One Needle Hand Acupuncture for MSK Disorders
One Needle Hand Acupuncture for MSK Disorders
Patients with neck, shoulder, low back, or hip pain that is exacerbated by movement will be
 randomized 1:1:1 to receive either verum hand acupuncture at the correct location (with or
 without movement) or control acupuncture at a nearby incorrect location. After needling and
 as part of the intervention, the movement groups will perform gentle active range of motion
 (ROM) exercises, while the without movement group will lay on the examination table, all for
 10 minutes. Immediately pre- and post- intervention, numeric pain rating scores (NPRS) and
 goniometer- or inclinometer-obtained ROM measurements will be recorded for the most
 provocative movement plane.

 In the physical therapy literature, within-session improvements in pain and ROM have been
 shown to correlate with between-session improvements.All patients will complete PROMIS Pain
 Interference, Physical Function, Anxiety, and Depression measures prior to the acupuncture
 intervention and then 1,2, 4, and 8 weeks later.

 Four potential treatment response modifiers will be assessed. In Traditional Chinese Medicine
 (TCM), a strong needling sensation felt by the patient during an acupuncture treatment is
 called a "deqi" response and is thought to be a positive prognostic sign. In Western
 medicine, a local twitch response (LTR) observed during needling of muscle trigger points is
 thought to represent a polysynaptic reflex and has been linked to local pain
 improvements.Other potential modifiers include patients' underlying musculoskeletal
 structural diagnosis and the provider's experience performing acupuncture.
Inclusion Criteria:

 -  Primary pain localized to neck, shoulder, low back, hip.

 -  Pain >=4 on Numeric Pain Rating Scale with one of predetermined motions.

 -  Willing to participate in study and fill out questionnaires.

 Exclusion Criteria:

 -  Fracture, malignancy

 -  Condition that requires urgent treatment (e.g. cervical myelopathy)

 -  Contraindications to needling (e.g. pregnancy, active infection)