title: Novel Noxipoint Therapy versus Conventional Physical Therapy for Chronic Neck and Shoulder Pain: Multicentre Randomised Controlled Trials.
abstract: As chronic pain affects 115 million people and costs $600B annually in the US alone, effective noninvasive nonpharmacological remedies are desirable. The purpose of this study was to determine the efficacy and the generalisability of Noxipoint therapy (NT), a novel electrotherapy characterised by site-specific stimulation, intensity-and-submodality-specific settings and a immobilization period, for chronic neck and shoulder pain. Ninety-seven heavily pretreated severe chronic neck/shoulder pain patients were recruited; 34 and 44 patients were randomly allocated to different treatment arms in two patient-and-assessor-blinded, randomised controlled studies. The participants received NT or conventional physical therapy including transcutaneous electrical nerve stimulation (PT-TENS) for three to six 90-minute sessions. In Study One, NT improved chronic pain (-89.6%, Brief Pain Inventory, p < 0.0001, 95% confidence interval), function (+77.4%, range of motion) and quality of life (+88.1%) at follow-up (from 4 weeks to 5 months), whereas PT-TENS resulted in no significant changes in these parameters. Study Two demonstrated similar advantages of NT over PT-TENS and the generalisability of NT. NT-like treatments in a randomised rat study showed a similar reduction in chronic hypersensitivity (-81%, p < 0.01) compared with sham treatments. NT substantially reduces chronic neck and shoulder pain, restores function, and improves quality of life in a sustained manner.
authors.affiliation: Stanford University, Stanford, CA 94305, U.S.A.|College of Medicine, National Taiwan University, Taipei, Taiwan 100.|Pain Cure Centre, Palo Alto, CA 94306, U.S.A.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Koo
authors.affiliation: Pain Cure Centre, Palo Alto, CA 94306, U.S.A.
authors.forename: Ray S
authors.initials: RS
authors.lastname: Lin
authors.affiliation: Department of Physical Medicine &Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan 100.
authors.forename: Tyng-Guey
authors.initials: TG
authors.lastname: Wang
authors.affiliation: School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan 100.
authors.forename: Jau-Yih
authors.initials: JY
authors.lastname: Tsauo
authors.affiliation: College of Medicine, National Taiwan University, Taipei, Taiwan 100.|Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan 115.
authors.forename: Pan-Chyr
authors.initials: PC
authors.lastname: Yang
authors.affiliation: Department of Life Science, National Taiwan University, Taipei, Taiwan 106.
authors.forename: Chen-Tung
authors.initials: CT
authors.lastname: Yen
authors.affiliation: Diagnostic Radiology, Department of Radiology, Stanford University Medical Centre, Stanford, CA 94305, U.S.A.
authors.forename: Sandip
authors.initials: S
authors.lastname: Biswal
mesh_terms: D000328:Adult; D000818:Animals; D059350:Chronic Pain; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006930:Hyperalgesia / Q000628:therapy / Q000662:veterinary; D008297:Male; D008875:Middle Aged; D063806:Myalgia / Q000209:etiology; D011788:Quality of Life; D051381:Rats; D020069:Shoulder Pain / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome