Thread Embedding for Pain

THREAD EMBEDDING · 埋線 · Non-surgical chronic pain care

Not a stimulus that passes,
but one that stays and works

Some pain does not improve much even after treatment at several places. Its root is usually muscle and fascia that have stiffened and dried out over a long time. Thread embedding for pain is a non-surgical treatment that places absorbable threads that are harmless to the body into the acupoints, muscles and ligaments behind the pain, creating an environment in which the body can recover on its own while the threads remain inside.

Non-surgical · no incision or stitches, and you can go about your day on the day of the procedure
While the threads remain, stimulation continues for months, buying time for tissue recovery
Whether to proceed, how wide an area to treat and whether to add pharmacopuncture are decided after examination

Cross-section of the lower back — muscle wrapped in fascia beneath the skin and fat layer, with acupoints beside the spine and ligaments and tendons — The threads settle in the fascial layer, and stimulation continues for months until they are absorbed (conceptual illustration)

MECHANISM AT A GLANCE

How thread embedding works,
at a glance

The key point is simple.
The stimulus does not just pass — it stays until recovery takes place.
That is why it can make a difference in long-standing pain. (Conceptual illustration)

STEP 01 · Day of procedureThread placement
Absorbable threads are placed at acupoints and in muscles and ligaments. The needle is withdrawn and only the thread remains.
STEP 02 · 4–10 weeksOngoing stimulus
While the thread remains, the stimulus does not stop. Acupuncture is momentary; thread embedding continues.
STEP 03 · Weeks to monthsBlood flow · tissue repair
The ongoing stimulus triggers a tissue response, new blood vessels grow and collagen forms.
STEP 04 · 3–6 monthsStructural stability
Even after the threads are absorbed, the newly formed fibrous tissue remains and supports muscles and joints.

PAIN THAT DOES NOT GO AWAY

Injections, painkillers,
physical therapy…
so why does this pain keep coming back?

Acute pain and chronic pain have different causes. With long-standing pain, the problem often lies less in the ‘sore spot’ itself than in the condition of the surrounding tissue. We first look at three common reasons pain keeps recurring.

AdhesionStiff, dried-out fascia
IschemiaReduced blood flow and oxygen
InstabilityWeakened muscles and structure

Three reasons pain keeps recurring

A person with a stiff shoulder rubbing it while stretching the arm out

01

Stiff, dried-out fascia

Repeated tension, poor posture and stress cause muscles and fascia to lose flexibility and moisture. As tissues begin to stick together (adhesion), the source of pain takes hold.

A person sitting on a sofa holding their knee

02

Reduced blood flow and oxygen

Adhesion and tension reduce local blood flow. Muscles short of oxygen and nutrients cannot recover, and a cycle that produces more pain and tension repeats itself.

A person holding their lower back and struggling to get up from a sofa

03

Weakened muscles and unstable structure

When pain limits movement, muscles grow weaker and lose the strength to support the joints and spine. Once the structure becomes unstable, pain recurs more easily.

HOW IT WORKS

What does the thread
do inside the body?

Thread embedding looks similar to acupuncture, but the principle is different. An acupuncture needle gives a brief stimulus and is removed, whereas an embedded thread stays in the body and keeps working until it is absorbed. In the meantime, the following changes take place in the tissue.

DurationA stimulus that stays
RegenerationMicro-stimulus that prompts repair
CirculationNew blood vessels
ControlRegulating muscle tension

Four changes that follow in the tissue

01

DURATIONA stimulus that stays

With acupuncture, the effect fades quickly once the stimulus ends. With thread embedding, the thread remains, so the stimulus does not stop. Because it continues for as long as the muscle needs to recover, it can make a difference in chronic pain.

ThreadMade of absorbable material (such as PDO), it slowly dissolves and disappears inside the body.

02

REGENERATIONA micro-stimulus that prompts repair

A very small, localized reaction occurs around the embedded thread, and this acts as a signal for the tissue to repair itself. New collagen and fibrous tissue form where the thread was, helping the tissue firm up again.

Analogy‘Taping from the inside’. The thread does inside the muscle what tape does from the outside.

03

CIRCULATIONNew blood vessels grow

Ongoing stimulation draws blood flow to the area. As tiny new blood vessels form nearby and moisture in the tissue increases, dried-out muscle becomes softer again and regains its elasticity.

Key pointRestoring blood flow and oxygen supply is a key pathway to pain relief.

04

CONTROLRegulating muscle tension

Muscles and tendons contain receptors that sense tension. The ongoing stimulus of thread embedding works toward normalizing how these sensors respond, helping muscles that have stiffened from overtension to relax.

ExplanationIt is explained by more efficient muscle spindle and Golgi tendon organ responses and by modulation of deep reflexes.

Acupuncture vs. thread embedding: how long the stimulus lasts

Even when the same area is treated, the stimulus stays for a different length of time.

Acupuncture

Stimulus at the moment of treatment

Thread embedding

Continues until the thread is absorbed (4–10 weeks)

This illustration compares conceptually ‘how the stimulus stays’ in the two treatments. The actual course of treatment varies with each patient's condition, and acupuncture maintains stimulation through repeated sessions.

How many threads go into one area?

The number and position of threads depend on the thickness of the fascia at the painful area and on body type.

Focused treatment of one area: 30–50 threadse.g. one shoulder · lower back
Whole-body structural setting: 100–150 threadsSupporting the whole-body structure together

The treatment area and number of threads are decided based on examination, and the figures above are typical ranges. Even with the same thread, which layer it goes into (upper fat layer, ligament or muscle) matters.

PROCEDURE & RECOVERY

The procedure
and recovery timeline

Thread embedding unfolds over several months, from examination through to recovery. Here is an overview of the steps on the day of the procedure and the changes that take place in the body afterward.

Same dayExam → relax → pain control → threads → guidance
4–10 weeksThe period the threads stay in the body
3–6 monthsThe period in which tissue regenerates and structure stabilizes

The treatment area, whether pharmacopuncture is added and the number of threads depend on examination findings. The steps are the same, but the actual plan differs for each patient.

STEP 01
Examination · assessment
- We check which muscles have weakened and where the problem lies
- We look at the extent and duration of pain, posture and range of motion, and imaging findings when needed
STEP 02
Relaxation
- The affected area and surrounding muscles are thoroughly relaxed with physical therapy and similar care
- With the muscles relaxed, the procedure goes more smoothly and the threads settle in more easily
STEP 03
Pain control
- If inflammation and pain are severe, pharmacopuncture is used first to reduce them
- Acute pain is eased first, and then we move on to treatment that addresses the structure
STEP 04
Thread embedding
- Absorbable threads are placed at acupoints and in muscles and ligaments
- The number and position of threads are set according to fascial thickness, body type and the extent of pain
STEP 05
Wrap-up · guidance
- We check the treated area and explain aftercare and the next appointment
- We adjust the treatment plan as we follow your progress

Recovery timeline

Day 0A heavy feeling begins
The treated area may feel heavy, tight or tender. This is a normal tissue response, and you can resume daily activities on the day of the procedure.
Day 2Discomfort settles
Bruising and tenderness mostly subside. Redness or warmth at the treated area lasting 3–7 days is also within the normal range of response.
1–2 wksChanges start to be felt
You may begin to notice less muscle fatigue and a more stable core. When and how much change is felt varies greatly from person to person.
4–10 wksThreads are absorbed
The embedded threads gradually dissolve and are absorbed. Newly formed fibrous tissue remains in their place and supports the structure.
3–6 monthsStructure settles
As tissue regeneration progresses, muscles recover to a more flexible and firmer state than before. At this point, the treatment plan is reviewed and set again.

The timeline above is a conceptual illustration of the general course. The speed and effect of recovery vary with the duration and extent of pain, muscle condition and underlying conditions, and the number and interval of sessions are decided after the first examination.

WHERE IT IS USED

Where is it
most often used?

Thread embedding can be applied to almost any part of the body, but it is especially often used in areas such as the neck, shoulders, lower back and knees, where muscles and fascia are repeatedly overloaded and do not recover well.

Commonly treated areas

Full-body anatomical illustration — dots mark the areas where thread embedding is most often used — Tap a dot or button to see details for each area (conceptual illustration)

Neck · cervical spine

Main treatment sitesCervical erector spinae · upper trapezius · levator scapulae · suboccipital muscles

Used for pain such as

Postural neck pain such as forward head posture or straight neck
Numbness in the neck, shoulder or arm from a cervical disc herniation
Neck pain and numbness in the limbs from cervical spinal stenosis
Chronic stress-related neck stiffness
Tension headaches from tight suboccipital muscles

Main treatment sites

Upper trapezius fibers
Cervical erector spinae
Levator scapulae
Suboccipital muscles
Deep posterior neck muscles

※ Nerves and blood vessels run through the neck, so the anatomical structure must be confirmed precisely before treatment. Effects and progress vary from person to person.

The uses by area are general examples; the actual treatment sites and combinations are decided after examination. Pain rarely arises in one place in isolation, so areas that affect each other — such as the neck and shoulders, or the lower back and pelvis — are looked at together.

SPECIAL CLINIC · FACIAL THREAD EMBEDDING

Facial palsy sequelae
and facial asymmetry:
where thread embedding
matters most

Acute-phase treatment for facial nerve palsy (Bell's palsy) is well established, but few treatment options are available once sequelae set in. Facial muscles are far thinner and more delicate than other muscles in the body, and stiffened muscles need to be lengthened while weakened muscles are revived, at the same time.

PrecisionFacial muscles are only a few mm thick — depth, position and thread type shape the result
ExaminationMuscles around the eyes and mouth are checked one by one and left-right symmetry compared
TimeEffects tend to appear over time rather than right after treatment

Results of facial thread embedding depend greatly on the practitioner's anatomical understanding and experience. We recommend consulting a medical team experienced in treating facial palsy sequelae before proceeding.

Why sequelae remain, and what thread embedding does in the face

Face illustration with red dots marking thread embedding sites for each facial muscle, including the frontalis, temporalis, orbicularis oculi, corrugator supercilii, zygomaticus, orbicularis oris and depressor anguli oris — Red dots = thread embedding sites for each facial muscle (conceptual illustration)

Key point

In facial thread embedding, the choice of thread depth, position and type shapes the result. Facial muscles are only a few mm thick, so which muscle a thread enters and at what depth must be planned precisely. That is why, at the examination stage, we check the muscles around the eyes and mouth one by one and compare left-right symmetry before deciding on the treatment sites.

Why sequelae remain

30%still have sequelae
3–6 months after onset

Mild 12%
Moderate 13%
Severe 4%

Many patients with facial palsy improve within three weeks of onset, but about 30% still experience sequelae 3–6 months later. Of these, about 12% are reported as mild, 13% as moderate and 4% as severe. Typical sequelae include incomplete recovery from paralysis, synkinesis (such as the mouth moving when the eyes close), involuntary movements and contracture.

What threads do in the face

Stiff musclesLoosen

Weak musclesRevive

The challenge in the sequelae phase is that each muscle is in a different state. Some muscles are stiff, while others lack strength. Thread embedding keeps stimulating the muscles where threads are placed for several months, and as the threads break down, it induces collagen synthesis and muscle regeneration responses. It works toward loosening stiff tissue and reviving weakened muscles, gradually balancing the left and right sides of the face.

Approach by type of sequela

Asymmetry · contracture

One drooping corner of the mouth, a slanted philtrum, differences in nasolabial folds or nostril size, and contracture that pulls the face to one side.

Approach

Each side is adjusted differently: stiff, pulling muscles are eased, and muscles on the drooping side are strengthened.

Synkinesis

The eye moves along when the mouth moves, or the area around the mouth pulls when the eyes close.

Approach

Tension is reduced in the muscles showing synkinesis and stimulation is spread to surrounding muscles, retraining the face to use only the intended muscles.

Residual paralysis · weakness

The eye does not close fully (lagophthalmos), the forehead does not wrinkle, and facial expressions are hard to form.

Approach

Threads placed in the paralyzed muscles provide ongoing stimulation to help restore contractile strength. Around the eyes, we work delicately with fine threads and short needles.

Which muscles, and howSites, goals and thread choice by facial muscle.

Treatment site	Main goal	Thread · needle choice
Frontalis (forehead)	Forming forehead wrinkles, strengthening forehead muscles	38–60 mm embedding needles placed along the muscle fibers
Orbicularis oculi · levator palpebrae	Helping the eye close, strength around the eye	Delicate work around the eye with fine 20 mm needles
Corrugator supercilii · nasalis	Easing wrinkles and tension between the brows and around the nose	38 mm, planned placement in the superficial layer
Zygomaticus major · minor	Reinforcing cheek muscles, lifting the mouth corners	38–60 mm; barbed embedding needles where tissue is thick
Risorius · orbicularis oris	Pulling the mouth corners, speech and expression	Multi-thread embedding needles for strong stimulation at once
Depressor anguli oris · depressor labii inferioris	Drooping mouth corners, lower lip asymmetry	38 mm, amount adjusted by comparing both sides
Temporalis	Tension at the temples, adjusting the cheek and jawline	38 mm multi-thread embedding needles

The treatment sites and choice of needles and threads above summarize methods reported in the treatment of facial palsy sequelae; the actual procedure is planned after examining the patient's muscle condition and left-right differences.
About 20–30 threads per session is a typical range, and the interval and total number of sessions vary with the condition.

Clinical results of facial thread embedding

2019
Case report
4cases
Thread embedding combined with Jeongan acupuncture in patients with synkinesis sequelae. Left-right symmetry ratios improved numerically and facial stiffness decreased. Once a week, 10–30 sessions in total.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology · 2019
2020
First randomized controlled trial
Primary endpoint No significant difference
In the first randomized controlled trial on facial sequelae, the primary endpoint (FDI) showed no statistically significant difference, while clinical effects were observed in some measures such as facial stiffness and the FDI physical score.
2023
Retrospective observational study
68patients·215sessions
Patients with facial palsy sequelae. The Sunnybrook Facial Grading System (SFGS) and the Facial Disability Index (FDI) total and physical scores improved significantly from the second session onward (P<.05). Across all 215 sessions, there were 0 adverse events requiring medical treatment or threatening life.
Ko MJ et al. · Medicine · 2023
2025–
Multicenter randomized controlled trial
142patientsOngoing · not yet published
Target sample size (study design value). Compares electroacupuncture alone with electroacupuncture plus thread embedding, at 20 acupoints once a week for 6 weeks.
Kim JH et al. · Frontiers in Neurology · 2025 (protocol)

Limits of evidence

We also state the limits of the current evidence

In the first randomized controlled trial on facial sequelae (2020), the primary endpoint (FDI) showed no statistically significant difference, while clinical effects were observed in some measures such as facial stiffness and the FDI physical score.
The 68-patient study above is a retrospective observational study without randomization, so a causal relationship cannot be confirmed.
Results of the multicenter trial that began in 2025 have not yet been published. We are currently awaiting the results, and the figures above are study design values.
Results of facial thread embedding depend greatly on the practitioner's anatomical understanding and experience. We recommend consulting a medical team experienced in treating facial palsy sequelae before proceeding.

PHARMACOPUNCTURE × MAESEON

Pharmacopuncture and
thread embedding
fill each other's gaps

The two treatments are not competing options; they play different roles over time. Pharmacopuncture quickly eases the pain you feel now, while thread embedding builds up the structure so the pain is less likely to return. Used together, they reduce the gaps in treatment.

When bee venom pharmacopuncture is used, we first test a small amount to check for an allergic reaction before proceeding. If you have a history of bee venom allergy, please be sure to tell us in advance.

Pharmacopuncture eases quickly; thread embedding builds slowly

PHARMACOPUNCTURE

Pharmacopuncture — fast, starting with inflammation and pain

A treatment that injects a pharmacopuncture solution, extracted and refined from medicinal herbs, into acupoints and painful areas. The pharmacological action of herbal medicine is added to the physical stimulus of the needle, and anti-inflammatory and analgesic effects tend to appear relatively quickly.

How long it staysActs fast · short-lived

Common types: Bee venom, safflower (Carthamus), placenta (Hominis Placenta) and deer antler pharmacopuncture, among others — chosen according to symptoms and constitution.
Strengths: Suited to acute pain, pain with inflammation, and swelling with warmth.
Limits: Its effect stays for a relatively short time, so chronic structural problems require repeated sessions.

MAESEON

Thread embedding — slowly rebuilding the structure

Absorbable threads are placed in muscles, ligaments and acupoints to continue stimulation for several months. It is a treatment that buys time for weakened muscles and stiff fascia to recover on their own.

How long it staysActs gradually · lasts months

Strengths: Because the stimulus lasts long, it is suited to chronic pain, recurring pain and pain with muscle weakness.
Limits: Its effects appear gradually, so pharmacopuncture is better for quickly easing acute pain right after treatment.
Together: When tension and inflammation are first reduced with pharmacopuncture and thread embedding follows, the threads settle in while the muscles are relaxed, and the course of treatment is more stable.

How the window of pain control changes when the two are combined

Pharmacopuncture is sharp; thread embedding is long. When the two curves overlap, the gaps shrink.

Pharmacopuncture · quickly eases acute pain and inflammationThread embedding · lasts until the muscles recoverHorizontal axis: start → 1 month → 3 months or more / vertical axis: pain-control effect

This illustration compares the characteristics of the two treatments conceptually. In an actual treatment plan, the weight given to each depends on the stage and condition of the pain.

How combined treatment proceeds

STEP 01
First, reduce tension
Relaxation with physical therapy
Before the procedure, the affected area and surrounding muscles are thoroughly relaxed with physical therapy and similar care. With the muscles relaxed, the procedure goes more smoothly and the threads settle in more easily.
STEP 02
Ease pain with pharmacopuncture
Inflammation and pain first
Pharmacopuncture is applied to the affected area and attachment points to reduce inflammation and pain first. Many patients feel less pain during this stage.
STEP 03
Build structure with threads
Stimulation lasting months
Threads are placed in the relaxed muscles, ligaments and acupoints so that stimulation continues for several months. Thread embedding turns the breathing room created by pharmacopuncture into structural support.

THREE TREATMENTS

Thread embedding, pharmacopuncture
and acupuncture:
how do they differ?

They are all offered at the same clinic, but their purposes and time frames differ. Korean medicine doctors use these differences to build a combination suited to each patient's condition.

AcupunctureThe foundation for overall circulation and condition
PharmacopunctureEases acute pain and inflammation first
Thread embeddingMaintains the relief and builds up the structure

Side-by-side comparison

Item	AcupunctureChim	PharmacopunctureYakchim	Thread embeddingMaeseon
Principle	Needles are inserted into acupoints to provide a physical stimulus.	A pharmacopuncture solution extracted and refined from medicinal herbs is injected into acupoints and painful areas. The pharmacological action of herbal medicine is added to the needle stimulus.	Absorbable threads are placed at acupoints and in muscles and ligaments, and stimulation continues while the threads remain.
Main action	Eases pain by regulating qi and blood circulation and muscle tension.	Anti-inflammatory and analgesic effects appear relatively quickly.	Supports tissue regeneration and structural stability, creating an environment in which muscles can recover on their own.
How long the stimulus stays	The moment of treatment. Stimulation is maintained through repeated sessions.	Relatively short.	Continues until the threads are absorbed (4–10 weeks), after which the fibrous tissue that has formed supports the structure.
When changes start to be felt	From right after treatment, building up with each session.	Relatively quickly.	Gradually from a few days to 2 weeks, settling in over 3–6 months.
Best suited to	Acute and chronic pain in general, and pain with functional problems.	Pain with strong inflammation, and swelling with warmth.	Long-standing pain that is slow to improve, recurring pain, and pain with muscle weakness.
After treatment	Usually none or mild.	There may be a stinging sensation or mild bruising at the injection site.	There may be heaviness, tightness, tenderness or bruising for a few days, and redness or warmth may last 3–7 days.
Treatment interval	Repeated at short intervals depending on symptoms.	Repeated according to symptoms and response.	Performed at intervals of weeks to months. A typical range is 30–50 threads for one area, and about 100–150 threads when supporting the whole-body structure.
When combined	Serves as the foundation for overall circulation and condition.	Eases acute pain and inflammation first.	Maintains the reduced pain and builds up the structure.

The three treatments are not ranked against each other; they play different roles. The actual combination, order and weight of each treatment depend on the patient's condition and are decided after examination. When changes are felt and how they progress vary from person to person.

EVIDENCE

The clinical evidence
gathered so far

Thread embedding is not a treatment that relies on experience alone. Randomized controlled trials on conditions such as chronic low back pain and neck pain have been published in Korean and international journals, and a systematic review and meta-analysis of adverse events appeared in 2026.

RCTChronic low back pain · cervical radiculopathy · nonspecific neck pain
ReviewsKnee osteoarthritis · post-stroke spasticity · mechanism
SafetyMeta-analysis of 90 trials — adverse events mostly mild and temporary

Safety meta-analysis (Hong et al., Biomedicines, 2026)

Trials included

90trials

Number of randomized controlled trials of thread embedding included in the systematic review and meta-analysis

Hong et al. · Biomedicines · 2026 View paper

Pooled adverse event rate3%
With thread embedding alone (95% CI 2–7%)
Serious adverse events0.06%
Serious thread-embedding-related adverse events reported among 1,697 patients (1 case)
Risk ratio vs. acupuncture0.97×
0.641.0 (no difference)1.49
95% CI 0.64–1.49, no significant difference

Most adverse events were mild and temporary, and the discontinuation rate due to adverse events was 0.36% (9/2,524).

Clinical studies by condition

RCT · multicenterMedicine 2020

Chronic low back pain

Thirty-eight patients with chronic low back pain were assigned 1:1 to thread embedding plus acupuncture or acupuncture alone for 8 weeks, and followed up until 3 months after the last treatment. The threads used were polydioxanone (PDO), 29 gauge, 40 mm.

ResultsVAS 33.7 vs 15.6P=.013

Change in VAS (pain): 33.7±25.1 (thread embedding plus acupuncture) vs 15.6±17.0 (acupuncture alone), P=.013. Four adverse events were reported in each group, but they were judged to be unrelated to thread embedding.

Sung WS et al. · Medicine (Baltimore) · 2020

View full text

RCT · multicentereCAM 2018

Cervical radiculopathy

One hundred and two patients with chronic pain from a cervical disc condition were assigned to three groups (sham embedding 34 / middle-layer embedding 34 / deep-layer embedding 34), and polyglactin 910 sutures were placed under ultrasound guidance into the semispinalis capitis (middle layer) or multifidus (deep layer) once a week for 3 weeks.

ResultsSignificant VAS dropP<0.001

In the deep-layer group, VAS decreased significantly from baseline at 1, 2 and 3 weeks of treatment (P<0.001), and remained significantly lower than in the sham group 10 weeks after the first treatment (95% CI −4.4 to −3.2, P<0.001). No serious adverse events (such as inflammatory granuloma) were reported. Three patients who reported tingling after treatment of the neck recovered spontaneously without any specific treatment.

Chu YX et al. · Evidence-Based Complementary and Alternative Medicine · 2018

View paper

RCTJACM 2019

Chronic nonspecific neck pain

In 106 patients with chronic neck pain, PDO thread embedding was given as an adjunctive therapy once a week for 4 weeks. Neck pain, functional disability and anxiety and depression symptoms improved more than in the control group, and quality of life and overall satisfaction also improved.

NotableLarger effect after week 5

The treatment effect was greater after week 5 than right after treatment, which was interpreted as the result of ongoing stimulation from the threads remaining in the tissue.

Kim E et al. · The Journal of Alternative and Complementary Medicine · 2019

View paper News coverage

Systematic reviewKorean J Acupunct 2018

Knee osteoarthritis

A systematic review of clinical studies applying thread embedding to degenerative knee arthritis, suggesting that thread embedding may be used in the treatment of knee osteoarthritis.

Limits

The review noted that the included studies lacked detailed information on treatment methods (thread type, treatment sites and depth), so the evidence should be interpreted with caution.

Park JM et al. · Korean Journal of Acupuncture · 2018

View paper

Narrative review · 13 RCTsJKM 2022

Post-stroke spasticity

Thirteen randomized controlled trials applying thread embedding to post-stroke spasticity were analyzed. The most common regimen was once every 1–2 weeks for 4 sessions, and results for spasticity, motor function and activities of daily living were better than with conventional treatment.

Limits

The review cited the lack of follow-up, the shortage of sham-controlled groups and the low quality of the included studies as limitations.

Cho S, Kim E · Journal of Korean Medicine · 2022

View PDF

Literature analysisJKMOOD 2023

Mechanism of action

Of 60 papers retrieved from the Oriental Medicine Advanced Searching Integrated System (OASIS), six describing the treatment mechanism were analyzed. The action of thread embedding is summarized as physical stimulation (long-term needle retention, acupoint stimulation and tissue repair) and chemical stimulation (an aseptic inflammatory response as the thread breaks down).

Reported

This process was reported to promote the formation of collagen and elastic fibers and to improve blood circulation.

Park EY, Seo HS · The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology · 2023

View paper

Limits of the evidence

Listing only favorable results does not help patients. We also state the limits of the current evidence.

01
Sample sizes are small
38patients
The multicenter trial on chronic low back pain had 38 participants, which is not enough to generalize the results.
02
Follow-up periods are short
~3months
Most studies followed patients for only about 3 months, so long-term effects and recurrence have not yet been studied sufficiently.
03
Sham-controlled groups are lacking
Several reviews pointed to the absence of sham controls as a common limitation.
04
Studies are regionally concentrated
81/ 90 trials
Of the 90 trials included in the safety meta-analysis, 81 (90.0%) were conducted in China.
05
Adverse event reporting criteria vary
Definitions and reporting methods are inconsistent, which limits direct comparison between studies.
06
Treatment methods vary widely
Thread material, length, treatment depth and treatment points differ from study to study, so there is not yet a conclusion on which method is most effective.

ReferencesA list of the academic sources cited in this section.

Sung WS, Hong Y, Jeon SR, et al. Efficacy and safety of thread embedding acupuncture combined with acupuncture for chronic low back pain: a randomized, controlled, assessor-blinded, multicenter clinical trial. Medicine (Baltimore). 2020;99(48):e22526. View full text
Chu YX, Cui WQ, Xu F, et al. Acupoint embedding of polyglactin 910 sutures in patients with chronic pain due to cervical spondylotic radiculopathy: a multicenter, randomized, controlled clinical trial. Evid Based Complement Alternat Med. 2018;2018:3465897. View full text
Kim E, Kim YS, Kim YI, et al. Effectiveness and safety of polydioxanone thread-embedding acupuncture as an adjunctive therapy for patients with chronic nonspecific neck pain: a randomized controlled trial. J Altern Complement Med. 2019. View full text
Hong J, Noh WH, Suh JW, Woo Y, Fregni F, Kim JH. Safety profile of thread-embedding acupuncture: a systematic review and meta-analysis of randomized controlled trials. Biomedicines. 2026;14(9):1901. View full text
Cho S, Kim E. A narrative review of clinical studies on thread embedding acupuncture treatment for spasticity after stroke. Journal of Korean Medicine. 2022;43(4):131. View PDF
Park EY, Seo HS. Analysis of the mechanism of thread-embedding acupuncture in Korean medicine beauty treatment. The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology. 2023;36(4):113. View full text
Park JM, Lee JS, Lee EY, Roh JD. A systematic review on thread embedding therapy of knee osteoarthritis. Korean Journal of Acupuncture. 2018. View full text
Goo B, Ryoo DW, Kim EJ, et al. Clinical research on the efficacy and safety of thread-embedding acupuncture for treatment of herniated intervertebral disc of the lumbar spine: a protocol for a randomized controlled trial. Trials. 2018. View full text
Kim JI, Han CH, Jeon JH, Kim JY, Kwon O. Effectiveness of thread-embedding acupuncture compared to physical therapy in patients with non-specific chronic neck pain: an assessor-blinded, randomized, controlled trial. J Pain Res. 2021. View full text
Ko MJ, et al. Thread embedding acupuncture for sequelae of peripheral facial palsy: a retrospective observational study. Medicine. 2023.
Choi BI, Lee SR, Lee SH. Maeseon Therapy: A Manual for Treating Chronic Pain through Structural Stabilization (in Korean). Korean Society of Pain Thread Embedding. 2025. About the book

This section summarizes academic sources on thread embedding for informational purposes. The figures cited are results reported in each study and are not intended to guarantee or advertise the effect of any particular treatment. If you need to interpret the original findings, please refer to the full text of each paper.

FAQ

Thread embedding
FAQ

We have gathered the questions asked most often in consultations, grouped by topic. For anything not covered here, feel free to ask us by phone.

BasicsVs. acupuncture and thread lifts, safety, indications
Same dayPain · number of threads · multiple areas · bruising
Daily lifeShowering · exercise · alcohol · massage
SafetySide effects · contraindications · recovery · cost

How it works and general questions

QWhat is thread embedding for pain?

It is a non-surgical treatment in which absorbable threads that are harmless to the body and break down inside it are placed into the acupoints, muscles and ligaments behind the pain. While the threads remain in the body, stimulation continues without interruption, buying time for stiff and weakened tissue to recover on its own. It involves no incision or stitches, and you can return to daily life right after the procedure.

QHow is it different from regular acupuncture?

An acupuncture needle stimulates at the moment of treatment and is then removed, so the stimulus does not last long. With thread embedding, the thread remains, so stimulation continues even after the needle is withdrawn. The threads are usually absorbed gradually over 4–10 weeks, and newly formed fibrous tissue remains in their place and continues to support the structure. The fact that the stimulus stays for a long time is the biggest difference from acupuncture.

QIs it the same as cosmetic thread embedding (thread lifting)?

The materials are similar, but the purpose and placement differ. Cosmetic thread embedding places threads in the facial skin layers for lifting and elasticity. Thread embedding for pain places threads in the muscles, fascia and ligaments behind the pain, with the aim of restoring muscle function and the body's structure. Both the treatment sites and the layers the threads go into are different.

QIs it safe to have threads left in the body?

The threads used are made of absorbable material (such as PDO) that is harmless to the body and breaks down inside it. After placement they slowly dissolve and are absorbed, and even after absorption, newly formed fibrous tissue remains in their place and supports the structure. However, which layer the thread goes into matters. Foreign-body reactions or inflammation have been reported in rare cases, so we recommend getting a full explanation of the threads used and the treatment area before the procedure.

QWhat kinds of pain is it particularly suited to?

It is often used in areas such as the neck, shoulders, lower back and knees, where muscles and fascia are repeatedly overloaded and do not recover well. It is suited to long-standing pain in which muscles have weakened and the structure has become unstable, and to pain that has been slow to improve despite treatment elsewhere. On the other hand, when inflammation is strong, as with a fresh acute sprain, pharmacopuncture or other treatments are considered first.

QWhen does it start to work, and how many sessions are needed?

Many people begin to notice changes between right after the procedure and 1–2 weeks later, and the effect settles in over 3–6 months as the threads are absorbed and tissue regenerates. When and how much change is felt varies greatly from person to person. The number and interval of sessions depend on how long you have had the pain, its extent and the condition of your muscles; a plan is made at the first examination and adjusted according to your progress.

On the day of the procedure

QHow painful is the procedure, and how long does it take?

The procedure is brief for each area, and during it you feel a localized stimulus. Right afterward there may be heaviness, tightness or tenderness, but these mostly subside within a few days. How much it hurts varies with the treatment area and individual sensitivity, so please let us know if you feel uncomfortable, even during the procedure.

QHow many threads are placed at once?

A typical range is 30–50 threads for focused treatment of one area and about 100–150 threads when setting the whole-body structure together. The number and position of threads depend on the thickness of the fascia at the painful area and on body type. More is not necessarily better; what matters is which muscle and which layer the threads go into.

QCan several areas be treated at once?

Pain rarely arises in one place in isolation. Areas that affect each other, such as the neck and shoulders or the lower back and pelvis, give more stable results when looked at together, so they are often treated in one session. However, the wider the area, the greater the heaviness afterward, so the area and order are sometimes split up in consideration of your stamina and condition.

QCan pain briefly get worse right after the procedure?

There may be heaviness and tenderness for a few days after the procedure. Redness or warmth at the treated area lasting about 3–7 days is also a normal response. However, if pain clearly worsens or swelling persists, please do not ignore it — be sure to let us know.

QI have a large bruise. Is that okay?

Bruising is the most common reaction. It occurs when blood vessels are stimulated during the procedure or when the affected area is shallow, and usually fades within a few days to 1–2 weeks. Cold compresses help for 1–2 days after the procedure, and when bruising is severe, working up a light sweat with gentle activity can help it fade.

Daily life after the procedure

QWhen can I shower, wash my face or take a bath?

Everyday showering and face washing are fine, as long as you do not rub the treated area hard or apply heat to it. Avoid activities that raise body temperature significantly, such as saunas, jjimjilbang (Korean bathhouses) and half-body baths, for a few days after the procedure, and resume them as your condition allows.

QWhen can I exercise, and how much?

Avoid strenuous exercise for a few days after the procedure; light walking or stretching can be started as your condition allows. Once the pain has eased, adding strength exercises helps recovery. However, please consult the medical team before doing exercise that puts heavy strain on the treated area.

QShould I avoid alcohol or saunas?

Alcohol can affect blood flow and inflammatory responses, so it is best avoided for a few days after the procedure. We also recommend avoiding activities that raise body temperature significantly, such as saunas, jjimjilbang and half-body baths, during the same period.

QCan I get a massage or meridian massage?

While the threads remain, it is best to avoid massage or meridian massage that puts strong pressure on the treated area. Routine care is generally possible from one week after the procedure, but if the treated area was large or bruising remains, please check with the medical team first.

Safety · schedule · cost

QAre there side effects or precautions?

The most common reactions are bruising, heaviness, tightness and mild swelling, which usually fade within 1–2 weeks. Redness or warmth at the treated area lasting 3–7 days is also within the normal range of response. Foreign-body reactions or inflammation have been reported in rare cases, so it is important to choose the right layer for the threads and to perform the procedure hygienically. If you develop a fever, severe pain or clear red swelling at the treated area, please contact us right away.

QAre there cases where it should not be done?

During pregnancy, when there is a skin infection or wound at the treatment site, when there is a bleeding tendency or anticoagulants are being taken, or with uncontrolled diabetes or a weakened immune system, we either adjust whether and how widely to treat or do not perform the procedure. Please be sure to tell us about any medications you are taking and any past procedures or surgeries at your visit. When pharmacopuncture is used together, we first test a small amount to check for an allergic reaction before proceeding.

QHow long does it take to return to daily life?

Because the procedure involves no stitches, most people can go about their daily lives on the same day. However, heaviness and bruising at the treated area may remain for a few days. If you have an important event coming up, it is best to schedule the procedure with plenty of time to spare. Let us know your schedule at your consultation before the procedure, and we will adjust the area and order accordingly.

QWhat are the cost and treatment period?

They depend on the treatment area and the combination of treatments used together (such as pharmacopuncture). Thread embedding is not covered by insurance, and the exact cost and treatment period will be explained by phone or at an in-person consultation.

Not a stimulus that passes,but one that stays and works

How thread embedding works,at a glance

Injections, painkillers,physical therapy…so why does this pain keep coming back?

Three reasons pain keeps recurring

Stiff, dried-out fascia

Reduced blood flow and oxygen

Weakened muscles and unstable structure

What does the threaddo inside the body?

Four changes that follow in the tissue

DURATIONA stimulus that stays

REGENERATIONA micro-stimulus that prompts repair

CIRCULATIONNew blood vessels grow

CONTROLRegulating muscle tension

Acupuncture vs. thread embedding: how long the stimulus lasts

How many threads go into one area?

The procedureand recovery timeline

Examination · assessment

Relaxation

Pain control