Ultrasound-Guided Acupotomy Release With Biomechanical Assessment For Trapezius Myofascial Pain Syndrome

Trapezius myofascial pain syndrome (MPS) is a highly prevalent musculoskeletal disorder. Conventional acupotomy release relies heavily on operator experience and lacks objective quantitative outcomes, thus severely limiting its reproducibility and mechanistic research. This protocol establishes a standardized ultrasound-guided acupotomy release combined with an objective biomechanical assessment system, detailing standardized patient positioning, ultrasound localization of pathological fascial layers, precise needle insertion, and layered superficial/deep fascial release. Shear wave elastography (SWE) and digital palpation were applied to quantitatively assess soft tissue biomechanical properties under both resting and passive stretching conditions. Results from 27 affected sides in patients with trapezius MPS who underwent ultrasound-guided acupotomy release demonstrated that: VAS scores at 1 week and 2 weeks post intervention were significantly reduced compared with both baseline and immediately after intervention (all P < 0.001); resting-state shear modulus (G-value) immediately, at 1 week, and at 2 weeks post-intervention was significantly improved compared with baseline (P < 0.05 or P < 0.01); muscle tone and stiffness at both resting and passive stretching positions, as well as resting elasticity, were significantly improved at 1 and 2 weeks compared with immediately after intervention (P < 0.05 or P < 0.01); elasticity at both passive stretching and resting positions was significantly improved at 2 weeks compared with baseline and immediately after intervention (P < 0.05 or P < 0.01). These representative short-term results suggest that the protocol can be applied reproducibly to perform ultrasound-guided acupotomy release and to quantify associated clinical and biomechanical changes. The workflow may support standardized clinical practice, technical training, and mechanistic studies of acupotomy in trapezius MPS.