Effectiveness of Acupuncture for Neck Pain: Systematic Review and Meta‑analysis with Trial Sequential Analysis

Area of Science:

• Integrative Medicine
• Pain Management
• Clinical Research Methodology

Background:

• Acupuncture is a common intervention for neck pain.
• Previous studies suggest acupuncture reduces neck pain intensity, but validity is debated due to repeated significance testing.
• The efficacy and safety of acupuncture for neck pain require further robust investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of acupuncture for neck pain.
• To address inconclusive findings from previous research through meta-analysis and trial sequential analysis (TSA).

Main Methods:

• A systematic search of OVID Medline, Embase, and Cochrane Library was conducted up to October 30, 2024.
• Included randomized controlled trials (RCTs) comparing acupuncture with inert, manual, or active treatments for adult neck pain.
• Meta-analysis and trial sequential analysis (TSA) were employed to assess the evidence.

Main Results:

• Twenty-six trials with 3520 participants were analyzed; 50% had a low risk of bias.
• Acupuncture significantly reduced pain intensity (MD -1.26, 95% CI -1.77 to -0.75) and pain perception (MD -3.46, 95% CI -5.71 to -1.21) compared to inert treatments.
• TSA confirmed acupuncture's superiority in reducing pain and functional disability (MD -6.52, 95% CI -9.8 to -3.2), meeting the required information size.

Conclusions:

• Acupuncture appears to be a safe and effective therapy for neck pain, supported by TSA findings.
• Despite low to moderate evidence quality and heterogeneity, acupuncture is a potential option for patients unresponsive to conventional therapies.
• High-quality trials are necessary to solidify these findings and strengthen the evidence base.