cervical pain means that the collum or regio occipitalis , a muscle , or a muscle and a blood vessel inside the neck are pulled or that pain is felt such areas . in most cases , when a patient moves his or her neck towards a certain direction , pain appears , limiting in the neck s movement , and pressure pain appears on the collum . cervical pain in oriental medicine is categorized as stiffness of the neck , headache , pain caused by stiffness , pain caused by stiffness of the neck , paresthesia , etc . the causes are fatigue damage , stress , the aftereffect of wind and moiteur , congenital deformation , trauma , external contraction , etc . , which lead to the collateral meridian interruption and interruptions in the circulation of energy and blood . cervical pain in western medicine is associated with a ruptured cervical disk , cervical spine osteoarthritis , cervical spondylosis , a spinal cord tumor , torticollis , damage to the cervical muscle and tendon , a cervical sprain , neurogenic muscle tone on a cervical area , etc . [ 3 , 4 ] . pharmacopuncture therapy is a new form of therapy derived from the conjunction of meridian studies theory and herbal medicine theory . meridian studies theory includes therapy to treat disease by controlling the functioning of the meridian system through acupuncture . since pharmacopuncture therapy was first introduced to korea in 1960s , it has been frequently used clinically and is becoming a common therapy in oriental medicine . because pharmacopuncture therapy has been applied as a clinical treatment for some 40 years , studies on it have progressed in a variety of ways , and the results of many studies are becoming grounds for applying pharmacopuncture therapy as a clinical treatment [ 6 , 7 ] . recently , a number of studies about pharmacopuncture therapy have been done . studies by han et al   and kim et al   dealt with bee venom pharmacopuncture , and studies by lee et al   and cho et al   dealt with hominis placenta acupuncture and scolopendra pharmacopuncture . thus , various studies according to the type of pharmacopuncture have been released , but analytic research on pharmacopuncture according to the disease is still not being actively pursued . also , pharmacopuncture is useful for patients with whiplash injuries and posterior neck pain patients , and its use has been on the rise . accordingly , to explore the direction of future studies , the authors report the results of an analysis of theses released until now where pharmacopuncture was used for cervical spine disease . for that reason , we investigated until now the trend in research on pharmacopuncture used to treat cervical spine disease . objects for search were original copies and abstracts of theses listed on a database or published until july 2014 . the search was made on the oriental medicine advanced searching integrated system ( oasis ) , the national digital science library ( ndsl ) , and the korean traditional knowledge portal . cervical pain ,  stiffness of the neck ,  posterior cervical pain , and  neck disability , and those concerned with disease were  cervical disk ,  whiplash injury , cervicalgia ,  herniated nucleus pulposus ( hnp) , and  herniated intervertebral disc ( hivd) ,  ruptured cervical disk , and  cervical disc disorder. these words were selected so that we could find theses involving patient groups undergoing korean medicine treatments for cervical pain . the author selected these on research involving pharmacopuncture therapy for cervical spine disease from among theses released in korea . after the authors had selected or excluded specific theses independently , the decision whether or not to include a thesis was made by the entire research staff . such extraction was centered on the type of pharmacopuncture , the related disease and symptoms , the treatment s effectiveness , the publication year . the number of reports in the literature that were searched by using the above method totaled 1594 . among them , 222 were selected ; 511 repeated reports and 861 theses that were not related to cervical disease were excluded . finally , 25 clinical theses related to pharmacopuncture were selected ( table 1 ) chronologically , these were released as follows : 1 thesis in 2002 , 1 in 2004 , 3 in 2005 , 3 in 2006 , 4 in 2007 , 1 in 2009 , 1 in 2010 , 4 in 2011 , 4 in 2012 , and 2 in 2013 ( fig 1 ) . among the 25 selected theses , 13 used bee venom pharmacopuncture , among which a study by park et al   involved a randomized controlled trial ( rct ) with hwangryun pharmacopuncture . in six theses , ouhyul pharmacopuncture was used , and among them , a study conducted by kim et al   comparison of the effect of shinbaro pharmacopuncture to the effect of ouhyul pharmacopuncture . in addition , three theses involved the use carthami - flos pharmacopuncture , and one each involved the use of scolopendra pharmacopuncture , soyeom pharmacopuncture , and hwangryunhaedok - tang pharmacopuncture ( fig 2 ) . among the 25 selected theses , 11 came from the korean acupuncture & moxibustion society , 3 came from the journal of the pharmacopuncture institute , and 3 came from the journal of the korean academy of oriental rehabilitation medicine . in addition , two each came from the institute of oriental medicine studies of daejeon university and the association of spine & joint korean medicine , and 1 each came from the korean journal of acupuncture , the korean association of oriental medicine information , the korea institute of oriental medicine , and the journal of the korean association of sports oriental medicine ( fig 3 ) . the studies by lee et al , shin et al , and gwon et al   showed a significant decrease when using then japanese orthopedic association score ( joa score ) as an assessment scale for cervical pain . among them , in the studies by lee et al   and shin et al , bee venom pharmacopuncture was used ; in the study by gwon et al , scolopendra pharmacopuncture was used . among the selected theses , in the studies by park et al , lee et al , lee et al , woo et al , jang et al , and kim et al , the effect of pharmacopuncture for treating cervical pain for example , in the studies by park et al   and kim et al , the results achieved using hwangryun pharmacopuncture and bee venom pharmacopuncture were compared , as were the results achieved using shin- baro pharmacopuncture and ouhyul pharmacopuncture . in those two studies , bee venom pharmacopuncture and shinbaro pharmacopuncture were more effective . in a study by lee et al , chuna manual medicine and hwangryunhaedok- tang pharmacopuncture for the first two weeks , both were effective , but after that , chuna manual medicine was more effective . the study by lee et al   included groups treated with chuna manual medicine , ouhyul pharmacopuncture , and chuna manual medicine combined with ouhyul pharmacopuncture . in that study , chuna manual medicine combined with ouhyul pharmacopuncture was a little more effective . in a study by woo et al , the improvements in the group that received acupuncture therapy combined with chuna manual medicine and in the group that received acupuncture therapy combined with ouhyul pharmacopuncture were compared . significant improvements were seen in both groups , but difference in improvements between the two groups was not large . in the studies by an et al   and kim et al , a group that received bee venom pharmacopuncture therapy and a group that received electroacupuncture were compared . here , the group that received bee venom pharmacopuncture therapy showed better effective . in the study by jang et al , the acupuncture group was compared with the group that received acupuncture combined with carthami - flos seeds and juglandis semen pharmacopuncture . the result showed that acupuncture combined with pharmacopuncture was more effective . in a study of bee venom pharmacopuncture by gang et al , a group with bee venom pharmacopuncture therapy and a group with acupuncture were compared after two treatments . in the group that received bee venom pharmacopuncture therapy , the visual analogue score ( vas ) ranged from 7.2  0.44 ( index ) to 1.5  0.36 ( index ) ; however , in the group that received acupuncture , the vas ranged from 6.4  0.46 ( index ) to 4.0  0.56 ( index ) . in a study by park et al , in the group that received bee venom pharmacopuncture therapy , the average response - to - treatment time was 12.3 days while in the acupuncture group , it was 15.6 days . in a study by song , after five treatments , vas changes were - 4.60  1.50 in the bee venom pharmacopuncture group and - 2.30  1.34 in the normal saline group , so bee venom pharmacopuncture was more effective . in a study by gang and song , the group that underwent bee venom pharmacopuncture therapy and the group that received acupuncture combined with bee venom pharmacopuncture were compared , and the levels of pain and the rates of improvement for the two groups were similar 5 days later . however , 10 days later , the group that received acupuncture combined with bee venom pharmacopuncture showed a better result than the group that received only the bee venom pharmacopuncture . also , in the studies by gang et al , choi et al , lee et al , and kim et al , bee venom pharmacopuncture was reported to be effective for treating cervical pain . in the studies by yoon   and seol et al , ouhyul pharmacopuncture and normal saline were used to treat posterior cervical patients . in both groups , the vas was significantly lower , but the ouhyul pharmacopuncture group had the better result . in a study by lim et al , in the soyeom pharmacopuncture group five treatment later , the vas change was from 6.375  1.302 to 2.250  0.886 and the neck disability index ( ndi ) change was from 21.75  6.390 to 9.00  4.956 , both results being statistically significant . in a study by lim et al , patients with posterior neck pain due to whiplash injuries caused by traffic accidents were treated with ouhyul pharmacopuncture and with soyeom pharmacopuncture , but no statistically significant results for the prepost difference index ( vas ndi short - form mcgill pain questionnaire ) were reported . finally , in a study by park et al , the patients positive on the spurling test were treated with pharmacopuncture therapy for 2 weeks ; in 66.66% of the bee venom pharmacopuncture group , pain disappeared while it disappeared in only 40% of the hwangryun pharmacopuncture group . as a result of analyzing clinical theses involving the use of pharmacopuncture for treating diseases in cervical area according to the type of pharmacopuncture used by publication year , 9 out of the 13 clinical theses related to pharmacopuncture released before 2007 were theses involving the use of bee venom pharmacopuncture . however , after 2007 , of the 12 clinical theses involving the use of pharmacopuncture to treat cervical pain , only 4 used bee venom pharmacopuncture . this shows that the type of pharmacopuncture is changing from bee venom pharmacopuncture to ouhyul pharmacopuncture , carthami - flos pharmacopuncture , hwangryunhaedok - tang pharmacopuncture , etc . these days , many people complain of cervical pain caused by excessive job , stress , etc . thus , it has become necessary to actively study about the treatment of cervical pain in oriental medicine . in oriental medicine , many treatments are used for cervical pain : for example , acupuncture therapy , herbal medicine , pharmacopuncture , chuna manual medicine therapy , electroacupuncture . among them , pharmacopuncture therapy combines existing meridian channel theory with the efficacy of herbal medicine . as efficacy of pharmacopuncture therapy is excellent , its use is on the rise , and the types of pharmacopuncture are increasing . for those reasons , lee et al , cho et al , kim et al , and han et al   performed studies according to the type of pharmacopuncture : for example , hominis placenta pharmacopuncture , scolopendra pharmacopuncture , bee venom pharmacopuncture . for this reason , the authors investigated the use of pharmacopuncture therapy for treating cervical pain . objects for search were original copies and abstracts of theses listed in a database or published until july 2014 . the search was made on oasis the ndsl , and the korean traditional knowledge portal . the number of reports in the literature that were searched by using the above method totaled 1594 . finally , 25 clinical theses related to pharmacopuncture were selected . among the 25 selected theses , 13 ( 52% ) used bee venom pharmacopuncture . thus , clinical studies using bee venom pharmacopuncture to treat cervical disease were in a slight majority . by academic journal in which the selected theses were published , 11 came from the korean acupuncture & moxibustion society , which accounted for 44% of the total and ranked no . 1 , and 3 each came from the journal of the korean pharmacopuncture institute and the journal of the korean academy of oriental rehabilitation medicine , which accounted for 12% of the total and ranked no . 2 . also , among the 25 selected theses , 16 involved rcts . of these 16 , 8 compared a pharmacopuncture group to an acupuncture combined with pharmacopuncture group , and the acupuncture combined with pharmacopuncture group showed a better result than the pharmacopuncture group . in the study by kim et al , shinbaro pharmacopuncture was more effective than ouhyul pharmacopuncture . in the study by park et al , bee venom pharmacopuncture was more effective than hwangryun pharmacopuncture , but in the study by lim et al , there was no difference between ouhyul pharmacopuncture and soyeom pharmacopuncture when treating patients with whiplash injuries caused by traffic accidents . in comparing chuna with pharmacopuncture , in a study by woo et al , there was no difference between the acupuncture combined with chuna group and the acupuncture combined with pharmacopuncture group . as a result of examining the recent trend in pharmacopuncture used to treat disease in the cervical area , we found that the main study theme before 2008 was bee venom pharmacopuncture . however , from 2008 , the type of pharmacopuncture has been changing from bee venom pharmacopuncture to ouhyul pharmacopuncture , carthami- flos pharmacopuncture , hwangryunhaedok - tang pharmacopuncture , etc . this means that clinical researchers are highly interested in various types of pharmacopuncture , but still there are not enough studies to confirm the effect pharmacopuncture . thus , in the future , many studies are needed to identify the most effective pharmacopuncture treatments , along with their type , volume , procedure region , and number of treatments , and it is out hope that many such reports actually be published . by analyzing theses related to cervical pain published in journals of academic institutes for korean medicine , we were able to draw the following conclusions : 1 . pharmacopunctures used for cervical pain were pharmacopunctures used for cervical pain were bee venom pharmacopuncture , carthami - flos pharmacopuncture , scolopendra pharmacopuncture , ouhyul pharmacopuncturen , hwangryun pharmacopuncture , corpus pharmacopuncture , soyeom pharmacopuncture , hwangryunhaedoktang pharmacopuncture , shinbaro phamacopuncture . 2 . as a result of a rct study , a group treated with pharmacopuncture therapy combined with another method showed effective results . , bee venom pharmacopuncture oriented studies were actively pursued , but the number of studies on various types of pharmacopuncture has been gradually increasing . , the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient s condition .