed and higher-quality studies are needed in the future.| | ||
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| + | === Castellani 2022 (network meta-analysis) === | ||
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| + | Castellini G, Pillastrini P, Vanti C, Bargeri S, Giagio S, Bordignon E, Fasciani F, Marzioni F, Innocenti T, Chiarotto A, Gianola S, Bertozzi L. Some conservative interventions are more effective than others for people with chronic non-specific neck pain: a systematic review and network meta-analysis. J Physiother. 2022 Oct;68(4):244-254. https://doi.org/10.1016/j.jphys.2022.09.007 | ||
| + | ^Question| Which is the most effective conservative intervention for patients with non-specific chronic neck pain (CNSNP)?| | ||
| + | ^Design| A systematic review and network meta-analysis of randomised clinical trials.| | ||
| + | ^Participants| Adults with CNSNP of at least 3 months duration.| | ||
| + | ^Interventions| All available pharmacological and non-pharmacological interventions.| | ||
| + | ^Outcome measure|The primary outcomes were pain intensity and disability. The secondary outcome was adverse events.| | ||
| + | ^Results|Overall, 119 RCTs (12,496 patients; 32 interventions) were included. Risk of bias was low in 50.4% of trials, unclear in 22.7% and high in 26.9%. Compared with inert treatment, a combination of active and/or passive multimodal non-pharmacological inventions (eg, exercise and manual therapy) were effective for pain on a 0-to-10 scale at 1 month (MD range 0.84 to 3.74) and at 3 to 6 months (MD range 1.06 to 1.49), and effective on disability on a 0-to-100 scale at 1 month (MD range 10.26 to 14.09) and 3 to 6 months (MD range 5.60 to 16.46). These effects ranged from possible to definite clinical relevance. Compared with inert treatment, anti-inflammatory drugs alone or in combination with another non-pharmacological treatment did not reduce pain at 1 month or 3 to 6 months. At 12 months, no superiority was found over inert treatment on both outcomes. Most mild adverse events were experienced following **acupuncture/dry needling intervention**. On average, the evidence varied from low to very low certainty.| | ||
| + | ^Conclusions|While multimodal non-pharmacological interventions may reduce pain and disability for up to 3 to 6 months of follow-up when compared with inert treatment, the evidence was very uncertain about their effects. Better quality and larger trials are needed to improve the certainty of evidence.| | ||
| === Seo 2017 Ø=== | === Seo 2017 Ø=== | ||
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| === Comparison of acupuncture techniques === | === Comparison of acupuncture techniques === | ||
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| + | == Lin 2024 == | ||
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| + | Lin Y, Zhong S, Huang C, Zhang G, Jiang G. The efficacy of acupuncture therapies in cervical spondylotic radiculopathy: A network meta-analysis. Heliyon. 2024 May 27;10(11):e31793. https://doi.org/10.1016/j.heliyon.2024.e31793 | ||
| + | ^Objective| To evaluate the efficacy of acupuncture-related therapy in the Bayesian setting by means of a network Meta-analysis.| | ||
| + | ^Methods| Relevant clinical randomized controlled trials(RCTs) of acupuncture-related therapy for Cervical Spondylotic Radiculopathy(CSR) were searched in the Chinese and English databases from the inception to November 13, 2023. Two researchers reviewed the literature, extracted the data, assessed the risk of bias of the included studies independently, and then used Stata14.0 and WinBUGs14 to analyze.| | ||
| + | ^Results| There are **28 RCTs** in total, of which **2593 patients** and 14 acupuncture interventions. Network Meta-analysis revealed that, regarding the VAS scores, Acupoint catgut-embedding, Fu's Subcutaneous Needling and Needle Knife are better than Conventional acupuncture, Electro-acupuncture, Sham needle, Western Medicine, and Electrotherapy; Conventional acupuncture is better than Electrotherapy and Sham needle; Qihuang needle is superior to Sham needle and Electrotherapy; besides, Acupoint catgut-embedding is better than Tuina (Message), Chinese Medicine, Warm needle as well. Regarding the NDI scores, Needle Knife, Warm needle, Fire needle, Long round needle, Acupoint catgut-embedding are better than Conventional acupuncture, Electro-acupuncture, and Cervical traction; Conventional acupuncture is superior to Electro-acupuncture, Cervical traction, Needle Knife and Warm needle; whereas we found Qihuang needle is superior to Acupoint catgut-embedding, besides, Need Knife is superior to Qihuang needle, Long round needle and Acupoint catgut-embedding. In terms of improving the Tanaka Yasuhiro 20-point scale scores(TY), Needle Knife and Qihuang needle are superior to Conventional acupuncture, Warm needle and Electro-acupuncture; moreover, Conventional acupuncture is better than Warm needle.| | ||
| + | ^Conclusion| In general, Acupoint catgut-embedding shows the best effect at relieving neck pain, then followed by Fu's Subcutaneous Needling and Needle Knife. Needle Knife is the best intervention in improving the functionality of the cervical spine. Like improving overall clinical performance, Needle Knife is the best treatment. Furthermore, our conclusion still needs to be confirmed by higher-quality documentation. In order to choose the best treatment for patients, clinicians are expected to take into account different clinical features and practical clinical settings with caution while choosing an acupuncture-related therapy in CSR.| | ||
| + | ^Key message| This article aims at selecting the best acupuncture-related treatment for clinicians to help patients in CSR, and the results of this study indicated that Acupoint catgut-embedding shows the best effect in relieving neck pain, Needle Knife shows the best effect in improving the functionality of cervical spine, Needle Knife shows the best effect in treating overall clinical performance.| | ||
| == Jo 2022 == | == Jo 2022 == | ||
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| + | ==== German Society of General Practice and Family Medicine (DEGAM, Germany) 2025 ⊕ ==== | ||
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| + | El-Allawy A, Hecht N, Luedtke K, Schleicher P, Weidner N, Kötter T. Clinical Practice Guideline: Nonspecific Neck Pain. Dtsch Arztebl Int. 2025 Oct 3;122(20):552-557. https://doi.org/10.3238/arztebl.m2025.0119 | ||
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| + | |Acupuncture (for the treatment of chronic nonspecific neck pain in combination with activating methods; LoE I)| | ||
| + | ==== American Psychological Association (APA, USA) 2024 ⊕ ==== | ||
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| + | 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 | ||
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| + | | 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).| | ||
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| + | ==== Centers for Disease Control and Prevention (CDC, USA) 2022 ⊕==== | ||
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| + | Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022. MMWR Recomm Rep. 2022 Nov 4;71(3):1-95. https://doi.org/10.15585/mmwr.rr7103a1 | ||
| + | | Clinicians should recommend appropriate noninvasive nonpharmacologic approaches to help manage chronic pain, such as [...] mind-body practices (e.g., yoga, tai chi, or qigong), massage, and **acupuncture** for //neck pain//. || | ||
| ==== American Academy of Family Physicians (AAFP, USA) 2021 ⊕ ==== | ==== American Academy of Family Physicians (AAFP, USA) 2021 ⊕ ==== | ||
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| + | ==== Canadian Chiropractic Association (CCA, Canada) 2016 Ø ==== | ||
| + | Bussières AE, Stewart G, Al-Zoubi F, Decina P, Descarreaux M, Hayden J, Hendrickson B, Hincapié C, Pagé I, Passmore S, Srbely J, Stupar M, Weisberg J, Ornelas J. The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. J Manipulative Physiol Ther. 2016 Oct;39(8):523-564.e27. https://doi.org/10.1016/j.jmpt.2016.08.007 | ||
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| + | | Treatment Interventions That Should NOT Be Offered for Neck Pain–Associated Disorders (NAD) grade I-II : electroacupuncture | | ||
| ==== Ontario Protocol for Traffic InjuryManagement Collaboration ((OPTIMa, Canada) 2016 Ø ==== | ==== Ontario Protocol for Traffic InjuryManagement Collaboration ((OPTIMa, Canada) 2016 Ø ==== | ||
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| |//Neck pain//. Acupuncture. Evidence Force 3 - Limited scientific evidence \\ //Whiplash-related pain//. Acupuncture. Evidence Force 3 - Limited scientific evidence | | |//Neck pain//. Acupuncture. Evidence Force 3 - Limited scientific evidence \\ //Whiplash-related pain//. Acupuncture. Evidence Force 3 - Limited scientific evidence | | ||
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| + | ===== Review of Clinical Practice Guidelines ===== | ||
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| + | ==== Ng 2022 ==== | ||
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| + | Ng JY, Uppal M, Steen J. Neck pain clinical practice guidelines: a systematic review of the quality and quantity of complementary and alternative medicine recommendations. Eur Spine J. 2022 Oct;31(10):2650-2663. https://doi.org/10.1007/s00586-022-07288-7 | ||
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