Seven hundred sixteen adults with chronic neck pain were randomized to receive individualized acupuncture at higher sensitive acupoints (HSA) (n=169), lower sensitive acupoints (LSA) (n=168), sham acupoints (SA) (n=170), or no treatment on a waiting list (WL) (n=176). All acupuncture groups received 10 sessions over 4 weeks. The primary outcome was the change in visual analogue scale (VAS) pain score from baseline to 4 weeks. Secondary outcomes included measures of pain, function, quality of life, and psychological well-being assessed every 4 weeks through 24 weeks. Overall, the study found that HSA and LSA groups had significantly greater pain reduction compared to SA and WL groups at 4 weeks and sustained through 24 weeks; however, the differences did not meet the 10-point minimal clinically important difference (MCID). These results suggest that individualized acupuncture is modestly effective for chronic neck pain but may fall short of clinically meaningful thresholds.