Efficacy and Safety of Acupuncture Combined with Traditional Chinese External Therapy for the Treatment of Scalenus Anticus Syndrome: A Systematic Review and Meta-Analysis
In brief
Acupuncture plus Chinese external therapy raises success by 21% and cuts recurrences 68%
A meta-analysis of 11 Chinese RCTs (746 patients) found that adding acupuncture to traditional Chinese external therapy improved overall clinical effectiveness by about one-fifth and lowered recurrence rates by roughly two-thirds compared with control treatments, while also reducing pain scores modestly. Safety data were sparse, and the evidence quality was low, so larger, well-designed trials are needed.
- Journal
- Journal of pain research (Q1)
- Published
- 10 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Xinyu Wei, Qian Du, Dehui Ma, Xiaobo Guo, Qianxiang Yang
- PMID
- 42454012
- DOI
- 10.2147/JPR.S609709
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (top studies of the week, 19 July 2026): SR/MA of acupuncture + TCM for Scalenus Anticus Syndrome
Abstract
This study systematically evaluated the efficacy and safety of acupuncture combined with traditional Chinese medicine (TCM) external therapy for Scalenus Anticus Syndrome (SAS) and explored the certainty and limitations of the current evidence. A comprehensive search of eight electronic databases identified eligible randomized controlled trials (RCTs), and 11 RCTs involving 746 patients met the inclusion criteria. All included studies were conducted in China and enrolled patients with neurogenic SAS. Meta-analysis demonstrated that acupuncture combined with TCM external therapy significantly improved overall clinical effectiveness compared with control interventions (RR = 1.21, 95% CI: 1.13-1.29), reduced pain intensity as reflected by lower visual analogue scale scores (MD = -1.04, 95% CI: -1.58 to -0.50), and decreased recurrence rates (RR = 0.32, 95% CI: 0.14-0.70). Sensitivity analyses supported the robustness of the pooled findings, whereas Egger's test indicated potential publication bias. Subgroup analyses were conducted to explore sources of heterogeneity in pain outcomes; however, no statistically significant subgroup differences were identified. Safety evidence remained insufficient because only one study reported mild adverse reactions and most studies did not document adverse events. These findings suggest that acupuncture combined with TCM external therapy may provide clinically meaningful benefits for patients with SAS. However, the overall certainty of evidence was low because of methodological limitations, insufficient safety reporting, publication bias, and heterogeneity across studies. Further high-quality multicenter randomized controlled trials with standardized outcome measures and long-term follow-up are required to confirm efficacy and safety.
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.