Exploring the Effectiveness of Acupuncture as an Adjunct to Physiotherapy in the Treatment of Musculoskeletal Conditions: A Systematic Review

Abstract

Background: Acupuncture is one of the most popular forms of complementary and alternative medicine, and its usage is linked to an improvement of physical and psychological symptoms. Main Objectives: Determine whether the use of acupuncture as an adjunct to physiotherapy treatment is more effective than physiotherapy alone or acupuncture alone in MSK conditions. Methodology: A systematic review of the literature was conducted using three major databases, from March 2019 to May 2019, i.e., Cochrane Library, PubMed, and PEDro (Physiotherapy Evidence Database). The inclusion criteria were limited to randomized controlled trials (RCT) published in English, only studies published within the past decade, and investigating adult populations with MSK conditions. Results: From the 227 titles and abstracts that were identified, 75 were duplicates, leaving us with 152 studies for the initial screening. Eight studies [13-20] were included in this review for a qualitative analysis. The studies that assessed pain did not found statistically significant results that support the combination of physiotherapy and acupuncture, the same results were also obtained for Range of motion in knee osteoarthritis. Muscular tension was found statistically significant within-group improvements for all parameters in comparison with the baseline. For Isometric Neck Muscle Strength (INMS), the studies reported significant improvements within the groups, with Physiotherapy combined with Acupuncture being more effective than Acupuncture or Physiotherapy alone. The Constant Shoulder Assessment (CSA), for shoulder function was significantly higher in the exercise plus acupuncture group compared with the exercise group. Conclusion: As an integrative or complementary therapy for pain, acupuncture has been increasingly used. However, this review did not find significant evidence to support that the addition of acupuncture to physiotherapy treatment has an added benefit to pain relief. This review did, however, find benefits of adding acupuncture to treatment to reducing neck disability and improving muscular strength and shoulder function.