title: Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial.
abstract: BACKGROUND
  Despite substantial increases in its popularity and use, the efficacy of acupuncture for chronic mechanical neck pain remains unproved.
  
  
  OBJECTIVE
  To compare acupuncture and placebo for neck pain.
  
  
  METHODS
  A randomized, single-blind, placebo-controlled, parallel-arm trial with 1-year follow-up.
  
  
  METHODS
  The outpatient departments of 2 major hospitals in the United Kingdom, 1999 to 2001.
  
  
  METHODS
  135 patients 18 to 80 years of age who had chronic mechanical neck pain. Eleven patients withdrew from treatment, and 124 completed the primary end point.
  
  
  METHODS
  The primary outcome was pain 1 week after treatment, according to a visual analogue scale. Secondary outcomes were pain at other time points, score on the Neck Disability Index and the Short Form-36, and use of analgesic medications.
  
  
  METHODS
  Patients were randomly assigned to receive, over 4 weeks, 8 treatments with acupuncture or with mock transcutaneous electrical stimulation of acupuncture points using a decommissioned electroacupuncture stimulation unit.
  
  
  RESULTS
  Both groups improved statistically from baseline, and acupuncture and placebo had similar credibility. For the primary outcome (weeks 1 to 5), a statistically significant difference in visual analogue scale score in favor of acupuncture (6.3 mm [95% CI, 1.4 to 11.3 mm]; P = 0.01) was observed between the 2 study groups, after adjustment for baseline pain and other covariates. However, this difference was not clinically significant because it demonstrated only a 12% (CI, 3% to 21%) difference between acupuncture and placebo. Secondary outcomes showed a similar pattern.
  
  
  CONCLUSIONS
  All treatments were provided by 1 practitioner. Although the control was credible, it did not mimic the process of needling. A nonintervention group was not present to control for regression to the mean.
  
  
  CONCLUSIONS
  Acupuncture reduced neck pain and produced a statistically, but not clinically, significant effect compared with placebo. The beneficial effects of acupuncture for pain may be due to both nonspecific and specific effects.
authors.affiliation: Complementary Medicine Research Unit, Mail Primary Medical Care, University of Southampton, Aldermoor Health Centre, Southampton, United Kingdom. pjw1@soton.ac.uk
authors.forename: Peter
authors.initials: P
authors.lastname: White
authors.forename: George
authors.initials: G
authors.lastname: Lewith
authors.forename: Phil
authors.initials: P
authors.lastname: Prescott
authors.forename: Joy
authors.initials: J
authors.lastname: Conway
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D015670:Acupuncture Therapy / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000628:therapy*; D016037:Single-Blind Method
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen