Lung cancer remains a leading cause of cancer mortality globally. Spinal cord metastases (SCMs) indicate an advanced disease stage with a particularly dire prognosis, primarily due to severe neurological deficits. While modern systemic therapies can control tumor growth, they often inadequately address the critical issue of neurological recovery. This case report details a 47-year-old female with ALK-positive lung adenocarcinoma who developed multiple SCMs. Following post-SCM systemic therapy, her tumor burden decreased, but limb strength deteriorated. Adjunctive acupuncture then led to improved muscle strength and quality of life for the patient. Her overall survival from SCM diagnosis was over 9 months. This case highlights that integrating acupuncture with standard therapy shows promise for improving function and outcomes in SCMs, warranting further study.