Acupuncture-Related interventions for exercise-induced delayed-onset muscle soreness in active adults: A systematic review and meta-analysis for sport rehabilitation.

BackgroundDelayed-onset muscle soreness (DOMS) is a common post-exercise condition that can impair athletic performance, training quality, and rehabilitation.ObjectiveTo evaluate the efficacy and safety of acupuncture-related interventions for exercise-induced DOMS in active adults.MethodsPubMed, Embase, Cochrane Library, and CNKI were searched from inception to December 2025, with a manual reference-list update in January 2026. Randomized controlled trials comparing acupuncture-related interventions with sham/placebo or no treatment in healthy adults with exercise-induced DOMS were eligible. Nine RCTs met the eligibility criteria, and seven contributed compatible pain data to meta-analysis. Two reviewers independently extracted data, assessed risk of bias using RoB 2, and rated evidence certainty with GRADE. Pain intensity on a 0-10 visual analogue scale was pooled using random-effects models.ResultsAcross seven RCTs, acupuncture-related interventions reduced DOMS pain at 24 h (MD -0.62, 95% CI -1.01 to -0.23), 48 h (MD -0.71, 95% CI -1.20 to -0.22), and 72 h (MD -0.84, 95% CI -1.35 to -0.32). Heterogeneity was low (I2 = 0%, 3%, and 23%, respectively). None of the pooled estimates reached commonly cited 1.0- or 1.3-point pain thresholds, and no DOMS-specific minimal clinically important difference has been established. Evidence certainty was moderate.ConclusionAcupuncture-related interventions may provide modest short-term reductions in DOMS pain, but their clinical importance remains uncertain. The evidence base is small and does not support dry-needling-specific conclusions. Larger, rigorously controlled, modality-specific RCTs are needed.