The aim of this study was to determine the effects of acupotomy on energy crises 
in rat trigger points (TrPs) by measuring mechanical pain thresholds (MPTs) and 
levels of acetylcholinesterase (AChE), free sarcoplasmic calcium (Ca2+), 
adenosine 5'-triphosphate (ATP), adenosine 5'-monophosphate (AMP), substance P 
(SP), and calcitonin gene-related peptide (CGRP) in rat muscle TrP tissue. Male 
Sprague Dawley rats (n = 32) were randomly divided into four groups: control, 
TrP, acupotomy, and lidocaine injection. Enzyme-linked immunosorbent assays were 
used to measure AChE, and free sarcoplasmic Ca2+ concentrations were determined 
by fluorescent staining with Fura-2 AM; high-performance liquid chromatography 
was used to measure ATP and AMP, and SP and CGRP were evaluated by 
immunohistochemistry. Compared with the control group, free sarcoplasmic Ca2+, 
AMP, SP, and CGRP were higher in the model group, while MPT, AChE, and ATP were 
lower. Treatment with acupotomy or lidocaine injection reduced free sarcoplasmic 
Ca2+, SP, and CGRP and increased MPTs and AChE levels compared with the model 
group. However, only acupotomy also led to decreased AMP and increased ATP 
levels relative to the model group. We conclude that acupotomy can alleviate 
energy crises at TrPs.