Acupuncture has been investigated in randomized controlled trials for the treatment of neck pain. However, whether there is an agreement between the combinations of acupuncture points in the scientific literature and prescriptions performed by acupuncturist physiotherapists remains unknown.

This study investigated the agreement between acupuncture point prescriptions in the scientific literature and pragmatic prescriptions by physical therapists for people with neck pain.

Twenty-four acupuncture points were obtained from 27 randomized clinical trials investigating the effects of acupuncture on neck pain. Fourteen reviewers (8 men [57%], time (median [min, max]) since completion of undergraduate and specialization courses of 18 [8, 27] and 12 [2, 25] years) reported which acupuncture points they recommend via an online questionnaire. The frequency and co-occurrence of prescribed acupuncture points were evaluated, as well as absolute and inter-rater agreement.

Physiotherapists reported 22 (94%) acupuncture points and (median [min, max]) 7 [1, 16] acupuncture points individually. The most common acupuncture points were Ashi (n=11, 79%), Houxi SI-3 (n=10, 71%) and Kunlun BL-60 (n=9, 64%); the most common co-occurrent acupuncture points were BL60 (Kunlun) and Ashi (n=9, 64%). Inter-rater reliability was better-than-chance for 5 points (ranging from κ=0.432, 95% CI=[0.276; 0.533] Ashi point to κ=0.125, 95% CI=[0.087; 0.192] GB21 point). Furthermore, inter-rater agreement was worse-than-chance for 16 points (ranging from κ= -0.453, 95% CI=[-0.453; -0.116] TE14 to κ= -0.152, 95% CI=[-0.152; 0.000] points SI12 and GV20).

Pragmatic prescriptions of acupuncture points for neck pain by specialist acupuncture physiotherapists do not agree with prescriptions in the scientific literature.

There is a need for explicit, high-level evidence-based rules for prescribing and teaching acupuncture point combinations for neck pain to be included in future clinical trials.