Mixing traditional Chinese therapies is superior to only one treatment for those suffering from chronic neck pain, new research suggests.
In a controlled, randomized study that included more than 100 participants the combination of yijinjing and tuina therapy was more effective than tuina therapy by itself to treat pain, functional recovery and anxiety.
Tuina is an Chinese manual therapy consisting of manipulation of soft tissues, including pressing on, pushing, and kneading. It is also accompanied by spinal manipulation. Yijinjing is a form practice of the classical Chinese exercise that focuses upon the co-ordination of posture, meditation and breathing.
Both treatments are extensively used in China to treat neck pain that is not specific however evidence for their synergistic effects is insufficient.
The latest results suggest that tuina, when combined along with yijinjing “can be suggested for use in routine as a supplementary treatment for pain management” for patients suffering from chronic neck pain that is not specific to the area. Zi-ji Chang, MS Shanghai University of Traditional Chinese Medicine, China, and colleagues write.
The results were published online 12 December within JAMA Network Open.
Clinically, statistically significant
Researchers enrolled 102 people (mean age of 36 years) who suffered from chronic, nonspecific neck pain that was present for at least three months.
Half of the patients received the tuina therapy by itself, and half received tuina and yijinjing. Both interventions were provided by experienced therapists, who held three sessions a week for eight weeks consecutively. There were no drops in the program.
In comparison to tuina on its own when combined with yijinjing, tuina was associated with a less visual analogue scale (VAS) score at the time the intervention was over for an 8-week period, and this was in line with the primary objective.
At the beginning the mean VAS score stood at 7 for both groups. In week 8, for the tuina group there was an 4.1-point decrease in VAS score versus an 5.4-point diminution in group with combined therapy (mean difference of 1.2 points the P value was= .001).
The most significant impact of the combination therapy on the severity of pain continued to be evident after the 12 week follow-up.
In the 8-week follow up, for patients in the yijinjing plus tuina class, they had an improvement in soft tissue and disability, as well as more mobility than those in the tuina-only category.
In the group with the same name the results showed an increase in the reduction of anxiety-related symptoms. Yijinjing is a combination of deep breathing and physical movements that could affect negative emotions and the quality of life, the researchers take note of.
“Our results indicate that the reduction in disability and pain in the tuina group was not just statistically significant, but equally clinically relevant,” they write.
As far as they know it is the first clinical trial that has been randomized to prove the efficacy of tuina and yijinjing for people suffering from nonspecific chronic neck pain.
No Surprises
Commenting on Medscape Medical News,Charles Kim, MD, an expert in integrative pain management as well as the director of operations for clinical services at NYU Langone Rusk Rehabilitation spine services in New York City, said that he was not shocked by the results.
“This isn’t groundbreaking. I’ve observed that patients who combine treatments are more successful all-around — for instance when acupuncture is combined with physical therapy as opposed to just acupuncture,” said Kim who was not part of the research currently being conducted.
“Tuina and yijinjing both are treatments employed in traditional Chinese medicine. They are examples of treatment that are comparable to the massage we use in the West such as shiatsu.” the doctor said.
Kim who’s been practicing holistic medicine for nearly twenty years observed the fact thatcomplementary and alternative treatments are “more and more sought-after and are also offered by a number of Western health centers like NYU. We’re also seeing more of these kinds of treatments being evaluated.”
Daniel Schrier, doctor of oriental medicine and director of acupuncture-based experiential education within the Maryland University of Integrative Health in Laurel and was also not astonished with the outcomes.
The yijinjing and Tuina therapies “complement one another extremely well and enhance the therapeutic qualities of the treatment. It’s like acupuncture or herbal medicine,” he told Medscape Medical News when was asked to comment.
“While you can get positive results using one of them however, having both is more beneficial. Both yijinjing as well as tuina share similar properties in that they assist to open and relax sinew channels and it, help to increase the circulation of qi blood through the body.” Schrier explained.
He stated that he would “absolutely recommend both methods for patients, particularly yijinjing since patients are able to take the practice with them home when they have an instructional video that reinforces what they were taught by their practitioner.”
The study was financed through a grant from the 3-Year Development Plan to Traditional Chinese Medicine and the Future Plan for Traditional Chinese Medicine Inheritance and Development Shanghai Municipal Hospital of Traditional Chinese Medicine. Yao, Kim, and Schrier have not disclosed any relevant financial relationship.
JAMA Netw. Published online December 13 2022. Full article
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