Articles Vol. 67 No. CĐ6-NCKH 16/06/2026

POTENTIAL MECHANISMS UNDERLYING THREAD EMBEDDING ACUPUNCTURE IN THE TREATMENT OF MUSCULOSKELETAL DISORDERS: A NARRATIVE REVIEW

Bui Thi Mai1,2, Tran Hoa An3,4
1 Hoc Mon Regional General Hospital, 79 Ba Trieu, Hoc Mon Commune, Ho Chi Minh City, Vietnam.
2 Bệnh viện Đa khoa khu vực Hóc Môn, 79 Bà Triệu, Xã Hóc Môn, Thành phố Hồ Chí Minh.
3 University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, Cho Lon ward, Ho Chi Minh City, Vietnam
4 Đại học Y Dược Thành phố Hồ Chí Minh, 217 Hồng Bàng, Phường Chợ Lớn, Thành phố Hồ Chí Minh.
DOI: 10.52163/yhc.v67iCD6.5359
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Keywords
thread embedding acupuncture; acupuncture; musculoskeletal disorders; mechanism of action
Abstract

Background: Musculoskeletal disorders (MSDs) are a leading cause of disability worldwide. Thread embedding acupuncture (TEA) is an advanced modality evolved from traditional acupuncture, utilizing absorbable materials to maintain acupoint stimulation. However, the biological mechanisms underlying this method have not been summarized.

Methods: This narrative review was conducted through a literature search on PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar, including publications up to March 15, 2026. Evidence derived from cellular models, animal studies, clinical trials, and review articles concerning the mechanisms of TEA in MSDs and related biological pathways was screened and analyzed.

Results: The mechanism of TEA operates through three distinct effect phases including the mechanical needling effect, the biochemical-immune response to the embedded material, and the maintenance of prolonged stimulation. This integration creates a specific acupoint microenvironment that acts as a stimulation depot, modulating anti-inflammatory cytokine networks, potentially disrupting the pathological cycle at myofascial trigger points, and supporting nerve regeneration. However, the majority of current evidence regarding these mechanisms is still based on animal models or extrapolated from the theoretical framework of traditional acupuncture.

Conclusion: TEA exerts multi-layered therapeutic effects through the intersection of mechanical and biochemical factors. To firmly establish the independent physiological standing of this method, future research should focus on head-to-head trials comparing TEA with traditional acupuncture, evaluating differences among various thread materials, and acquiring direct evidence using objective human biomarkers.

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