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Electroacupuncture for Shoulder and Neck Pain, Including Blood Flow

Electroacupuncture for Shoulder and Neck Pain, Including Blood Flow AIM June 2008 Text.qxd 18/06/2008 08:46 Page 126 Research shorts Still too few studies of needling myofascial trig- Electroacupuncture for shoulder and neck pain, ger points to be conclusive including blood flow Tough EA, White AR, Cummings TM, Richards Lee SH, Chen CC, Lee CS, Lin TC, Chan RC. SH, Campbell JL. Acupuncture and dry needling in Effects of needle electrical intramuscular stimula- the management of myofascial trigger point pain: tion on shoulder and cervical myofascial pain syn- Asystematic review and meta-analysis of ran- drome and microcirculation. J Chin Med Assoc domised controlled trials. J Pain Epub 2008 Apr 3. 2008;71(4):200-6. This systematic review updates part of a previous Patients (n=40) with active MTrPs in the upper review on dry or ‘wet’ needling of myofascial trig- trapezius or levator scapulae underwent four weekly ger points. This time, the only studies included sessions with needle electrical intramuscular were those in which trigger points were needled stimulation (NEIMS). Pain VAS and pain pressure directly, ie not including superficial acupuncture or threshold (PPT) significantly improved immediately distant acupuncture. Seven studies were included. after each treatment, and effects persisted till the end One found that direct dry needling was superior to of the experiment. Cervical and shoulder range of no intervention. Two, comparing direct dry motion improved as well. There was an overall needling to needling elsewhere in the muscle, pro- negative correlation between epidermal blood flow duced contradictory results. Four studies used a and VAS score before the first treatment. Regional placebo control and were included in a meta-analy- blood flow was measured by laser Doppler sis. Combining these studies (n=134), needling was flowmetry; it significantly increased immediately, not found to be significantly superior to placebo though temporarily, after each treatment. The authors (standardised mean difference, 14.9 [95%CI, -5.81 concluded that NEIMS did have positive effects on to 33.99]), but there was marked statistical hetero- myofascial pain syndrome, but the data did not geneity. The authors concluded that there is limited indicate that increased regional microcirculation was evidence from one study that needling directly into the possible therapeutic mechanism. myofascial trigger points has an overall treatment effect, and the overall direction of the meta-analy- sis comparing placebo controls could be compati- Acupuncture for repetitive strain caused side ble with a treatment effect. effects, and no benefit Goldman RH, Stason WB, Park SK, Kim R, STRICTAstill not widely used to report Schnyer RN, Davis RB. Acupuncture for treatment acupuncture studies of persistent arm pain due to repetitive use: a ran- domized controlled clinical trial. Clin J Pain Prady SL, Richmond SJ, Morton VM, MacPherson 2008;24(3):211-218. H. Asystematic evaluation of the impact of STRICTAand CONSORTrecommendations on This study in patients with persistent arm pain quality of reporting for acupuncture trials. PLoS (n=123) received either true or sham acupuncture ONE 2008;3(2):e1577 (non-penetrating needle on the same points) for eight treatments over four weeks. Pain scores in the These authors wanted to know whether there had sham acupuncture group reduced more than in the been an improvement in quality of reporting of ran- acupuncture group – but the latter experienced domised controlled trials of acupuncture since the more side effects. publication of the STRICTAand CONSORTstate- Comment This condition reflects a state of ments. They randomly selected 90 articles in three increased sensitivity of the nervous system. It is not time periods (1994–1995, 1999–2000 and surprising that further nociceptive stimulation from 2004–2005). There was an increase in the reporting needles, as a sole therapy, caused an aggravation of of CONSORTitems, but not of STRICTAitems. symptoms. ACUPUNCTURE IN MEDICINE 2008;26(2):124-127. 126 www.acupunctureinmedicine.org.uk/volindex.php http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acupuncture in Medicine SAGE

Electroacupuncture for Shoulder and Neck Pain, Including Blood Flow

Acupuncture in Medicine , Volume 26 (2): 1 – Jun 1, 2008

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Publisher
SAGE
Copyright
© 2008 British Medical Acupuncutre Society
ISSN
0964-5284
eISSN
1759-9873
DOI
10.1136/aim.26.2.126-b
Publisher site
See Article on Publisher Site

Abstract

AIM June 2008 Text.qxd 18/06/2008 08:46 Page 126 Research shorts Still too few studies of needling myofascial trig- Electroacupuncture for shoulder and neck pain, ger points to be conclusive including blood flow Tough EA, White AR, Cummings TM, Richards Lee SH, Chen CC, Lee CS, Lin TC, Chan RC. SH, Campbell JL. Acupuncture and dry needling in Effects of needle electrical intramuscular stimula- the management of myofascial trigger point pain: tion on shoulder and cervical myofascial pain syn- Asystematic review and meta-analysis of ran- drome and microcirculation. J Chin Med Assoc domised controlled trials. J Pain Epub 2008 Apr 3. 2008;71(4):200-6. This systematic review updates part of a previous Patients (n=40) with active MTrPs in the upper review on dry or ‘wet’ needling of myofascial trig- trapezius or levator scapulae underwent four weekly ger points. This time, the only studies included sessions with needle electrical intramuscular were those in which trigger points were needled stimulation (NEIMS). Pain VAS and pain pressure directly, ie not including superficial acupuncture or threshold (PPT) significantly improved immediately distant acupuncture. Seven studies were included. after each treatment, and effects persisted till the end One found that direct dry needling was superior to of the experiment. Cervical and shoulder range of no intervention. Two, comparing direct dry motion improved as well. There was an overall needling to needling elsewhere in the muscle, pro- negative correlation between epidermal blood flow duced contradictory results. Four studies used a and VAS score before the first treatment. Regional placebo control and were included in a meta-analy- blood flow was measured by laser Doppler sis. Combining these studies (n=134), needling was flowmetry; it significantly increased immediately, not found to be significantly superior to placebo though temporarily, after each treatment. The authors (standardised mean difference, 14.9 [95%CI, -5.81 concluded that NEIMS did have positive effects on to 33.99]), but there was marked statistical hetero- myofascial pain syndrome, but the data did not geneity. The authors concluded that there is limited indicate that increased regional microcirculation was evidence from one study that needling directly into the possible therapeutic mechanism. myofascial trigger points has an overall treatment effect, and the overall direction of the meta-analy- sis comparing placebo controls could be compati- Acupuncture for repetitive strain caused side ble with a treatment effect. effects, and no benefit Goldman RH, Stason WB, Park SK, Kim R, STRICTAstill not widely used to report Schnyer RN, Davis RB. Acupuncture for treatment acupuncture studies of persistent arm pain due to repetitive use: a ran- domized controlled clinical trial. Clin J Pain Prady SL, Richmond SJ, Morton VM, MacPherson 2008;24(3):211-218. H. Asystematic evaluation of the impact of STRICTAand CONSORTrecommendations on This study in patients with persistent arm pain quality of reporting for acupuncture trials. PLoS (n=123) received either true or sham acupuncture ONE 2008;3(2):e1577 (non-penetrating needle on the same points) for eight treatments over four weeks. Pain scores in the These authors wanted to know whether there had sham acupuncture group reduced more than in the been an improvement in quality of reporting of ran- acupuncture group – but the latter experienced domised controlled trials of acupuncture since the more side effects. publication of the STRICTAand CONSORTstate- Comment This condition reflects a state of ments. They randomly selected 90 articles in three increased sensitivity of the nervous system. It is not time periods (1994–1995, 1999–2000 and surprising that further nociceptive stimulation from 2004–2005). There was an increase in the reporting needles, as a sole therapy, caused an aggravation of of CONSORTitems, but not of STRICTAitems. symptoms. ACUPUNCTURE IN MEDICINE 2008;26(2):124-127. 126 www.acupunctureinmedicine.org.uk/volindex.php

Journal

Acupuncture in MedicineSAGE

Published: Jun 1, 2008

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