The goal of this clinical trial is to determine whether acupuncture can improve neck pain and shoulder movement in people with chronic neck pain. Researchers will compare acupuncture with sham acupuncture (a procedure designed to resemble acupuncture without therapeutic effects) to determine whether acupuncture provides specific benefits.

Participants will be randomly assigned to receive either acupuncture or sham acupuncture. They will attend 1 treatment session and undergo assessments of neck and shoulder movement, muscle activity, pain intensity, and neck-related disability before and after treatment. Researchers will also monitor any adverse events associated with treatment.

The goal of this clinical trial is to learn whether acupuncture can improve neck and shoulder function in patients with chronic neck pain. It will also evaluate the effects of acupuncture on scapular movement, muscle activity, pain intensity, and neck-related disability.

The main questions it aims to answer are:

Does acupuncture improve muscle activation onset time in patients with chronic neck pain? Does acupuncture change electromyographic activity of the neck and shoulder muscles? Does acupuncture reduce pain intensity and neck-related disability?

Researchers will compare real acupuncture with sham acupuncture to determine whether the observed effects are specifically related to acupuncture treatment.

Participants will:

Be randomly assigned to receive either real acupuncture or sham acupuncture Receive one treatment session over the study intervention period.

Undergo assessments of muscle activation onset time and electromyographic activity before and after treatment

Complete questionnaires evaluating pain intensity, neck disability, and related symptoms Attend follow-up assessments and report any adverse events during the study period.

Inclusion Criteria:

• age between 18 and 65 years;
• presence of neck discomfort for at least 3 months; and
• baseline neck disability index(NDI) score between 5 and 24, indicating mild to moderate disability, and baseline Numerical Rating Scale (NRS) score between 1 and 6 for pain intensity.

Exclusion Criteria:

• scored >24 on the NDI, indicating severe disability;
• had a history of neck, shoulder, or upper limb surgery or major trauma;
• had restricted shoulder joint ROM, joint instability, or shoulder pain during movement;
• had taken analgesics, muscle relaxants, anti-inflammatory agents, or traditional Chinese or Western medicine 3 days prior to study initiation;
• had received acupuncture, massage, cupping, or other manual therapies within 1 week prior to the intervention; and/or
• were pregnant.

Individual participant data (IPD) will not be shared because the informed consent obtained from participants did not include permission for public sharing of de-identified individual-level data. Data containing potentially identifiable information will be retained by the study investigators and institution in accordance with applicable regulations and ethical requirements.

Participants were blinded to treatment allocation and informed that they would receive one of two forms of acupuncture intervention. Outcome assessors responsible for collecting clinical, kinematic, and electromyographic data were blinded to group assignment. Data analysis was performed using coded group labels to maintain blinding until completion of the primary analyses. Acupuncturists delivering the interventions were not blinded because of the nature of the treatment procedures.