Objective. To review the literature and systematically evaluate the effectiveness of Chuna (or Tuina) manual therapy (C[T]MT) on pain and function for musculoskeletal disorders. Methods. We searched 15 English, Chinese, Japanese, and Korean databases using relevant keywords. All randomized controlled trials (RCTs) of C(T)MT for musculoskeletal disorders were considered, and we limited analyses to studies with a low‐risk bias for randomization and/or allocation concealment. Results. Sixty‐six RCTs with 6,170 participants were included. One sham‐controlled RCT showed that C(T)MT relieved pain more effectively than a sham control (SMD −3.09 [−3.59, −2.59]). For active‐controlled RCTs, pooled meta‐analysis showed that C(T)MT had statistically significant effects on pain reduction, especially compared to traction (P < 0.00001), drugs (P = 0.04), and physical therapies (P < 0.0001). For functional improvement, combined effects of C(T)MT with drugs (P = 0.04) and traction (P = 0.05) also showed similar positive effects. Conclusions. This systematic review suggests that C(T)MT is safe and effective for pain reduction and functional improvement for musculoskeletal diseases; however, the evidence for functional improvement was not as strong as for pain reduction. For future studies, high‐quality RCTs such as sham‐controlled studies with standardized interventions are needed to provide sufficient evidence on the effects of C(T)MT for musculoskeletal diseases. Protocol registration number is CRD42016038307 04/07/2016.

Soo-Hyun Sung, Gwang-Ho Choi, Nam-Woo Lee, and Byung-Cheul Shin. J Pharmacopuncture 2020;23:8-17. https://doi.org/10.3831/KPI.2020.23.002

This study aimed to investigate the effects of ultrasound-guided high-dose Shinbaro 2 pharmacopuncture on the pain, dysfunction, and quality of life in patients with low back pain and radiating pain due to an acute herniated intervertebral disc (HIVD). A 39-year-old male patient with low back pain and radiating pain caused by an acute HIVD was treated with Korean and Western integrative medicine, with a focus on ultrasound-guided high-dose Shinbaro 2 pharmacopuncture at Kambin’s triangle. The treatment lasted 16 weeks, including a 12-day hospitalization. The low back pain and radiating pain were evaluated using the numeric rating scale (NRS). The lumbar function and quality of life were assessed using the Oswestry disability index (ODI) and the EuroQol five-dimension index (EQ5D). Satisfaction was gauged using the patient global impression of change (PGIC). After treatment, the NRS score decreased from 10 to 1, whereas the ODI and EQ5D scores improved from 84.44 to 28.89 and from 0.303 to 0.871, respectively. The PGIC was rated as 1, indicating considerable improvement. Notably, the changes observed during hospitalization were significant. This report suggests that ultrasound-guided high-dose Shinbaro 2 pharmacopuncture at Kambin’s triangle significantly improves the pain, dysfunction, and quality of life in patients with an acute HIVD, demonstrating its potential usefulness among Korean medicine practitioners.

Many individuals suffer from sleep disorders associated with chronic pain, neuroendocrine diseases, and primary sleep disorders. Although cervical manual therapy (CMT) is frequently presumed to enhance sleep quality in clinical settings, evidence regarding its effects on sleep remains inconclusive. We aimed to evaluate the therapeutic effect of CMT and clinical patterns, providing novel insights into its applicability for sleep disorders and further mechanism studies. Methods: A comprehensive literature survey was conducted by using 6 databases through February 2025, to identify randomized controlled trials (RCTs) assessing the effect of CMT on sleep quality as clinical outcome, regardless of primary diseases. Results: Among 1220 initial studies, a total of 10 RCTs involving 552 participants were included. All included RCTs assessed sleep quality using patient-reported outcome measures, while only one study utilized objective assessment via polysomnography. Among them, seven RCTs (70.0%) reported significant improvements in sleep quality that were not dependent on alleviating the primary diseases, with notable enhancements in subjective sleep depth and efficiency rather than sleep duration or latency. Sleep benefits were pronounced in primary sleep disorders, such as obstructive sleep apnea and bruxism, and in sleep disturbances secondary to other conditions, with limited effects in fibromyalgia (FM). Conclusions: With the dysregulated hypothalamic–pituitary–adrenal axis and aberrant serotonergic activity in FM, in this review, we formed a hypothesis and explored the potential effects of CMT on sleep-related serotonergic activity and HPA axis regulation. This scoping review underscores the need for further research to clarify the neuroendocrinological mechanisms underlying CMT’s role in sleep modulation and its potential applications in sleep-related disorders.