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Comparison of Traditional Chinese Manual Therapy (Tuina) and Extracorporeal Shock Wave Therapy in Patients With
Hongyu Li1,2,3,4, Lili Zhao2,3,4, Zhenning Zhao2,3,4
1Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, China.
Background:
Nonspecific neck pain (NNP) is a highly prevalent musculoskeletal condition worldwide, yet optimal noninvasive treatments remain to be established. Tuina and extracorporeal shock wave therapy (ESWT) are both commonly used in clinical practice, but comparative evidence is limited.
Objective:
This study aims to compare the clinical efficacy of Tuina versus ESWT in patients with NNP.
Methods:
In this randomized, controlled, single-blind trial, 58 patients with NNP will be allocated in a 1:1 ratio into 2 groups: Tuina therapy and ESWT. The Tuina group will receive 30-minute sessions 3 times per week for 4 weeks (12 sessions total). The ESWT group will receive interventions on days 1, 5, 10, 15, 20, 25, and 30 (7 sessions total). The primary outcome measure will be pain intensity measured by the visual analog scale. Secondary outcome measures will include the Neck Disability Index, cervical active range of motion, shear wave elastography (SWE) using musculoskeletal ultrasound, and serum inflammatory factors. All outcome measures will be assessed at baseline, during treatment (2 and 4 wk), and at the 8-week follow-up, except for SWE and inflammatory factors. SWE will be measured at baseline, 4 weeks, and 8-week follow-up; inflammatory factors will be measured at baseline and 4 weeks.
Results:
Recruitment began on January 4, 2026, and is expected to be completed by August 2026. As of March 30, 2026, of the planned 58 participants, 26 had been enrolled. Data collection, including follow-up, is projected to finish by October 2026. Data analysis will commence after data collection is completed, and the results are anticipated to be submitted for publication in early 2027.
Conclusions:
This trial will provide direct comparative evidence to determine whether Tuina is superior to ESWT for reducing pain and disability in NNP, thereby informing evidence-based clinical decisions. Key design limitations include the inability to blind participants, which we mitigated by using blinded outcome assessors and rigorous allocation concealment.
