Efficacy and safety of the thumbtack needle for neck pain: a systematic review and meta-analysis

Background: Neck pain (NP) is a common musculoskeletal disorder that significantly affects the physical function and quality of life of patients. Thumbtack needle therapy is widely used to manage NP. However, previous studies have reported inconsistent clinical outcomes. This study aims to systematically evaluate the efficacy and safety of thumbtack needle therapy for NP. Methods: A systematic search was conducted in the Cochrane Library, Web of Science, Embase, PubMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal (VIP), and Wanfang databases from their inception to 24 September 2023 for randomized controlled trials (RCTs) on thumbtack needle therapy for NP. Outcome measures included the visual analog scale (VAS) scores, neck disability index (NDI) scores, total effective rate, and adverse events. A meta-analysis was performed using Review Manager 5.3. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: < 0.05). Adverse events were not reported in several studies, limiting conclusions on safety. A subgroup analysis revealed that heterogeneity may be related to the variation in combination therapies and treatment course. A sensitivity analysis confirmed the robustness of the results. The overall quality of evidence ranged from very low to moderate. Conclusions: This study found that thumbtack needle therapy can effectively relieve pain and improve cervical mobility in patients with NP. The reduction in VAS scores reached the level of the minimum clinically important difference, indicating that thumbtack needle treatment for neck pain has a clinically significant impact. In the future, high-quality RCTs are needed to further validate the clinical efficacy of thumbtack needle therapy for NP. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025632076, PROSPERO CRD42025632076.