Thread-Embedding Acupuncture: Current Perspectives on Mechanisms, Clinical Applications, and Safety

Objective: This study aims to provide a critical overview of the current literature on thread-embedding acupuncture (TEA), with emphasis on its proposed mechanisms, clinical applications, and safety profile.Methods: Relevant published literature was reviewed to summarize current knowledge regarding the proposed mechanisms, clinical applications, and safety profile of TEA.Results: TEA is a modified acupuncture technique in which absorbable threads are implanted into acupuncture points to provide prolonged mechanical and sensory stimulation. Proposed mechanisms include sustained peripheral sensory stimulation, localized tissue responses, and possible modulation of central nervous system and neuroimmune pathways; however, these mechanisms remain largely hypothetical and are supported primarily by indirect evidence extrapolated from conventional acupuncture and biomaterial research. Available clinical studies have primarily focused on pain-related and neurological conditions. Some studies have reported improvements in pain intensity and functional outcomes compared with control interventions. However, the overall certainty of evidence remains low because of methodological limitations, including small sample sizes, inadequate randomization and blinding, heterogeneous treatment protocols, short follow-up periods, and inconsistent outcome reporting. Reported adverse events were predominantly mild and localized, although serious complications, including infection and delayed inflammatory reactions, have also been documented.Conclusion: Preliminary evidence suggests that TEA may offer therapeutic potential for selected conditions. However, current evidence remains insufficient to support firm conclusions regarding its effectiveness and safety. Well-designed randomized controlled trials, standardized intervention protocols, and rigorous safety reporting are needed to clarify the role of TEA in contemporary clinical practice.