The Effectiveness of Tuina in Relieving Pain, Negative Emotions, and Disability in Knee Osteoarthritis: A Randomized Controlled Trial

Abstract

Objective To evaluate the effectiveness of Tuina in relieving the pain, negative emotions, and disability of patients with knee osteoarthritis (KOA). Design Single-centre, parallel, randomized controlled trial. Setting Shanghai Guanghua Integrated Chinese and Western Medicine Hospital, Shanghai, China. Subjects Adult patients with KOA who were able to speak Chinese and self-report symptoms were eligible. Methods A total of 104 patients were randomly allocated to receive the 6-week treatment of Tuina (Tuina group) or celecoxib (celecoxib group). Data on pain, negative emotions, and disability were collected at baseline, at week 2, 4 and 6, and follow-up (one month after the last treatment). The primary outcomes were the pressure pain thresholds. The secondary outcomes were: (1) numerical rating scale at rest and with movement; (2) Hamilton Anxiety Scale; (3) Hamilton Depression Scale; (4) Western Ontario and McMaster Universities Osteoarthritis Index; and (5) clinical effective rate. The adverse events of the trial were evaluated. Results In total, 99 patients completed the follow-up. Generalized linear mixed models were constructed to analyse the between-group differences. Statistically significant differences were found in the interaction effects (p < 0.05). In evaluating the group effect, statistical differences were found at week 6 and follow-up (p < 0.05). Further, all variables showed a time effect (p < 0.05). A statistical difference in the clinical effective rate was found between the Tuina and celecoxib groups (p < 0.05). Conclusions Tuina produced superior effects for pain, negative emotions, and disability over time, as compared to celecoxib in patients with KOA.

Tuina on knee pain and physical function for patients with mild-moderate knee osteoarthritis in Shanghai: protocol for a multicenter, assessor-blinded, randomized controlled trial

“…These points in TCM theory are interpreted as tonifying Qi and Blood, promoting the circulation of meridian channels and collaterals, leading to facilitating joint function recovery. Previous RCTs have also con rmed that acupoint stimulation around the knee joint has a signi cant effect on KOA and improves patients' pressure-pain threshold [53,55], which was consistent with the ndings of our previous study [39]. This multicenter pilot study expands patient recruitment beyond a single hospital setting to minimize regional differences that may exist.…”

“…The calculation of sample size was based on the hypothetical changes in the outcome measurement, WOMAC pain subscale, at week 4. According to our previous clinical trial [39], we formulate expected effects with WOMAC pain subscale as the primary outcome. We hypothesized that a 2-point improvement in WOMAC pain subscale occurred in the Tuina group.…”

“…Building upon the ndings of our previous studies [39,40], we developed the multicenter, large-sample RCT with the aim of implementing this effective complementary intervention for treating knee pain and lower limb dysfunction in diverse community settings in Shanghai. Through this study, we hope results of this study will provide adequate and valid data to demonstrate the effectiveness and safety of Tuina in pain reduction in patients with KOA, which could bolster the credibility of Tuina as a complementary therapy.…”

Tuina for peripherally-induced neuropathic pain: A review of analgesic mechanism

“…Glx is also involved in mood regulation. A study has shown that tuina can relieve the negative emotions in pain patients (Xu et al, 2022), suggesting that tuina may reduce pain sensitivity by improving negative emotions. Zhang et al (2014) found that the levels of gama amino-butyrlcacid (GABA) and GABAAR in the periaqueductal gray and rostral ventromedial medulla of CCI rats increased after pressing and kneading the "Huantiao" (GB30).…”

Cognitive behavioral therapy combined with head and face tuina/massage for negative emotions and sleep disorders in patients with protracted withdrawal symptoms: a study protocol for a randomized controlled trial

“…When carrying out tuina, mechanical force stimulation can be transmitted to blood vessels and nerve tissues, thereby altering the neuroendocrine system and blood circulation [29]. This enhances the function of the brain area responsible for controlling mood and sleep state, and several studies have substantiated this claim [30][31][32][33][34][35]. Moreover, conscious and autonomous tuina could help drug abusers rewire their brains, foster new neural connections, and gradually decrease their urge to use drugs [36].…”