Different Acupuncture Treatments for Myofascial Pain Syndrome in Neck or Shoulder: A Network Meta-Analysis Based on Randomized Controlled Trials.

Myofascial pain syndrome (MPS) in the neck and shoulder is a common condition causing muscle pain and stiffness that affects daily activities. Researchers conducted a comprehensive review of 29 studies involving 2,424 patients to compare different acupuncture techniques for treating this condition. They analyzed thirteen different approaches, including specialized methods like internal heat acupuncture, electroacupuncture, and conventional acupuncture combined with other treatments such as moxibustion, herbal medicine, or exercise. The study found that several acupuncture methods worked better than standard acupuncture alone. For pain reduction measured by visual analog scale (VAS) scores, the top three treatments were moxibustion, internal heat acupuncture, and conventional acupuncture combined with moxibustion. When considering both pain relief and overall treatment effectiveness, internal heat acupuncture emerged as the most beneficial approach. This research is valuable because it directly compared multiple acupuncture techniques, something rarely done in clinical studies. The findings suggest that if you're experiencing neck or shoulder myofascial pain, discussing specialized acupuncture methods—particularly internal heat acupuncture or treatments incorporating moxibustion—with your practitioner may offer superior pain relief compared to conventional acupuncture alone. These advanced techniques appear to provide meaningful improvements in managing this painful condition. When seeking treatment, ensure you consult with a licensed acupuncturist trained in these specialized techniques.

This network meta-analysis examined 29 RCTs (n=2,424) comparing thirteen acupuncture interventions for cervical/shoulder myofascial pain syndrome. Studies were retrieved from eight databases through April 2025 and analyzed using Stata 16.0. Interventions included Fu's subcutaneous needling, internal heat acupuncture, electroacupuncture, round-point needle, needle knife, moxibustion, sunken cord, acupoint injection, and conventional acupuncture combined with various adjunctive therapies. VAS score analysis revealed the highest SUCRA rankings for moxibustion (0.84), internal heat acupuncture (0.84), and conventional acupuncture plus moxibustion (0.79). Comprehensive efficacy assessment across outcome measures identified internal heat acupuncture as demonstrating optimal therapeutic effect. Multiple acupuncture modalities showed significant advantages over conventional acupuncture monotherapy. Clinical takeaway: Internal heat acupuncture and moxibustion-based protocols warrant prioritization in treatment planning for cervical/shoulder MPS, with evidence supporting their superior analgesic efficacy compared to standard needling techniques.