Several studies reported that Tai Chi showed potential effects for chronic pain, but its role remains controversial. This review assessed the evidence regarding the effects of Tai Chi for chronic pain conditions. 18 randomized controlled trials were included in our review. The aggregated results have indicated that Tai Chi showed positive evidence on immediate relief of chronic pain from osteoarthritis (standardized mean difference [SMD], −0.54; 95% confidence intervals [CI], −0.77 to −0.30; P < 0.05). The valid duration of Tai Chi practice for osteoarthritis may be more than 5 weeks. And there were some beneficial evidences regarding the effects of Tai Chi on immediate relief of chronic pain from low back pain (SMD, −0.81; 95% CI, −1.11 to −0.52; P < 0.05) and osteoporosis (SMD, −0.83; 95% CI, −1.37 to −0.28; P = 0.003). Therefore, clinicians may consider Tai Chi as a viable complementary and alternative medicine for chronic pain conditions.

Objective.To evaluate the effectiveness of massage therapy (MT) for neck and shoulder pain.Methods.Seven English and Chinese databases were searched until December 2011 for randomized controlled trials (RCTs) of MT for neck and shoulder pain. The methodological quality of RCTs was assessed based on PEDro scale. The meta-analyses of MT for neck and shoulder pain were performed.Results.Twelve high-quality studies were included. In immediate effects, the meta-analyses showed significant effects of MT for neck pain (standardised mean difference, SMD, 1.79; 95% confidence intervals, CI, 1.01 to 2.57;P<0.00001) and shoulder pain (SMD, 1.50; 95% CI, 0.55 to 2.45;P=0.002) versus inactive therapies. And MT showed short-term effects for shoulder pain (SMD, 1.51; 95% CI, 0.53 to 2.49;P=0.003). But MT did not show better effects for neck pain (SMD, 0.13; 95% CI, −0.38 to 0.63;P=0.63) or shoulder pain (SMD, 0.88; 95% CI, −0.74 to 2.51;P=0.29) than active therapies. In addition, functional status of the shoulder was not significantly affected by MT.Conclusion.MT may provide immediate effects for neck and shoulder pain. However, MT does not show better effects on pain than other active therapies. No evidence suggests that MT is effective in functional status.

Background: Local neuroinflammation secondary to spinal nerve compression in lumbar disk herniation (LDH) is a key driver contributing to neuropathic pain. Manual therapy (MT), a widely used nonsurgical therapy, can relieve LDH-mediated pain by reducing inflammation. MT has attracted extensive attention; however, its mechanism remains poorly understood. MicroRNAs (miRNAs) are important regulators of pain signaling transduction, but are rarely reported in the chronic compression of dorsal root ganglia (CCD) model, and further investigation is needed to decipher whether they mediate anti-inflammatory and analgesic effects of MT.Methods: We used a combination of in vivo behavioral and molecular techniques to study MT intervention mechanisms. Neuropathic pain was induced in a CCD rat model and MT intervention was performed according to standard procedures. Enzyme-linked immunosorbent assay (ELISA) was used to detect inflammatory cytokine levels in dorsal root ganglia (DRG). Small RNA sequencing, immunofluorescence, Western blot, and qRT-PCR were performed to screen miRNAs and their target genes and determine core factors in the pathway possibly regulated by miRNA-mediated target gene in DRG of MT-treated CCD rats.Results: Compared with naive rats, small RNA sequencing detected 22 differentially expressed miRNAs in DRG of CCD rats, and compared with CCD rats, MT-treated rats presented 19 differentially expressed miRNAs, which were functionally associated with nerve injury and inflammation. Among these, miR-547-3p was screened as a key miRNA mediating neuroinflammation and participating in neuropathic pain. We confirmed in vitro that its function is achieved by directly regulating its target gene Map4k4. Intrathecal injection of miR-547-3p agomir or MT intervention significantly reduced Map4k4 expression and the expression and phosphorylation of IκBα and p65 in the NF-κB pathway, thus reducing the inflammatory cytokine levels and exerting an analgesic effect, whereas intrathecal injection of miR-547-3p antagomir led to opposite effects.Conclusions: In rats, CCD-induced neuropathic pain leads to variation in miRNA expression in DRG, and MT can intervene the transcription and translation of inflammation-related genes through miRNAs to improve neuroinflammation and alleviate neuropathic pain. MiR-547-3p may be a key target of MT for anti-inflammatory and analgesia effects, which is achieved by mediating the Map4k4/NF-κB pathway to regulate downstream inflammatory cytokines.

Introduction: Synthesised data on the global prevalence of scoliosis in children and adolescents and its associated risk factors remain scarce. This systematic review aimed to estimate the global prevalence of scoliosis in children and adolescents and identify associated risk factors in children and adolescents. Methods: We conducted a systematic review and meta-analysis, searching nine electronic databases for observational population-based studies on scoliosis in children and adolescents published until June 02, 2024, without language or geographical restrictions. We estimated the global prevalence using the DerSimonian-Laird random-effects model with Free-Tukey double arcsine transformation and stratified prevalence through prespecified subgroup analyses. Fixed-effects models were used for consistent risk factors across studies, while random-effects models were applied for factors with high heterogeneity. Results: We initially identified 12,339 records, of which 239 studies comprising 46,565,512 participants were included. The estimated global prevalence of scoliosis in children and adolescents was 1.65% (95% CI 1.38–1.94), varying from 0.05% in Ecuador to 16.67% in Romania. We found higher prevalence in European (2.88%) and Americas (2.54%) than other regions (Eastern Mediterranean 1.22%, South-East Asia 1.35%, Western Pacific 1.35%, and African 1.46%). The higher prevalence was in high-latitude regions (2.96% vs mid-latitude 1.62% vs low-latitude 1.73%). The prevalence in girls was nearly double that in boys (1.76% vs 0.87%), with a steady increase observed from ages 7 to 16 years, peaking at 12–14 years for girls and 15–16 years for boys. The prevalence in adolescents (10–18 years) was nearly four times higher than that in children (6–9 years) (1.13% vs 0.26%). Idiopathic scoliosis in children and adolescents constituted the majority of cases, predominantly presenting as mild scoliosis (Cobb angle 10°-19°, 86.65%) with the single thoracolumbar curve being the most common subtype (36.67%). Additionally, the prevalence may increase since 2020 year (3.02%). Scoliosis in children and adolescents was significantly associated with sex (girls, odds ratio 2.16, 95% CI 2.01–2.33), family history (1.92, 95% CI 1.47–2.50), sedentary behavior (≥ 11 h, 1.64, 95% CI 1.20–2.25), poor sitting posture (3.48, 95% CI 2.85–4.24), short outdoor time (< 1 h, 1.32, 95% CI 1.10–1.59), long screen time (≥ 2 h, 2.74, 95% CI 2.29–3.28), unilateral physical activity (1.36, 95% CI 1.20–1.55), and low BMI (1.15, 95% CI 1.08–1.22). Conclusions: Scoliosis in children and adolescents remains highly prevalent globally. Our findings can help to guide epidemiological characteristics and development of tailored preventive and therapeutic strategies, ultimately enhancing primary prevention and controlling disease progression. Trial registration: CRD42024584704

Objective. To evaluate the effectiveness of Tuina-focused integrative Chinese medical therapies (TICMT) on inpatients with low back pain (LBP).Methods. 6 English and Chinese databases were searched for randomized controlled trials (RCTs) of TICMT for in-patients with LBP. The methodological quality of the included RCTs was assessed based on PEDro scale. And the meta-analyses of TICMT for LBP on pain and functional status were conducted.Results. 20 RCTs were included. The methodological quality of the included RCTs was poor. The meta-analyses' results showed that TICMT had statistically significant effects on pain and functional status, especially Tuina plus Chinese herbal medicine (standardised mean difference, SMD: 1.17; 95% CI 0.75 to 1.60 on pain; SMD: 1.31; 95% CI 0.49 to 2.14 on functional status) and Tuina plus acupuncture (SMD: 0.94; 95% CI 0.38 to 1.50 on pain; SMD: 0.53; 95% CI 0.21 to 0.85 on functional status). But Tuina plus moxibustion or hot pack did not show significant improvements on pain. And the long-term evidence of TICMT was far from sufficient.Conclusions. The preliminary evidence from current studies suggests that TICMT might be effective complementary and alternative treatments for in-patients with LBP. However, the poor methodological quality of the included RCTs means that high-quality RCTs with long follow-up are warranted.

Adolescent idiopathic scoliosis (AIS) is a prevalent spinal disorder, and the efficacy of conservative interventions for AIS remains unclear. This study aimed to identify the comparative efficacy of all available conservative interventions for AIS. Nine databases were searched from their inception to February 2024 for randomized controlled trials comparing conservative interventions for AIS. Paired reviewers independently selected studies, assessed risk of bias, and assessed certainty of the evidence. Pairwise meta-analyses were performed by DerSimonian-Laird random-effects model. Network meta-analysis within the frequentist framework was conducted by R package netmeta, and network plots were generated by the network plot command in Stata. We identified 3903 citations, of which 54 trials including 3984 participants were included in our review. All subsequent estimates refer to the comparison with minimal interventions. Brace plus physiotherapeutic scoliosis-specific exercises (PSSE, mean difference (MD): 4.80, 95% confidence interval (CI): 0.56 to 9.04, moderate certainty), manual therapy plus PSSE (MD: 5.26, 95% CI: 1.09 to 9.43, moderate certainty), and manual therapy plus mind–body exercise (MD: 5.14, 95% CI: 1.25 to 9.04, moderate certainty) could be intermediately effective in improving Cobb angle of patients with AIS at post-interventions. Although brace alone (MD: 1.53, 95% CI: 1.09 to 2.14, high certainty) could be the intermediate effective intervention in preventing scoliosis progression, moderate to high certainty evidence showed that brace alone and PSSE alone probably have little or no difference in improving Cobb angle, function, mental health, self-image, angle of trunk rotation (ATR), or satisfaction of patients with AIS compared to minimal interventions. There was no evidence on the follow-up effects of conservative interventions for AIS. We did not identify serious adverse events for any included conservative interventions. Brace plus PSSE, manual therapy plus PSSE, and manual therapy plus mind–body exercise could provide short-term effects in improving Cobb angle of patients with AIS. The evidence of brace alone and PSSE alone for managing AIS is still not robust. Our findings are useful for decision-making in clinical practice, as we presented the most comprehensive evidence regarding all available conservative interventions for AIS. PROSPERO CRD42024521298.