Effects of Traditional Chinese Acupoint Massage Combined with Tailored Tai Chi on low back pain in patients with lumbar disc herniation: a randomized controlled trial

Objective: To determine the clinical efficacy of traditional Chinese acupoint massage (TCAM) combined with tailored tai chi multimodal therapy on low back pain (LBP)in patients with lumbar disc herniation (LDH). Methods: A total of 72 patients with LBP as the main clinical symptom were randomly divided into the intervention group (IG, TCAM combined with tai chi therapy) and control group (CG, TCAM therapy). Each intervention was conducted three times a week for 4 weeks. The primary outcome was Oswestry Disability Index (ODI) score, the secondary outcomes included Visual Analog Scale (VAS) score, Short-Form Health Survey (SF-36) score, and total effective rate measurements. Changes of trunk muscle group peak torque (PT) and average power (AP) at 60°/s and 90°/s isokinetic tests were also observed in the two groups. Results: All data were represented as mean and 95% Confidence Intervals(CI), and between-group comparison, it showed that ODI (3.88 [0.5, 7.27], P  = 0.026); VAS (8.1 [1.87, 14.34], P  = 0.012), and some items of the SF-36, namely, physical functioning (2.3 [0.96, 3.64], P  = 0.001), bodily pain (1.11 [0.51, 1.71], P  = 0.001), general health (1.0 [0.12, 1.8], P  = 0.027), vitality (1.91 [1.2, 2.6], P ༜0.001), and mental health (3.2 [2.4, 3.9], P ༜0.001), had higher levels of improvement in the IG group than in the CG group ( P  < 0.001). Within-group comparison showed that both treatments significantly alleviated pain and dysfunction and improved quality of life, consistent with the total effective rate (69.44% versus 72.22%, P  = 0.795). The PT and AP at angular velocities of 60°/s and 90°/s were higher in the IG group ( P  < 0.001), and the mechanical indexes at week 4 significantly increased compared with those at week 0 ( P  < 0.001). Conclusion: Both interventions were effective in treating pain and dysfunction and improving the quality of life in patients with LBP. However, TCAM combined with tai chi had higher efficacy than single TCAM, particularly in improving physical and mental states and back muscle strength. The exploratory results showed that the multimodal physical therapy could be used as a complementary and alternative therapy for patients with LBP caused by LDH. Trial registration Chinese Clinical Trial Registry (ChiCTR1900023028) on 08/05/2019 URL: http://www.chictr.org.cn/showproj.aspx?proj=38496