Does Acupuncture Produce Durable Analgesia in Trigeminal Neuralgia? An Updated Systematic Review and Meta-Analysis
In brief
Acupuncture cuts trigeminal neuralgia pain by ~1.5 VAS points in low-quality trials
5 points on a 0-10 visual analogue scale at the end of treatment, but the effect was seen only in studies judged at high risk of bias and most did not specify pain recall periods. A modest benefit persisted at three months, yet the result was unstable and based on few small studies, leaving uncertainty about true durability and clinical relevance.
- Journal
- Healthcare (Basel, Switzerland) (Q2)
- Published
- 1 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Wei Wang, Weiming Wang, He Chen, Xinyu Shen, Jiarong Fan, Shuai Gao, et al.
- PMID
- 42450934
- DOI
- 10.3390/healthcare14131926
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (top studies of the week, 19 July 2026): SR/MA of acupuncture durability in trigeminal neuralgia
Abstract
Background/Objectives: Trigeminal neuralgia (TN) is a relapsing-remitting condition predominantly managed in primary care, where carbamazepine remains the sole recommended first-line therapy. Prior meta-analyses report end-of-treatment pain reductions with acupuncture but have not stratified results by risk of bias, audited pain outcome reporting quality, or examined whether analgesic effects persist beyond the treatment period. This updated systematic review addressed these gaps. Methods: Seven databases were searched from inception to February 2026 for randomized controlled trials comparing acupuncture against non-acupuncture controls in adults with TN (PROSPERO: CRD420251271469). End-of-treatment VAS, follow-up VAS, attack frequency, recurrence rate, and adverse events were analyzed using random-effects models with Hartung-Knapp-Sidik-Jonkman adjustment. Risk of bias was assessed with Cochrane RoB 2. Recall period specification was audited for all pain outcomes. Results: Twenty-three trials (1774 participants) were included, all from China, with one sham-controlled comparator. Fewer than 15% of VAS outcomes specified a recall period. End-of-treatment pain intensity favored acupuncture (MD = -1.49; 95% CI -1.81 to -1.16; I2 = 93.1%), but the prediction interval crossed zero and significance was confined to high-risk studies (k = 16; p < 0.001). At three-month follow-up, the pooled estimate was comparable in magnitude (k = 3; MD = -1.50; I2 = 47.0%) but was not robust to single-study removal. Recurrence rate favored acupuncture in both reporting studies. Acupuncture was associated with fewer adverse events than carbamazepine (RR = 0.31; I2 = 0%). Conclusions: End-of-treatment estimates are compromised by risk-of-bias dependence and pervasive recall period omission. Follow-up data showed a directionally consistent but statistically fragile signal of analgesic persistence. Sham-controlled trials with prospective pain diaries and follow-up as a co-primary endpoint are needed.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.