Abstract
BACKGROUND: Acute neck pain is common and often resolves spontaneously; however, a substantial proportion of cases progress to chronicity, leading to long-term disability and socioeconomic burden. Effective interventions that facilitate rapid recovery during the acute phase remain limited. This study compared the effectiveness and safety of motion-style acupuncture treatment (MSAT) with conventional acupuncture in patients with acute neck pain. METHODS: This multicenter, randomized controlled trial was conducted across four Korean medicine hospitals. A total of 128 adults aged 19-70 years with acute neck pain (≤ 4 weeks) and visual analog scale (VAS) score ≥ 5 at rest or during movement were randomized in a 1:1 ratio to receive MSAT or conventional acupuncture 2-3 times weekly for 2 weeks. Randomization was performed using site-stratified permuted block sequences with variable block sizes, and outcome assessors were blinded to group allocation. The primary outcome was the change in neck pain during movement, measured by the visual analog scale (VAS), from baseline to Week 3. Analyses were conducted according to the intention-to-treat principle. RESULTS: MSAT resulted in significantly greater reductions in movement-related pain at Week 3 compared with acupuncture (between-group difference: 15.24 mm; 95% CI 9.43-21.05), with effects sustained through Week 9. MSAT also led to greater improvements in neck disability (Neck Disability Index difference at Week 3: 7.49; 95% CI 4.23-10.75) and health-related quality of life (EQ-5D-5L difference at Week 9: - 0.03; 95% CI - 0.06 to 0.00). Seven participants (5.5%; MSAT, n = 3; acupuncture, n = 4) were lost to follow-up or discontinued the intervention. Adverse events were mild and occurred at comparable rates between groups. CONCLUSIONS: MSAT, which integrates acupuncture with guided movement, was associated with more rapid pain relief and functional improvement than conventional acupuncture, without compromising safety. These fundings suggest that MSAT may be a clinically useful option to support early functional recovery in patients with acute neck pain. Trial Registration ClinicalTrials.gov (Identifier: NCT04539184).