Tuina Alleviates Pain Associated with Lumbar Disc Herniation by Regulating Functional Connectivity Between Inferior Frontal Triangularis and Multiple Brain Networks: A Randomized Controlled fMRI Study.

Researchers investigated how Tuina, a form of Chinese therapeutic massage, relieves lower back pain caused by lumbar disc herniation by examining changes in brain activity. The study included 76 patients with lumbar disc herniation who were randomly divided into two groups. One group received 14 days of Tuina therapy, while the other received conventional treatment combining electrical nerve stimulation and lumbar traction. Scientists used functional brain imaging (fMRI) to observe how Tuina affected brain networks involved in processing pain. The results showed that Tuina significantly reduced pain scores and improved function in patients with herniated discs. Brain scans revealed that Tuina worked by calming overactive areas in the frontal part of the brain called the inferior frontal gyrus triangular region, which plays a role in pain perception. The treatment also reduced problematic connections between this brain region and other pain-processing networks. Patients who received Tuina experienced greater pain relief compared to those receiving conventional therapy, and they also showed improvements in disability, depression, and anxiety measures. The study provides scientific evidence that Tuina doesn't just treat symptoms locally but actually modifies how the brain processes pain signals. This may explain why many patients experience lasting relief from this hands-on therapy. If you're considering Tuina for back pain, seek treatment from a qualified practitioner with proper training and certification in Chinese manual therapy techniques.

This randomized controlled trial (n=76 LDH patients, 38 healthy controls) used resting-state fMRI to elucidate Tuina's neurological mechanisms in lumbar disc herniation pain management. The test group received 14 days of Tuina therapy versus TENS plus traction in controls. Primary outcome (SF-MPQ) showed significant reduction in both groups (TG: -13.00, P<0.001; CG: -11.00, P<0.001) with between-group superiority for Tuina (P<0.05). Neuroimaging revealed Tuina inhibited spontaneous neural activity in bilateral inferior frontal gyrus triangular part (IFGtri) and decreased functional connectivity between IFGtri and multiple brain networks. Changes in FC between IFGtri.R and STG.pole.R positively correlated with SF-MPQ improvements (r=0.511, P=0.005). Secondary outcomes (PPT, ODI, BDI-II, BAI) showed improvements. Clinical significance: Tuina demonstrates measurable central nervous system modulation of pain processing networks, supporting its integration for multimodal LDH pain management with superior analgesic outcomes versus conventional electrotherapy approaches.