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09 to 1.57, respectively], but not TER (RR 1.03, 95% CI 0.96 to 1.1 compared to acupuncture. MSN treatment plus conventional treatment showed significant lower VAS and higher TER, MER, and TCR (mean difference -3.54, 95% CI -3.80 to -3.28; RR 1.14, 95% CI 1.06 to 1.23; RR 2.31, 95% CI 1.50 to 3.58; RR 3.01, 95% CI 2.25 to 4.02, respectively) compared to conventional treatment. CONCLUSIONS According to current evidence, MSN treatment as a monotherapy or as an adjunctive treatment to other existing treatments might have benefits on trea