Chinese Painology Expert Consensus on Acupotomy for the Treatment of Chronic Musculoskeletal Pain (2026 Edition)

Since the 1970s, acupotomy, a minimally?invasive therapeutic technique originating from China, has been widely adopted for managing chronic musculoskeletal pain and has yielded promising clinical outcomes in real-world practice. Despite its growing popularity, several critical challenges have emerged during its clinical implementation, including inappropriate selection of clinical indications, substandard technical performance, and inconsistent, heterogeneous treatment regimens across different practitioners and medical centres. Such practice-related limitations may contribute to unstable therapeutic effects, preventable treatment-related incidents, and avoidable peri-procedural complications, which consequently hinder the safe, standardised promotion and widespread popularisation of acupotomy therapy. To address these gaps and standardise the clinical application of acupotomy for chronic musculoskeletal pain, this expert consensus was initiated at the formal invitation of the Editorial Board of the Chinese Journal of Painology. A multidisciplinary panel of leading national specialists in pain medicine was convened to develop this document. The expert group systematically searched and appraised available evidence-based literature published both domestically and internationally, and integrated high-level research findings with extensive, long-term front-line clinical experience. After thorough discussion, the panel summarised core recommendations covering the fundamental principles, standard operating procedures, indications, contraindications and key safety precautions for acupotomy intervention in chronic musculoskeletal pain. Following multiple rounds of group discussion, peer review and iterative revision, the final version of this expert consensus was reached.