Fine-needle muscle microbiopsy: a feasible and well-tolerated alternative for skeletal muscle sampling, 2026, Johan Jakobsson et al

[Mij]

Abstract

Background:
Conventional muscle biopsy techniques, such as the Bergström method, require large tissue samples and skin incisions. Fine-needle muscle microbiopsy offers a minimally invasive alternative, but data on tolerability are lacking. We aimed to present a refined minimally-invasive muscle microbiopsy protocol using a 20-gauge needle with topical anaesthesia and compare perceived pain with routine venipuncture.

Methods:
Twenty-six healthy adults (50% female) underwent vastus lateralis microbiopsy using a 20-gauge needle (0.9 mm). Pain was assessed immediately after the microbiopsy and a venous blood draw using a 21-gauge needle, with the visual analogue scale (VAS). Procedures were randomized.

Results:
Seventy-eight microbiopsies were successfully obtained. Mean pain scores were low for both procedures (microbiopsy: 1.0 ± 0.9; venipuncture: 1.4 ± 1.2) with no significant difference (P = 0.311). Most participants reported minimal or low discomfort (VAS ≤3) from the microbiopsy.

Conclusions:
Fine-needle muscle microbiopsy using a 20-gauge needle is well tolerated, with pain comparable to routine venipuncture. This approach substantially reduces invasiveness compared to traditional biopsies while providing adequate material for proteomic analysis. These findings support its ethical and practical application in sensitive populations and longitudinal research.
LINK

 

[Trish]

I hope this means muscle biopsies with useful material produced will become much more useful as part of ME/CFS research.

 

[hotblack]

They say pain is comparable to an injection or blood draw and that would be something. Although they were applying topical local anaesthetic, something you don’t get in those. So its maybe a generous comparison.

It could be an improvement but I’m cautious abiur how feasible this is going to be for widespread sampling of people with ME/CFS particularly at home or the severe or in PEM. it’s still a pretty invasive thing from speaking to those I know who have had different types of biopsies for different purposes (I haven’t had one myself).

Another reason to be cautious is this:

A limitation in this study is that delayed soreness or discomfort at (i.e. 24–72 h) was not systematically recorded. While no delayed adverse events were reported to the research team, the absence of structured follow-up limits conclusions regarding short-term post-procedural soreness or localized inflammatory responses. Future studies should include standardized follow-up measures.

Link didn’t work for me so here’s the details

Fine-needle muscle microbiopsy: a feasible and well-tolerated alternative for skeletal muscle sampling

Spoiler: Authors

Jakobsson, Johan; Strigård, Karin; Theos, Apostolos; Svensson, Michael; Malm, Christer

Web | DOI | Frontiers in Physiology

 

[Jonathan Edwards]

By far the biggest problems with muscle biopsy are sampling variation and drying out.

I doubt that getting the same amount of readable tissue with 3 small needle hits is going to be less traumatic than one bigger needle hit.

I would also worry that a small needle may glance off pathological tissue and miss things.

Drying out will be such a serious problem that fine needle samples may need to be dropped into fluid, so a lot of quantitative chemical analysis is likely to be useless.

 

[Mij]

The pathologist wasn't able to get a 100% accuracy reading from my endometrial biopsy to r/o cancer, only 90% accuracy. It does have a high accuracy though. Very painful so I didn't want a redo.

I would go for this biopsy to see if anything comes up abnormal or interesting just for science because PEM is abnormal, very abnormal. Perhaps compare DOMS patients with pwME during delayed PEM- day one, day two et

 

[Mij]

They say pain is comparable to an injection or blood draw and that would be something. Although they were applying topical local anaesthetic, something you don’t get in those. So its maybe a generous comparison.

We used topical local freezing for psychological reasons for some patients to calm them down because they had anxiety and/or a fear of needles.

One patient freaked out after she learned we didn't use freezing, but was ok after the injection

 

[Mij]

Rolling my eyes while the doctor made unfunny jokes always made the patients laugh and relax. It most likely worked better than topical freezing.

 

[ScoutB]

For what it’s worth, I had a fine needle biopsy once and I remember being surprised how easy and painless it was (I believe they did use a topical anesthetic). I could imagine one into muscle be more painful/sensitive though.