PURPOSE AND OBJECTIVES: Acupuncture is widely utilized intervention for neck pain. Previous research has indicated that acupuncture effectively reduces pain intensity of neck pain. However, its validity remains inconclusive due to repeated significance testing. We aimed to examine the efficacy and safety of acupuncture for neck pain through meta-analysis and trial sequential analysis (TSA).
METHODS: We searched the OVID Medline, Embase, and Cochrane Library from inception to October 30, 2024. Randomized controlled trials (RCTs) comparing acupuncture with inert treatment, manual therapy, or other active treatments for neck pain in adults were included.
RESULTS: Twenty-six trials involving 3520 participants were included. Thirteen (50%) trials were at a low risk of bias. Acupuncture treatment demonstrated significantly greater reductions in pain intensity (mean difference [MD] ?1.26, 95% confidence interval [CI] ?1.77 to ?0.75, P < 0.001) and pain perception (MD ?3.46, 95% CI ?5.71 to ?1.21, P = 0.003) compared with inert treatment. The TSA revealed that the cumulative Z-curves for both analyses intersected the TSA cut-off in favor of acupuncture, with the total sample size exceeding the required information size (RIS). Additionally, acupuncture was superior to inert treatment in reducing functional disability after treatment (MD ?6.52, 95% CI ?9.8 to ?3.2, P < 0.001), with cumulative sample size reaching RIS. Acupuncture also showed significant improvements in quality of life. The cumulative z-curve intersects with the TSA cut-off, which is beneficial to acupuncture.
CONCLUSION: In conclusion, despite the very low to moderate quality of evidence and high heterogeneity that weaken the pooled estimates, our analysis suggests acupuncture might be a safe and effectiveness therapy for neck pain, a finding corroborated by TSA. These results position acupuncture as a potential treatment option, particularly for patients with an inadequate response to conventional therapies. Future high-quality trials are unequivocally needed to strengthen this evidence.
| Discipline Area | Score |
|---|---|
| Rehab Clinician (OT/PT) |  |
Rehab Clinician (OT/PT) rater
An example here of statistical significance surpassing clinical significance with very low-to-moderate quality evidence and high heterogeneity.
, McMaster University