Efficacy of Acupuncture in Treating Nape Back Myofascial Pain Syndrome: a Comprehensive Systematic Review and Meta-Analysis

Nape back myofascial pain syndrome (MPS) is a prevalent chronic pain condition affecting the neck and shoulder region, characterized by active trigger points in muscles like the upper trapezius and levator scapulae. This condition causes chronic non-specific cervical discomfort, dysfunction, stiffness, and limited mobility. While conventional treatments often rely on oral non-steroidal anti-inflammatory drugs (NSAIDs), these medications can cause significant cardiovascular, gastrointestinal, and organ-related side effects. Acupuncture, as part of traditional Chinese medicine, has shown promise in pain management, but the evidence for its effectiveness in treating nape back MPS has been scattered across small studies without comprehensive quantitative analysis.

The researchers conducted a comprehensive systematic review and meta-analysis by searching nine databases for randomized controlled trials comparing acupuncture to other treatments for nape back MPS. They included studies published from database inception through October 2024, focusing on adults aged 18 and older with diagnosed nape back MPS. The acupuncture interventions included various forms such as traditional needle acupuncture, electroacupuncture, floating needle, and warm acupuncture. Control groups received either oral NSAIDs or other treatments like massage, infrared therapy, or electrical stimulation.

The researchers used standardized tools to assess study quality and extracted data on multiple outcome measures including pain scores, neck disability, range of motion, and clinical effectiveness.

The analysis included 10 randomized controlled trials with 624 patients total (309 in acupuncture groups, 315 in control groups). Acupuncture demonstrated superior clinical effectiveness compared to control treatments, with a 25% higher success rate (RR=1.25, p<0.00001). For neck disability, acupuncture significantly reduced NDI scores by an average of 6.64 points compared to controls (p=0.003), particularly when compared to oral NSAIDs (8.73 point reduction, p=0.008). Pain relief varied by comparison: acupuncture was superior to non-drug therapies (massage, electrical stimulation) but showed no significant advantage over NSAIDs for immediate pain relief.

Range of motion improvements were notable, with acupuncture enhancing right lateral flexion by 4.86 degrees (p=0.003) and rotation by 0.52 degrees (p<0.00001). Pressure pain threshold also improved significantly (MD=0.95, p<0.001), indicating reduced pain sensitivity. Safety analysis showed minimal adverse events, with only 4 total adverse reactions reported across acupuncture groups.

This meta-analysis provides strong evidence that acupuncture is effective for treating nape back myofascial pain syndrome, particularly in improving neck function, range of motion, and overall clinical outcomes. The findings suggest that acupuncture offers a safer alternative to long-term NSAID use, with fewer side effects and comparable or superior results. For patients seeking non-pharmaceutical approaches, acupuncture appears to be especially beneficial compared to other physical therapies. However, the quality of included studies was generally low due to methodological limitations like inadequate blinding and allocation concealment.

Clinicians should consider acupuncture as a viable treatment option for patients with nape back MPS, particularly those who cannot tolerate NSAIDs or prefer traditional medicine approaches. The research supports acupuncture's integration into comprehensive treatment plans, though more high-quality, large-scale studies are needed to establish standardized protocols and confirm long-term effectiveness.