Background Neck pain is a common musculoskeletal disorder, which is becoming increasingly common with the rise in computer and smartphone use. For many, this condition leads to chronic discomfort, and disability in daily life. Although pharmacopuncture represents a major treatment modality for neck pain in Korean medicine, its effectiveness and safety as compared with standard acupuncture has not been thoroughly investigated.
Methods A study protocol for a multicenter, pragmatic, randomized clinical trial was designed with a parallel-group approach. A total of 128 participants, each experiencing chronic neck pain for at least 3 months, will be recruited. Participants will be randomly assigned to either the pharmacopuncture or acupuncture group and receive treatment twice weekly for 4 weeks. The primary outcome will be the change in score for neck pain, as assessed using the numeric rating scale, 5 weeks after baseline. Secondary outcomes will include evaluations using the visual analog scale, Northwick Park Questionnaire, Neck Disability Index, Patient Global Impression of Change, Health-Related Quality of Life Instrument with eight items, and the EuroQol-5 Dimension. In addition, a cost-effectiveness analysis will be conducted and reported separately.
Discussion The rigorous study design is intended to ultimately provide practical evidence for clinicians and policymakers regarding the use of pharmacopuncture treatment for chronic neck pain. By directly comparing its effectiveness with standard acupuncture, the results of the trial outcomes will offer insights that may inform future healthcare decisions. Trial registration: This protocol has been registered at ClinicalTrials.gov (NCT06520462) on July 25, 2024.
Background Low-level laser treatment (LLLT) is used to treat low back pain (LBP) however, its effects on lumbar disc herniation (LDH) remain unclear. The safety and effectiveness of LLLT for LDH was determined using a systematic review of randomized clinical trials.
Methods Studies on LLLT in adults with LDH were identified from 12 worldwide databases. A risk of bias assessment and a meta-analysis with categorization according to the type of control used (inactive, active, or add-on) was performed. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation.
Results The quantitative analyses included five studies. LLLT was significantly more effective at treating LDH [leg pain visual analog scale (VAS) mean difference (MD): -1.90, 95% confidence interval (CI): -2.01, -1.80, I2 80%; LBP VAS MD: -0.79, 95% CI: -0.87, -0.71, I2 80%] than inactive controls (placebo or sham). The quality of the evidence ranged from “low” to “very low.” As an add-on to usual care, LLLT significantly improved pain intensity and disability compared with usual care (leg pain VAS MD: -2.52, 95% CI: -2.65, -2.40, I2 97%; LBP VAS MD: -1.47, 95% CI: -1.58, -1.36; Oswestry Disability Index MD: -4.10, 95% CI: -4.55, -3.65, I2 6%). However, the quality of the evidence ranged from “moderate” to “low.”
Conclusion LLLT significantly improved outcomes compared with the inactive controls, but was not more effective than usual care for LDH. In combination with usual care, LLLT was significantly more effective than usual care alone highlighting the potential of LLLT.
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