June 29, 2001 -- Is acupuncture or massage therapy better for back and neck pain? One recent study came out in favor of massage while another has found acupuncture to be better. Your best bet may be to let personal preference be your guide.
The author of one study, Dominik Irnich, MD, tells WebMD that, "acupuncture is widespread in the world. Western medicine is wonderful and successful, but in many, many chronic conditions ... there is a lack of success, and Eastern medicine methods may be the right choice. ... [Our] study shows that acupuncture is more effective than one of the most customary treatments for chronic neck pain [that is, massage]." Irnich is an anesthesiologist specializing in pain therapy at the University of Munich and the German Medical Acupuncture Association.
Irnich and colleagues treated 177 people suffering from chronic neck pain with acupuncture, massage, or 'sham' laser acupuncture. Those given the sham laser treatment were told that special laser light was being beamed into acupuncture points in the body in order to stimulate those points. In reality, the laser light did nothing. The sham laser was performed in order to control for the possibility that the idea alone of having acupuncture might affect the results; this is known as the placebo effect.
After one week and five treatments, those treated with acupuncture had a greater improvement in motion related neck pain compared with those treated with massage but not compared with those given sham laser. However, the differences between the three groups were fairly small, and there were no differences between the groups in terms of neck mobility or pain after three months of follow up. The study is published in the June 30, 2001, issue of the British Medical Journal.
But is acupuncture really better than massage for this kind of pain? A recent study published in the April 23, 2001 issue of Archives of Internal Medicine found that, when comparing massage and acupuncture for back pain, massage actually came out on top.
According to expert Mike Cummings, MB, ChB, Dip Med Ac, who wrote a commentary to accompany the neck pain study, a major difficulty with acupuncture research lies in teasing out the placebo effect. In the neck pain study, the sham laser was used to control for the idea of having acupuncture on neck pain, but the experience of having a light shone on your neck and having needles stuck into it is not the same. Cummings is medical director of the British Medical Acupuncture Society in London.
The upshot? Cummings does not believe that, as yet, there is any clear evidence favoring either acupuncture or massage therapy for neck and back pain, so people should choose whatever therapy they prefer.
"If you want a quick response," he says, "you're probably better to go for acupuncture, and if you don't like needles, you're probably better to go for massage. They're effectively the same type of therapy: a pressure stimulus. Acupuncture is very intense pressure inside the muscles. With massage, you can't get quite the same intensity of pressure. This [pressure therapy] does appear to be an extremely effective therapy for neck pain."
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