Association of acupuncture combined with therapeutic massage with clinical outcomes in cervical radiculopathy: A retrospective cohort study

Cervical radiculopathy is associated with neck pain radiating to the upper-limb, sensory symptoms, restricted cervical mobility, and functional disability. Acupuncture and therapeutic massage are commonly used conservative treatments, but real-world comparative evidence evaluating their combined use remains less well characterized. This study aimed to evaluate the association between acupuncture combined with therapeutic massage and clinical outcomes in patients with cervical radiculopathy. This retrospective cohort study included 126 adults with clinically diagnosed cervical radiculopathy treated between January 2021 and December 2024. Patients treated with acupuncture alone were compared with those treated with acupuncture-plus therapeutic massage. The primary outcome was change in Neck Disability Index (NDI) score from baseline to the end-of-treatment. Secondary outcomes included visual analog scale pain score, cervical range of motion, global clinical response, 3-month recurrence, medication reduction, and adverse events. Adjusted regression and propensity-score sensitivity analyses were used to address measured baseline differences. Sixty patients received acupuncture alone and 66 received acupuncture-plus therapeutic massage. Baseline characteristics were similar between groups. Compared with acupuncture alone, combined-therapy was associated with greater improvement in NDI score (−23.4 vs −16.2 points), visual analog scale pain score (−3.4 vs −2.4 points), cervical range of motion (+19.6 vs +12.5 degrees), and marked or partial clinical response (83.3% vs 65.0%). After adjustment, combined-therapy remained associated with greater NDI improvement, greater pain reduction, and a higher clinical response rate; recurrence was numerically lower in the combined-therapy group. No serious treatment-related adverse events were documented. Acupuncture combined with therapeutic massage was associated with greater short-term improvement in pain, disability, cervical mobility, and clinical response than acupuncture alone. Because this was a retrospective observational study, prospective multicenter studies with standardized treatment protocols and longer follow-up are warranted.