Core acupoint selection strategies and multifactorial analysis for acute musculoskeletal pain

This study aims to synthesize research hotspots in acute musculoskeletal pain, elucidate strategies for core acupoint selection and their related factors, and provide evidence-based references for clinical practice.

A comprehensive literature search was conducted across eight Chinese and English databases up to October 15, 2025, to identify clinical studies utilizing 1-3 acupoints for treatment of acute musculoskeletal pain (AMP). CiteSpace was applied for bibliometric and visualization analyses, extracting core elements for frequency statistics and generating visualization pathway maps based on pain locations. Concurrently, multivariate logistic regression was performed to further explore associations between core elements and specific pain locations. A total of 438 studies were included, including 404 in Chinese and 34 in English.

Chinese publications demonstrated a fluctuating trend over time, while the number of English studies gradually increased after 2010. Keyword clustering showed that motion style acupuncture treatment (MSAT) has become a recent research focus in both Chinese and English literature. Descriptive analysis suggested that Chinese and English studies show similarities in diagnosis and lesion location distribution, with distal acupoints predominating and body acupuncture being the most common technique. Chinese studies emphasized hand acupuncture, while English studies more frequently applied wrist-ankle acupuncture. Perpendicular needle insertion was the most prevalent needling angle. Single-point prescriptions were widely adopted. Chinese studies tended to integrate exercise treatment. Regression analysis demonstrated significant correlations between ankle pain, low back pain, distal acupoint selection, hand acupuncture, and scalp acupuncture with exercise therapy. Although the English study sample is smaller, distal acupoint selection was consistently correlated with exercise. Further analysis revealed that low back pain and shoulder pain primarily employed distal acupoints, while thigh, knee, and upper limb pain favored proximal acupoints. Low back pain and ankle pain were more often treated in combination with exercise therapy.

This study indicated that treating acute musculoskeletal pain with a small number of core acupoints is feasible, and motion style acupuncture is a key technical approach, especially beneficial for acute lower back and ankle injuries.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251155446, identifier CRD420251155446.