Warm needle acupuncture at Jiaji points for lumbar disc herniation: A systematic review and meta-analysis of randomized controlled trials

BackgroundWarm needle acupuncture (WNA) has been widely used in the treatment of lumbar disc herniation (LDH). However, variations in acupoint selection across studies may influence the evaluation of its efficacy. This study aimed to assess the effectiveness of WNA at Jiaji points compared with conventional acupuncture for LDH.MethodsA systematic search was conducted in the Cochrane Library, Web of Science, PubMed, EMBASE, CNKI, Wanfang, and VIP databases from inception to March 17, 2026. Randomized controlled trials (RCTs) comparing WNA at Jiaji points with conventional acupuncture were included. Primary outcomes were total effective rate, Visual Analog Scale (VAS) score, and Oswestry Disability Index (ODI). Meta-analysis was performed using RevMan 5.4. Subgroup and sensitivity analyses were conducted to explore heterogeneity and assess robustness, and certainty of evidence was evaluated using GRADE.ResultsA total of 27 RCTs involving 2266 participants were included. Meta-analysis showed that WNA significantly improved the total effective rate compared with conventional acupuncture (RR = 1.26, 95% CI: 1.21-1.31, P < 0.00001). In addition, WNA significantly reduced VAS scores (MD = -1.39, 95% CI: -1.72 to -1.06, P < 0.00001) and ODI scores (MD = -5.24, 95% CI: -6.23 to -4.25, P < 0.00001). However, substantial heterogeneity was observed for VAS and ODI, and sensitivity analyses did not fully explain the residual heterogeneity. The certainty of evidence ranged from low to very low.ConclusionsWNA at Jiaji points may improve pain, functional disability, and overall clinical response compared with conventional acupuncture in patients with LDH. However, methodological limitations, substantial heterogeneity, and low to very low certainty of evidence limit confidence in the magnitude of the pooled effects. Further rigorously designed, adequately powered multicenter RCTs are needed.