Effectiveness of self-applied acupressure for cervical pain of benign origin (EDIDO-CUH): a randomized controlled clinical trial

Abstract

Background: Cervical pain is a problem with a high prevalence of ~13% of the population, and is more common in women (16.5%). The most affected age group is 65-74 years. Our aim was to assess the effectiveness of self-applied acupressure for decreasing benign-origin cervical pain, under the supervision of a health professional and in combination with usual treatment, as well as to examine its impact on the patient's self-perceived health condition and their opinion of the technique.

Methods: Pragmatic, multicenter, controlled clinical trial randomized by healthcare center. A total of 160 patients with benign-origin cervical pain between 18 and 65 years of age who attended primary care were included from 12 healthcare centers in the autonomous community of Madrid by consecutive sampling, and randomly assigned to a control or intervention group. The main outcome variable was pain intensity measured on a visual analogue scale (VAS) and secondary variables were self-perceived quality of life (EuroQol-5D utility index) and functional ability (neck disability index). An explanative model of generalized estimating equations was built taking into account the lack of independence among observations. The analysis was performed over 6 months.

Results: In total, 150 patients completed the study. Mean age was 45 years (SD: 10.7), 86.7% were women, 86.2% were currently employed, and 57.9% did not perform any physical exercise. Average days experiencing pain was 32.9 (SD: 2.8) and 80% were undergoing previous pharmacological treatment. The quality of life utility index after 3 months was 1.6 points (95% CI: 0.54-2.71) higher in the intervention group. The pain score on the VAS was 0.16 points (95% CI: 0.80-0.48) lower in the intervention group. The health professional explained 10.4% of the reduction in pain observed on the VAS throughout the medical visits.

Conclusion: Acupressure applied in addition to usual practice appeared to improve cervical pain in the long term. The effectiveness of this technique was partially explained by the health professional that trained the participants on technique application.

Trial registration number:: NCT01855893.

Keywords: acupressure; musculoskeletal disorders; orthopaedics & trauma; pain management.

Figure 1.

Flowchart of patients and losses to follow-up between baseline visit (V1) and subsequent visits at 3 days (V2), 7 days (V3), 30 days (V4), and 90 days (V5).

Figure 2.

Evolution of pain in both groups measured on a visual analogue scale (VAS) at baseline visit (V1) and follow-up visits at 3 days (V2), 7 days (V3), 30 days (V4), and 90 days (V5).