Tuina and Motion-based Analgesia: Integrating Passive and Active Therapies for Pain Rehabilitation

Abstract

Background: Pain is a sensory and emotional experience that typically arises from causes such as tissue damage, illness, or stimulation of the nervous system. It is a highly complex phenomenon consisting of both sensory and emotional components. Aim: This review aims to explore the role of Tuina in pain management by examining how passive and active motion interventions contribute to musculoskeletal rehabilitation. Methods: A narrative synthesis of randomised controlled trials, systematic reviews, and preclinical studies (2015–2024) was conducted to evaluate the biomechanical, neurobiological, and psychological pathways of Tuina, as well as its integration with traditional Chinese exercises and contemporary rehabilitation approaches. Results: Tuina exerts biomechanical effects through joint mobilisation, circulation enhancement, and fascial remodelling; neurobiological effects through descending pain inhibition, neuroplasticity, and modulation of inflammatory mediators; and psychological effects via stress regulation and improvements in mood. Passive interventions provide immediate analgesia and functional support, while active modalities, including Yi Jin Jing and Wu Qin Xi, sustain long-term recovery through neuromuscular retraining. Integrative strategies combining Tuina with exercise or traditional Chinese exercises outperform monotherapy in reducing pain, disability, and recurrence rates, with added economic benefits in rehabilitation settings. Conclusion: Tuina represents a safe, effective, and evidence-based approach for acute and chronic pain. By integrating passive and active therapies, Tuina aligns with the biopsychosocial model of care, offering holistic benefits for musculoskeletal rehabilitation.