Clinical Efficacy of Acupuncture on Cervical Spondylotic Radiculopathy / 日本温泉気候物理医学会雑誌

ABSTRACT

<B>Objective:</B> We applied acupuncture to the cervical region of patients suffering from upper extremity radicular symptoms due to cervical spondylotic radiculopathy (CSR) and verified clinical efficacy.<BR><B>Methods:</B> 16 extremities of 15 patients were selected as subjects diagnosed with CSR and suffering from upper extremity pain and/or dysaesthesia. All of the patients were treated with acupuncture once a week for four weeks, on up to ten sites where tension/induration was recognized in the cervical paraspinal region centered around the affected area. A stainless steel needle 0.18mm in diameter was inserted 10 to 20mm, manipulated using the sparrow pecking method (1Hz, 20sec) and removed. The severity of symptoms was recorded before each treatment and one month after the completion of the treatments using a Visual Analogue Scale (VAS) and evaluated. In addition, a Quality of Life (QOL) evaluation was conducted before treatment, after four treatments, and one month after the completion of the treatments using the Neck Disability Index (NDI) and CSR treatment effectiveness metrics.<BR><B>Results:</B> VAS plots show a significant change in pattern over time in all cases (Neck-shoulder pain <I>p</I><0.0001, upper extremity pain <I>p</I><0.0001, upper extremity dysaesthesia <I>p</I><0.001). Furthermore, in QOL evaluation, both NDI and CSR treatment effectiveness metrics similarly showed a significant change (NDI <I>p</I><0.0001, CSR treatment effectiveness metrics <I>p</I><0.0001). Because there was a significant difference (<I>p</I><0.001) between symptoms before treatment and before the fourth treatment, the efficacy of continued treatments was verified. Meanwhile, there was no significant difference between the symptoms at the completion of the treatments and the symptoms one month after the completion of the treatments; thus, the sustained efficacy of treatments over a certain period was verified (<I>p</I>=0.52).<BR><B>Discussion and Conclusion:</B> These results verified that acupuncture treatment to the cervix has continued and sustained efficacy not only on the symptoms of neck and shoulders due to CSR, but also on upper extremity pain and/or dysaesthesia; therefore, we think this is a promising treatment as the first choice for conservative therapy. The mechanism that alleviates upper extremity pain and/or dysaesthesia through acupuncture treatment to the cervix via the stimulation of the posterior branch of the spinal nerve dominating the cervical paraspinal muscle creates a reflex effect in the anterior branch of the same nerve; as a result, it is beneficial for suppressing upper extremity pain dominated by the anterior branch as well as improving nerve blood flow.