Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis.

Qi-Ling Yuan,Yin-Gang Zhang,Liang Liu,Fu Sun,Tuan-Mao Guo,Jan P A Baak

doi:10.1371/journal.pone.0117146

Abstract

BackgroundNeck pain (NP) and low back pain (LBP) are common symptoms bothering people in daily life. Traditional Chinese medicine (TCM) has been used to treat various symptoms and diseases in China and has been demonstrated to be effective. The objective of the present study was to review and analyze the existing data about pain and disability in TCM treatments for NP and LBP.MethodsStudies were identified by a comprehensive search of databases, such as MEDLINE, EMBASE, and Cochrane Library, up to September 1, 2013. A meta-analysis was performed to evaluate the efficacy and safety of TCM in managing NP and LBP.ResultsSeventy five randomized controlled trials (n = 11077) were included. Almost all of the studies investigated individuals experiencing chronic NP (CNP) or chronic LBP (CLBP). We found moderate evidence that acupuncture was more effective than sham-acupuncture in reducing pain immediately post-treatment for CNP (visual analogue scale (VAS) 10 cm, mean difference (MD) = -0.58 (-0.94, -0.22), 95% confidence interval, p = 0.01), CLBP (standardized mean difference = -0.47 (-0.77, -0.17), p = 0.003), and acute LBP (VAS 10 cm, MD = -0.99 (-1.24, -0.73), p< 0.001). Cupping could be more effective than waitlist in VAS (100 mm) (MD = -19.10 (-27.61, -10.58), p < 0. 001) for CNP or medications (e.g. NSAID) for CLBP (MD = -5.4 (-8.9, -0.19), p = 0.003). No serious or life-threatening adverse effects were found.ConclusionsAcupuncture, acupressure, and cupping could be efficacious in treating the pain and disability associated with CNP or CLBP in the immediate term. Gua sha, tai chi, qigong, and Chinese manipulation showed fair effects, but we were unable to draw any definite conclusions, and further research is still needed. The efficacy of tuina and moxibustion is unknown because no direct evidence was obtained. These TCM modalities are relatively safe.

Highlights

Neck pain (NP) and low back pain (LBP) are common symptoms bothering people in daily life
We found moderate evidence that acupuncture was more effective than sham-acupuncture in reducing pain immediately post-treatment for chronic NP (CNP) (visual analogue scale (VAS) 10 cm, mean difference (MD) = -0.58 (-0.94, -0.22), 95% confidence interval, p = 0.01), chronic LBP (CLBP) (standardized mean difference = -0.47 (-0.77, -0.17), p = 0.003), and acute LBP (VAS 10 cm, MD = -0.99 (-1.24, -0.73), p< 0.001)
Acupuncture, acupressure, and cupping could be efficacious in treating the pain and disability associated with CNP or CLBP in the immediate term

Summary

Introduction

Neck pain (NP) and low back pain (LBP) are common symptoms bothering people in daily life. More than 70% of people experience LBP [1], whereas approximately two-thirds of people experience NP [2,3] at some point in their lifetimes. The pain in most individuals (approximately 85% for LBP) [1] is non-specific, which indicates that the pain is not attributable to one of the definite above pathologies but instead to some ambiguous etiology. Conventional treatments, such as medications [6] and surgery [7], have demonstrated some efficacy.

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