Stimulated by Tu et al 2026.[1]
EA – electroacupuncture
IF – impact factor
RCT – randomised controlled trial
WL – waiting list
NPQ – Northwick Park neck pain questionnaire
VAS – visual analogue scale
MA – manual acupuncture
INT – intradermal needle therapy– key to acronyms
This is another paper on EA for chronic neck pain from Guangzhou (n=102). The same group published a paper I highlighted in 2025 – see EA for chronic neck pain 2025.[2] It is again published in the Journal of Pain Research (IF 3.1).
Again, it is a 3-arm RCT of EA applied to the same set of points on each side of the neck (SI15 and Jingbailao). The 2025 paper was a sham controlled trial using a non-penetrating sham and WL in the third arm. This time they tested 2 different active treatment schedules (3 times a week vs once a week) and again included a WL control up to the end of the treatment period (4 weeks).
In 2025 the treatment was applied twice a week for 5 weeks at the same points. The frequency of EA was changed from 2/100Hz in 2025 to 2Hz alone in this trial. The patient population was 18 to 60 years old and mostly male (~54%) in 2025, but 10 years younger on average (18 to 40) and mostly female (~80%) in 2026.
The primary outcome was again the NPQ, which I described in the previous blog post. The baselines were quite different between the trials and the populations somewhat different, not to mention differences in treatment length and schedules, as well as different follow-up times, so the results may not be easily comparable. Plus, the group sizes of just ~30 mean that the statistical power when comparing groups is not huge.
12 sessions over 4 weeks was significantly better than 4 sessions over 4 weeks in the primary outcome (NPQ), but that difference evaporated over the subsequent 4 weeks, leading to the obvious question of whether or not the extra 8 sessions were worth it. They certainly seem to be when the results are viewed at 4 weeks.
VAS scores were still significantly different at follow-up; however, the absolute difference in means was just 0.55 on a 0 to 10 scale, which is rather modest.
If we go back to the EA protocol and consider how easy it would be to set up (just 2 pairs of points in an easily accessible part of the lower neck of a seated patient), this would actually be a very easy protocol to apply in a high-volume group clinic.
Those of us who like to examine our patients’ necks for tender points might claim that this individualised approach to point selection is clearly superior; however, a very large trial (n=716) of MA from Chengdu that I highlighted previously failed to show any difference between targeting sensitive points compared with less sensitive ones when using MA in chronic neck pain – see Acupuncture for chronic neck pain 2024.[3]
The other big trial (n=896) from a few more years back,[4] published by some of the same authors as the current, much smaller, paper on EA, studied ‘optimized acupuncture’ (MA plus INT) against 2 sorts of shallow needling. I have described this in some detail here already.
The bottom line is that EA and MA appear to work reasonably well in chronic neck pain, but the clinical approaches so far have been rather heterogeneous, so there is no clear front-runner in terms of the optimal treatment approach. We cannot say, for example, that EA is clearly better, as it appears to be in knee osteoarthritis – see EA for OAK 2026.
References
1 Tu Q-Y, He Z-Y, Huang J-P, et al. Effects of Different Electroacupuncture Frequencies in Young Adults with Chronic Neck Pain: A Randomized Controlled Trial. J Pain Res. 2026;19:638747. doi: 10.2147/JPR.S638747
2 Li W, Liu X, Lin J, et al. Clinical Efficacy of Electroacupuncture in the Treatment of Chronic Neck Pain: A Randomized Clinical Trial. J Pain Res. 2025;18:2909–22. doi: 10.2147/JPR.S515679
3 Zhao L, Sun M, Yin Z, et al. Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain : A Randomized Controlled Trial. Ann Intern Med. Published Online First: 3 September 2024. doi: 10.7326/M23-2425
4 Chen L, Li M, Fan L, et al. Optimized acupuncture treatment (acupuncture and intradermal needling) for cervical spondylosis-related neck pain: a multicenter randomized controlled trial. Pain. 2021;162:728–39. doi: 10.1097/j.pain.0000000000002071
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