Acupuncture as a nonconventional chronic neck pain treatment Essay

Custom Student Mr. Teacher ENG 1001-04 12 October 2015

Acupuncture as a nonconventional chronic neck pain treatment

Acupuncture as a nonconventional chronic neck pain treatment

Introduction

Abstract

            Chronic neck pain is an ailment that is characterized by pain in the neck that lasts for a period of more than three months. It is usually different from common medical conditions of neck pains that last for only days. In most occasions, chronic neck pain is an ailment that may even take years without success in its treatment, particularly in the mainstream medical practices. Research assert that chronic neck pain is usually associated with a number of disorders, as well as diseases that can involve any of the tissues around the neck. The study was carried out to fully analyze the effectiveness of acupuncture in the reduction of chronic neck pain, and also to examine whether the possible effects attributed to the therapy are long lasting. The data used in this study was collected through specified procedures to ensure credibility of the results in regard to the use of acupuncture in health care to provide a remedy for chronic neck pain in both short and long term basis. Using a well-structured methodology to guide the research patients were carefully analyzed in regard to the various methods of acupuncture to determine the respective effectiveness of each method. Further, a thorough analysis of the data collected is subsequently discussed showcasing the viability of the medical alternative. Lastly, recommendations for further research of acupuncture as an ideal treatment for individuals with chronic pain of the neck is well provided in this paper.

            Research indicate that acupuncture as a recognized nonconventional alternative for chronic neck pain that is increasingly becoming popular across the world. Acupuncture therapy is among world widely known health care procedures that is used to treat over 30 health conditions and diseases, with a major emphasize of relieving pain to different ailments. One of the main uses of acupuncture is to relieve pain, hence it is one of effective remedies for chronic neck pains. Research has for a long time hinted on the benefits of acupuncture for relief of chronic neck pain, as well as other body pains such as chronic shoulder pain, migraines and osteoarthritis among others(Blossfeldt 2004, p. 146). Researchers have provided data from over 30 high quality studies involving more than 18,000 patients with different chronic pains. As a nonconventional remedy for different pains, acupuncture is commonly used in different methods, providing flexibility in its treatment procedures, as well as a provider of choice for patients who opt to use acupuncture as a remedy for chronic neck pain(Salter et al, 2004, p 10).

            Further, researchers assert that although acupuncture is increasingly being used for various conditions including chronic neck pain treatment, the evidence of its effectiveness remains inconclusive. This indicates that there is a need for a further well designed research. With the use of a variety of methods or options on the use of acupuncture to relieve pain, there is also a need to establish the key features required for the design, as well as implementation of larger scale trial on acupuncture for neck pain. Acupuncture is believed to decrease pain by enhancing the release of the chemicals responsible for blocking pain, commonly referred to as endorphins(Liang et al, 2010, p. 8). Most of the acu-points are usually found near the nerves. In this regard, when stimulated, the nerves cause a dull ache, a feeling of fullness in the patient’s muscle. The stimulated muscle then sends a message to central nervous system subsequently causing a release of endorphins. These are crucial elements in the human body that are automatically released to modify the nerve impulses, hence reducing or nullifying the effect of pain to the patient.The endorphins together with other neurotransmitters subsequently block the message of pain from being taken up to the brain, hence a relief to the patient(Blossfeldt 2004, p. 146). Acupuncture may be used as a reliable treatment for chronic neck,and therefore, should be included as a part of an extensive and comprehensive pain management programs for relieving pain in patients.

            The scope of this paper is to ascertain the effectiveness of acupuncture in the treatment of chronic neck pain. The paper seeks to understand the role played by the various methods of acupuncture that are used to relieve pain for patients ailing from neck pains. Shallow, Sham and randomized acupuncture therapies are well explained in regard to their role in relieving pain.

            Lastly, the main purpose of this study is to establish the use of acupuncture in individuals with chronic pain of the neck. The paper focuses to establish the effectiveness of three acupuncture therapies used as alternative medical conventions to relieve pain. Additionally, the study proposes to explain both the short term and long term effects of acupuncture therapies in the treatment of chronic neck pain.

  1. To establish the viability of acupuncture therapies in the treatment of chronic neck pain.
  2. To understand how sham, shallow and randomized acupuncture therapies are utilized in the treatment of chronic neck pain.
  3. To provide a conclusive evidence of the success of acupuncture as an ideal method of relieving pain.
  4. To establish the effects of the three acupuncture therapies in the treatment of individuals with chronic pain of the neck.
  5. To offer recommendation of the viability of acupuncture as a treatment option that can be used by people with chronic neck pains.

Basic approach to acupuncture as a nonconventional chronic neck pain treatment

            The use of acupuncture as an alternative chronic neck pain treatment is based on the medical understanding of the specific elements responsible for alienating pain or sending messages of pain to the brain. The study of acupuncture is based on the thought that decrease or alienation of pain can be enhanced by releasing the chemicals responsible for blocking pain, referred to as endorphins. Most of the acu-points are usually found near the nerves(Liang et al, 2012, p. 8). The approach of this study is based on the understanding that, when stimulated, the nerves cause a dull ache, a feeling of fullness in the patient’s muscle. The stimulated muscle then sends a message to central nervous system subsequently causing a release of endorphins. These are crucial elements in the human body that are automatically released to modify the nerve impulses hence reducing or nullifying the effect of pain to the patient(Willich et al, 2006, p. 98). The endorphins, as well as other neurotransmitters, subsequently block the message of pain from being taken up to the brain, hence a relief to the patient. The findings of this study will pin point out how the alienation of pain is conversely connected to the various elements thought to treat people suffering from chronic neck pains.

Basic Background information

            Acupuncture used in the modern day alternative treatment for pain is a branch of a traditional Chinese medicine practice. It is a practice that has historically been tired, and equally tested as a health care practice that has in practice for thousands of years, particularly in China and South East Asia. For centuries, acupuncture has been gradually developed, tested and researched, as well as refined over many centuries giving out a complex, and rather detailed understanding of the energetic balance of the human body. The first known record of Chinese Medicine was a book, the classic of Internal Medicine of Yellow Emperor, which dates back to between the 1st century BC and the 1st century AD(Sun et al, 2009, p. 850). It is essential to acknowledge that all the styles of acupuncture found in the modern day health care practices trace their roots to this particular text.

            Without the help of the modern day scientific equipment, scholars from the Ancient China discovered many aspects of biomedical science, like the effect of emotional stress on an individual’s immune system. The traditional acupuncturists were not less scientific or sophisticated that it is the case with the western clinicians with their understanding of the functioning of the body, although the contemporary acupunctural practices depict that of the culture and historic origin of the Chinese medicine. The traditional Chinese medicine has vividly remained in the shadow of the western medicine, until a certain period between 1934 and 1935, where the without drugs sick and wounded faced death. It was the intervention of traditional Chinese medicine, which generally used acupuncture and other several traditional treatment methods(Witt 2004, p. 99). From this point, the traditional and western medicines started to be practicing side to side in China. In the contemporary, the practice has gained popularity across different region of the world. More people with chronic pains, where it is primarily being used to treat such case, as it with the alienation chronic neck pain.

Methods

Population

            The research data collected in this study focused on patients suffering from chronic neck pain. The individuals used in the research fell within the age of 21 and 55 years old. Although there are many patients who report about neck pain ailments in different health care facilities across the United States, patients with the age of 21 and 55 years old were ideal for a research. This is due to the fact that they are easier to track their progress of healing over a longer period of time. Elderly patients over the age of 55 years are not best placed in this research considering the various attributes in the healing processes of such people, which is proven to be relatively lower. Most of the data about individuals with chronic pain of the necks was randomly collected in health care facilities in the State of California, United States. The majority of these patients was diagnosed with chronic neck pain and were put under a special focus while three acupuncture methods of therapies were performed(Witt 2004, p. 99). The study generally involved a thorough investigation of 191 patients in California’s health care. It is important to acknowledge that the various patients were deliberately initiated to acupuncture treatment as their decision to try the alternative medical practice after allegedly failed treatments in the mainstream medical procedures.

            There were certainly no limitation on the sex of the patients, hence the research involved both male and female patients. Additionally, there were no specified number of male or females in the study, as patients, as treatment and progress of treatment of patients was randomly taken. Further, it was assumed that both male and female patients presented similar responses to the different acupuncture therapies performed in the study(Sun et al, 2009, p. 850). The research was also not limited by either ethnicity or race, although believed to have different characteristics in regard to various medical procedures.

Variable and Delimitations

            The dependent variables in this study included the neck pain as an ailment caused by various aspects such as physical injury and disease or condition among others. The rates of cases involving chronic neck pains during the period of this study was generally unprecedented as the causes of such ailments greatly varied. Chronic neck pain among the patients varied in regard to the specific causes, which in this case included degenerative disc disease, neck injury, neck strain, herniated disc as well as pinched neck(Sun et al, 2009, p. 850). The first step in the treatment procedure involved a thorough diagnosis of common neck infections that caused the chronic pain.

            The key delimitations were based on neck pain due to common infection like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones around the neck.The different patients involved in this study had chronic neck pains attributed to extremely different causes, which included physical injuries, some rare infections, and virus infections among others(Witt 2004, p. 99). The patients with this problem are generally taken through the three acupuncture therapies, regardless of the cause of their condition(Hush 2004, p. 1533). The fact that all patients are uniformly taken into similar medical procedures without being categorized in relation to their specific cause of chronic neck pain remain as the greatest delimitating attribute of this research.

Search Criteria

            The key terms I commonly used while searching for the relevant articles included: chronic neck pain, cervical pain types of acupuncture, alternative medicine, sham acupuncture, Shallow acupuncture and randomized acupuncture. Short statements were also useful in searching for relevant information about the use of acupuncture in the treatment of chronic pain. These statements included: Alternative treatment of chronic pain, use of acupuncture in the treatment of chronic neck pain, and the acupuncture methods used in the treatment of chronic neck pain(Witt 2004, p. 99). I thoroughly searched in various databases for article that provided information for patients suffering from chronic neck pains, specifically those individuals between the age of 21 and 55 years old. I further categorized the data collected to form two groups of patients of the age bracket of 21 and 34 years and those between 35 and 55 years old. The creation of these two groups was essential as taking a wider range of people of ages 21 to 55 years old would present relatively a higher deviation in the healing processes of the patients, as those above the age of 35 years present a much longer period of healing as compared to the youthful 21 to 34 years group. I also focused my research on the following: MasterFile Premier, ALT Healthwatch, US National Library of Medicine, BioMed central.

Chronic Neck Pain

            Chronic neck pain is an ailment that is characterized by pain in the neck that lasts for an unusually long period of time, commonly over a period of three months. Although different from the common medical conditions of neck pains that last for only days, chronic neck pain is typically an ailment that takes even years without success in its treatment in the mainstream medical practices. Chronic neck pain is usually associated with a number of disorders, as well as diseases that can involve any of the tissues around the neck(Witt 2004, p. 99). For instance, the common causes of this condition are strains of the neck, injury of the neck like a herniated disc, pinched disc, or whiplash, and degenerative disc disease. In addition, chronic neck pain is also linked to common infection like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones around the neck. Some patients also had chronic neck pains caused by extremely different causes, which include physical injuries, some rare infections, and virus infections among others. Further, chronic neck pain is also caused by certain infections like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones around the neck.

Risk Factors

            Chronic neck pain is generally caused by numerous factors ranging from physical injury to certain infections around the neck body tissues. Since neck pain affects the muscles around the body areas of the neck, it becomes painful to move the neck as it is usually painful. The risk factors for pain usually include injury from involvement in motor vehicle accidents, horse rising, contact sports and bull riding among others(De Loose, 2008, p. 475). In order to avoid or to prevent neck pains for the patients, it is always essential to consider staying away from activities may twist the neck and subsequently aggravate the already painful section of the neck(Witt 2004, p. 99). In addition, it is also advisable to have activities that will enhance neck strengthening exercise, as well as neck bracing.

Types of acupuncture used in the treatment of chronic neck pain

Optimized acupuncture therapy

            Optimized acupuncture therapy in the treatment of chronic neck pain involves the utilization of traditional acupuncture, which is usually followed by intradermal needle therapy, commonly referred to as INT(Hush 2004, p. 1533). The use of OAT usually consists of the use of nine acupuncture points typically selected for an optimized acupuncture therapy group on the advice and consensus of the national expert committee of the OAT procedures. In this case, four points are subsequently located by physician intending to perform the OAT. The points selected are usually the cervical positive reactions planes found in the top and bottom of the cervical planes as well as horizontally away from the corresponding cervical vertebra(Witt 2004, p. 99). This type of acupuncture practice is highly sensitive and usually need to be performed by an individual with more than five of practice experiences.

Sham acupuncture therapy

            Sham acupuncture therapy involves the use of skin penetrating shallow needles on the specified sham groups’ tender points.The tender points that are used in this method of acupuncture therapy are categorized as the key areas recommended for the acupuncture, which are the Ah Shee, also referred to as “oh yes point”. The points are crucial in this therapy and have to be used throughout the treatment procedure. Typically, the location of sham points is commonly defined by 25mm lateral extending to the standard location used for the OAT group.They include: the sham point of Dazhui (GV14) 25mm, which is 25 mm vertically below the usual standard GV14, sham points of (S115) Jianzhongshu and Huatuojiaji, which is 25 mm lateral to standard S115 (Liang et al, 8).After the sham acupuncture, individuals undergoing the process or patients are treated through the use of point pressing (De Loose, 2008, p. 475).

Shallow acupuncture therapy

Shallow acupuncture group undergoes similar procedures as the other OAT groups.

            However, the physicians are required to insert the needles in a vertical manner in order to reach the subcutaneous level at a specified depth of not more than 3 mm (Salter et al, 2004). Needle manipulation or any other sensation is prohibited in this particular group. Ultimately, after the shallow acupuncture, the patients are additionally treated by INT through the use of a similar method as in the other OAT groups.

Physiotherapy versus acupuncture

            Zhuang (2012) compares the use of acupuncture and physiotherapy in the treatment of chronic neck pain in a research that took place in China. The research involved screening of a total of 310 patients. The patients were then randomly split into two equal groups, where one group was treated using acupuncture method, while the other group received treatment through physiotherapy. The outcome of the treatment of the two procedures revealed that patients treated under acupuncture procedures had better results in relieving neck pain, particularly after a period of three months.It is essential to acknowledge that physiotherapy is an alternative medical practice that can be used in the treatment of chronic neck pain. While acupuncture therapies generally used sterilizes needles that are usually inserted in the area around the neck depending on the type of acupuncture used, physiotherapy does not involve the use of needles. Physiotherapy utilizes several types of manipulation as well as exercise to relieve pain. The common illustration of the use of physiotherapy is the stretch, strengthen and straighten up exercise movements of the neck.

Adverse event and acupuncture

            White (2001) researched about the adverse events following a use of acupuncture to treat patients with chronic neck pain. In his survey, which included a prospective survey of 32,000 consultations with physiotherapists and doctors, the researcher, Adrian White aimed at ascertaining the incidence of adverse events that are related to acupuncture treatment, as practiced by British doctors during that time. The research utilized data that were collected for the June of 1998 to February of 2000, from a total of 78 acupuncturists. Altogether the resulting significant events were 43, subsequently giving only a rate of only 14 patients of the 10,000 patients included in the data. The results of this study showed that only 0.14 percent of the patients who used acupuncture in the treatment of chronic pain experience adverse events. All the adverse events were reported to have had cleared within the period of one week after the therapy. Similar diminishing events were characterized at a longer period, except foronly one incident that lasted for several weeks. The result derived from the data of acupuncture treatment did not report any serious adverse events. The rates can only be classified as minimal considering that it was only 14 adverse effects out of the total 10,000 patients who were analyzed with the data provided. Generally, these event rates do not give significant risk per individual patient.

Physician views on acupuncture

            The article by Chen, L. et al., (2010), offers exclusive views on acupuncture given by various physicians. The research by Chen among other authors who contributed to the article, there study targets collecting information that addresses the role of acupuncture in the management of pain in regard to opinions of physicians who manage such conditions. The research was conducted between 2007 and 2008 using a nationwide e-mail to 1083 physicians who were in active acupuncture practice in the United States. Chan et al., (2010) found that the overwhelmingly majority of the responders of the survey had a positive attitude and favorable experience of the use of acupuncture as an alternative modality in the management of chronic pain. The results of the survey subsequently indicate that acupuncture is considered effective by physicians in the management of chronic neck pain.

Discussion

            Chronic neck pain commonly occur as a result of a number of disorders, and diseases that in involve any of the tissues around the neck (Witt 2004, p. 99). The risk factors of this condition have also been linked tothe strains of the neck, injury of the neck such as the herniated disc, pinched disc, or whiplash, and degenerative disc disease. Additionally, chronic neck pain is also associated with to common infection like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones around the neck. Further, chronic neck pain is also found to be caused other different causes, which include physical injuries, some rare infections, and virus infections among others. Moreover, chronic neck pain is also caused by certain infections like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones around the neck. Despite the different causes of the chronic neck pain, the use of acupuncture has subsequently been showcased as an ideal alternative medical procedure towards the treatment of this condition. The research shows that the three types of acupuncture are equally ideal in providing effective treatment for neck pain.

            Although I extensively performed research on a wide range of databases, there are some articles that may have been missed out. Since I was individually conducting this research alone, it is possible that the large number of crucial articles were subsequently overlooked. In addition, there are many external factors that could have influenced the entire result of the use of acupuncture as an ideal treatment for chronic neck pain. The majority of studies slightly differs in a number of issues such as data collected, population, or any of combinations of these factors. White (2001) preciselyresearched about the adverse events following a use of acupuncture to treat patients with chronic neck pain, with an extreme number of respondents. Chen, L. et al., (2010), had a relatively smaller number of responders, and also had collection of data to be collected only through email in his research on the effectiveness of acupuncture in the management of chronic pain in the neck. These are some of the factors that were out of the scope of the research, hence determining the effectiveness of acupuncture was difficult, since the aspect of effectiveness could easily be isolated from some external factors.

            The analysis of the specific information provided by the studies of the literature review of this research paper indicate that either of the three methods of acupuncture can effectively treat the chronic neck pain. The procedural practice of sham, shallow and optimized acupuncture, though different, they present similar way of performing the acupuncture therapy, equally offering effective treatment for chronic neck pain. Liang et al, (2012) asserts that the three types of acupuncture to be based on the thought that decrease or alienation of pain can be enhanced by releasing the chemicals responsible for blocking pain. Issues of age in the study have been considered as the research only focused on individuals between 21 years old and 55 years, as they are likely to have a faster period of healing as compared to adult elderly groups of more than 55 years old. Generally, the use of acupuncture is illustrated as effective as it has previously been used to treat patients with chronic neck pain.

            The loopholes evident in the research include the possibility of a prior knowledge in determining the differences that may emerge upon consideration for gender in the treatment program. In the entire study, there is no single explanation of the ratio of females against the males in finding out the effectiveness of acupuncture treatment procedures. The study focused on a general perspective of patients with chronic neck pain regardless of their respective sex or gender. The knowledge of the differences that exist between males and females could have some effects on the understanding the use of acupuncture. In addition, the paper did not focus on the causes of the various neck pain, which could also compromise the results of the study, considering that such plans are typically attributed to a wide variety of causes.

            Topics that can be considered for further research are establishing the element of gender in determining the effectiveness of acupuncture while treating chronic neck problem. The various studies illustrated in the research paper did not point out the importance of understanding differences in the healing process of male and female patients with chronic neck pain. I suggest a study be conducted with a major emphasis on the aspect of gender differences between patients in order to determine the effectiveness of acupuncture treatment for neck pain in male and female patients. If this study is conducted, it will be possible to compare the effectiveness of acupuncture treatment between male and female patients within the same health condition of chronic neck pain.

References

Blossfeldt, P. (2004). Acupuncture for Chronic neck pain: a cohort study in an NHS pain Clinic.22(3): 146-151. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15551941Chen, L., Houghton, M., Seefeld, L., Malarick, C. & Mao. Jianren. (2010). A Survey of SelectedPhysician Views on Acupuncture in Pain Management. 11(4), 530-534

Salter, G.C, Roman, M., Bland, M. J & MacPherson, H. (2006). Acupuncture for chronic pain: apilot for randomized controlled trial. 7(1): 3-14 . Retrieved fromhttp://www.biomedcentral.com/1471-2474/7/99

Liang, Z. H., Di, Z., Jiang, S., Xu, S. J., Zhu, X. P., Fu, W,. & Lu, A. P. (2012). The optimizedacupuncture treatment for neck pain caused by cervical spondylosis: a study protocol of amulticenter randomized controlled trial. 13(1): 2-18 . Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/22776567

American Academy of Orthopaedic Surgeons. (2013). neck pain. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00231Chen, L., Houghton, M., Seefeld, L., Malarick, C., & Mao, J. (2010). a survey of selected physician views on acupuncture in pain management. Pain Medicine, 11(4), 530-534. Retrieved from SPORTDiscus.

De Loose, V., Burnotte, F., Cagnie, B., Stevens, V., & Van Tiggelen, D. (2008). Prevalence and risk factors of neck pain in military office workers. Military Medicine, 173(5), 474-479. Retrieved from Academic Search Premier.

Hush, J. M., Michaleff, Z., Maher, C. G., & Refshauge, K. (2009). Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study. European Spine Journal, 18(10), 1532-1540. Retrieved from Academic Search Premier.

Irnich, D., Behrens, N., Gleditsch, J. M., Stör, W., Schreiber, M. A., Schöps, P., & … Beyer, A. (2002). Immediate effects of dry needling and acupuncture at distant points in chronic neck pain: results of a randomized, double-blind, sham-controlled crossover trial. Pain (03043959), 99(1/2), 83. Retrieved from Academic Search Premier.

Ji-Eun, P., Myeong Soo, L., Jun-Yong, C., Bo-Young, K., & Sun-Mi, C. (2010). Adverse Events Associated with Acupuncture: A Prospective Survey. Journal Of Alternative & Complementary Medicine, 16(9), 959-963. Retrieved by Academic Search Premier.

National Center for Complementary and Alternative Medicine. (2012). Acupuncture: an introduction. Retrieved from http://nccam.nih.gov/health/acupuncture/introduction.htmNational Institutes of Health. (2013). neck pain. Retreived from http://www.nlm.nih.gov/medlineplus/ency/article/003025.htmRobertshawe, P. (2008). acupuncture and physiotherapy for neck tension. Journal Of The Australian Traditional-Medicine Society, 14(3), 187. Retrieved from Academic Search Premier.

Sun, M., Hsieh, C., Cheng, Y., Hung, H., Li, T., Yen, S., & Huang, I. (2010). The therapeutic effects of acupuncture on patients or individuals with chronic neck myofascial pain syndrome:: a single-blind randomized controlled trial. American Journal Of Chinese Medicine, 38(5), 849-859. Retrieved from Academic Search Premier.

Vas, J., Perea-Milla, E., Méndez, C., Navarro, C., León Rubio, J., Brioso, M., & Obrero, I. (2006). Efficacy and safety of acupuncture for chronic uncomplicated neck pain: A randomised controlled study. Pain (03043959), 126(1-3), 245-255. Retrieved from Academic Search Premier.

White, A. (2001). Adverse events following acupuncture: prospective survey of 32,000 consultations with doctors and physiotherapists. 10(1), 3-14 Retrieved from BMJ Research Articles

Willich, S. N., Reinhold, T., Selim, D., Jena, S., Brinkhaus, B., & Witt, C. M. (2006). Cost-effectiveness of acupuncture treatment in patients or individuals with chronic neck pain.Pain (03043959), 125(1/2), 107-113. Retrieved from Academic Search Premier

Witt, C. M., Jena, S., Brinkhaus, B., Liecker, B., Wegscheider, K., & Willich, S. N. (2006). Acupuncture for patients or individuals with chronic neck pain. Pain (03043959), 125(1/2), 98-106. Retrived from Academic Search Premier.

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