Difference in Clinical Effect between Deep and Superficial Acupuncture Needle Insertion for Neck-shoulder Pain: a Randomized Controlled Clinical Trial Pilot Study

抄録

Objective: The purpose of this study was to compare the effects of superficial and deep insertion of acupuncture needles in the treatment of patients with neck-shoulder pain and to search for more effective acupuncture methods.
Methods: The subjects were patients seen at the Meiji University of Integrative Medicine’s Department of Orthopedic Surgery Clinic. A randomized controlled clinical trial was conducted in which 20 patients with neck-shoulder pain were randomly allocated to either a superficial acupuncture group (n=10) or a deep acupuncture group (n=10). Treatment was applied to points where patients experienced the most pain. The maximum number of stimulation points for both groups was 10. In the superficial acupuncture group, the needle was only inserted to a depth of 5 millimeter. In the deep acupuncture group, the needle was inserted to a depth of 15 to 20 millimeter. Both groups were manually stimulated using a sparrow pecking method over 20 seconds, after which the needle was removed. Both groups were treated weekly for four weeks. The primary outcome measurement was intensity of pain evaluated using a Visual Analogue Scale (VAS). The secondary outcome measurement was the Neck Disability Index (NDI) for the purpose of evaluating the grade of disability in daily life due to neck-shoulder pain.
Results: There were no significant differences in age, male-female ratio, disease duration, or the initial scores of VAS and NDI between the two groups. VAS and NDI scores indicated significant differences between the groups (VAS: <0.0001, NDI: p<0.0001) in change over time, with the deep acupuncture group having more favorable results than the superficial acupuncture group. The degree of change from the baseline at the time of each evaluation was calculated, and results for the two groups were compared. The deep acupuncture group showed significantly better improvement in the sustained effects after completion of treatment (VAS: p<0.05). There were no significant differences directly after the first treatment (VAS: p=0.72) or in cumulative effect after repeated treatment (VAS: p=0.24).
Discussion and Conclusion: The results of this study suggested it would be more efficient to insert the needle to deep tissues when performing acupuncture treatment on subjective pain sites. The difference in the effects between the two acupuncture methods may be due to the difference in tissue stimulation received. The difference in effect is thought to be due to the differing influence of treatment on pain threshold, muscle blood flow, and muscle tones.