Stiff neck is a common acute musculoskeletal condition that significantly affects the quality of life of patients. Acupuncture is recommended as an effective method for alleviating pain and restoring neck mobility in patients with stiff neck, but there is currently a lack of scientific evidence supporting its efficacy and safety. The purpose of this study was to investigate the efficacy and safety of acupuncture in the treatment of stiff neck. This study searched 8 Chinese and English electronic medical databases, including China Biology Medicine disc, VIP database, Wanfang Data, China National Knowledge Infrastructure, Web of Science, PubMed, Embase, and the Cochrane Library, with a search period up to May 13, 2024. The focus was on clinical randomized controlled trials evaluating acupuncture treatment for stiff neck. The primary outcome measures were the total effective rate and visual analog scale scores. The quality of evidence and methodology of the included studies were assessed according to the GRADEpro guidelines. Meta-analysis was conducted to assess the results, with heterogeneity analysis, sensitivity analysis, subgroup analysis, trial sequential analysis, and publication bias analysis performed to verify the robustness of the combined results and explore potential sources of heterogeneity. This study evaluated 10 clinical randomized controlled trials comparing acupuncture therapy with conventional treatment, involving 754 patients. The treatment group received acupuncture alone or in combination with conventional treatment, whereas the control group received only conventional treatment. The analysis results showed that the treatment group was significantly superior to the control group in improving the total effective rate (risk ratio = 1.12, 95% confidence interval [CI] [1.04, 1.21], P = .002), reducing visual analog scale scores (mean difference [MD] = -0.93, 95% CI [-1.29, -0.57], P < .001), reducing neck disability index scores (MD = -6.39, 95% CI [-6.79, -6.00], P < .001), and restoring cervical range of motion (cervical lateral flexion: MD = 4.29, 95% CI [3.15, 5.43], P < .001; cervical rotation: MD = 6.08, 95% CI [4.46, 7.70], P < .001). Acupuncture is an effective and safe method for treating stiff neck. However, to validate this conclusion, more rigorously designed and higher-quality studies are needed in the future.
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