This study tested whether trigger point acupuncture (TrPA) is beneficial for office workers who have reduced job performance (presenteeism) due to chronic neck and shoulder pain (katakori).

A 4-week single-center randomized clinical trial was conducted on 20 eligible female office workers with chronic neck and shoulder pain of at least 3-month duration. The control group implemented only workplace-recommended presenteeism measures, whereas the intervention group received TrPA up to 4 times per month in addition to the presenteeism measures recommended by each workplace. The major outcome measure was the relative presenteeism score on the World Health Organization Health and Work Performance (WHO-HPQ). The secondary outcome measures were pain intensity (numerical rating scale), absolute presenteeism (WHO-HPQ), anxiety and depression (Hospital Anxiety and Depression Scale; HADS), catastrophic thoughts related to pain (Pain Catastrophizing Scale; PCS), and sleep (Athens Insomnia Scale; AIS).

All 9 cases in the intervention group and 11 cases in the control group were analyzed. TrPA up to 4 times per month reduced the intensity of neck and shoulder pain by 20% (P < .01, d = 1.65) and improved labor productivity (relative presenteeism value) by 0.25 (P < .01, d = 1.33) compared with the control group over 1 month. No significant differences were observed between the 2 groups in terms of absolute presenteeism score, HADS, PCS, or AIS.

The authors concluded that these results suggest that regular intervention with TrPA may be effective in the relative presenteeism score before and after the intervention and the degree of neck and shoulder pain over 28 days compared with the control group.

Sure, TrPA may be effective.

But is it?

I thought the trial was aimed at answering that question!

But it didn’t!

Why not?

Because, as we have discussed ad nauseam on this blog, the A+B versus B study design cannot answer it. On the contrary, it will always generate a positive result without determining whether the treatment or a nonspecific (placebo) effect caused the outcome (which, of course, is the reason why this study design is so popular in SCAM research).

In view of this, I suggest to re-formulate the conclusions as follows:

The study suggests that the researchers were ill-informed when designing it. Therefore, the findings show nothing of value.

8 Responses to The effectiveness of trigger point acupuncture on chronic neck and shoulder pain with work productivity loss in office workers

  • In this instance if Placebo and explained to patients that it is placebo is it at all worthwhile doing it if work absenteeism is reduced?

    • No!
      1) there might be better threatments that work beyond placebo.
      2) this would stop us looking for treatments that are better than placebo.

      • @Edzard
        Interesting typo:

        … threatments …

        “Now you better get better! Or else there’s gonna be trouble!”

        Wonder why no-one ever though of this alternative approach …

        • very good!
          (sorry for the typo – too nice to correct!)

        • _” no-one ever though of this . .”_

          Need for a little extra clarity of thought, Richard?

          You might well know that AltMed types have for years referred to “pHARMa”.

          And of course we know that standard pharma RCTs go out of their way to eliminate the individual.

          But yes, serendipitous typographical errors are wonderful.
          And ’tis a pity to destroy them when they are particularly apt.
          But you would be forgiven for correcting that thought, I think

          • @will

            And of course we know that standard pharma RCTs go out of their way to eliminate the individual.

            I’m afraid that your knowledge on RCTs is severely lacking. RCTs certainly look at individual responses, both with regard to the efficacy and, more importantly, adverse events.
            If a new compound doesn’t work at all for some people, or if something unexpected happens to someone, they want to know why that is. This involves information about individual cases. In earlier phases of medicine trials, they almost exclusively look at what happens (or doesn’t happen) to individuals.

            Of course they also look at aggregate data to determine how effective a new compound is, and how common any noted side effects are.

            But I guess your comment is prompted by SCAM’s common lie that they “Treat the Individual Person (and not just a disease or symptoms)”.
            This may superficially hold true, as victims of SCAMmers get a LOT of personal attention from SCAMmers. However, the problem is that almost always, the ‘treatment’ is not effective at all and often even completely nonsensical – exactly because most SCAMs don’t have any truck with RCT’s. And this in turn is because RCT’s almost always show that SCAMs don’t do anything, or are sometimes even harmful.

  • I don’t why this is an issue. Physiotherapists have been using placebos for years, As Dr Ireaci will attest. The Cochrane review says that exercises are no better than a placebo and also no better than doing nothing. Prescriptive exercise are the main treatment modality of Physiotherapists, no better than placebo. Prof Ernst, you should spend more of your time looking at the physiotherapy profession and the lack of scientific evidence for the use of it.

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