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

Pain Med. 2023 Mar 1;24(3):244-257. doi: 10.1093/pm/pnac127.


Objective: To evaluate the effectiveness of Tuina in relieving the pain, negative emotions, and disability of patients with knee osteoarthritis (KOA).

Design: Single-center, 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 (1 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 < .05). In evaluating the group effect, statistical differences were found at week 6 and follow-up (P < .05). Further, all variables showed a time effect (P < .05). A statistical difference in the clinical effective rate was found between the Tuina and celecoxib groups (P < .05).

Conclusions: Tuina produced superior effects for pain, negative emotions, and disability over time, as compared to celecoxib in patients with KOA.

Keywords: Joint Function; Knee Osteoarthritis; Negative Emotions; Pain; Tuina.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Celecoxib / adverse effects
  • China
  • Chronic Pain* / therapy
  • Emotions
  • Humans
  • Osteoarthritis, Knee* / therapy
  • Treatment Outcome


  • Celecoxib