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.

Ultrasound-guidance is applied during the administration of Korean medicine (KM) interventions to improve the safety and effectiveness of the interventions. Although many case series and reports on the use of ultrasound-guided KM interventions have been reported, no study has investigated the current use of ultrasound-guidance in clinical practice by doctors of Korean medicine (KMDs). An online survey was conducted with questions examining the status of ultrasound-guidance usage among KMDs practicing in various KM clinical settings. Survey responses from 335 KMDs were collected. Ultrasound started to be widely used in the clinical practice of KM since 2022. The primary objective of using ultrasound-guidance was “To improve the accuracy and efficacy” by 54.6%. Ultrasound-guidance was most frequently applied for shoulder joint diseases, and pharmacopuncture was the most frequently used intervention (76.1% and 90.4%, respectively). The respondents reported that effectiveness could be enhanced the most in nerve entrapment syndromes and especially when used in shoulder joints. Over 90% of KMDs responded that the safety and efficacy of treatment, specialty, and patients’ satisfaction were improved after adopting ultrasound-guidance. Moreover, 94.9% of KMDs agreed with the necessity for reimbursement of ultrasound-guidance in KM under national health insurance coverage. Most KMDs responded that they had positive perceptions regarding the clinical use of ultrasound-guidance in KM in terms of treatment effects, safety, and patient satisfaction, and the need for national health insurance coverage of the service. Our findings may provide practice-based evidence for conducting clinical studies.

Background: Pharmacopuncture, used for the treatment and management of musculoskeletal diseases, improves pain and functional outcomes. This study aimed to examine the practice trends, clinical effectiveness, and safety of ultrasound-guided pharmacopuncture for various conditions. Methods: All clinical studies across 11 databases on ultrasound-guided pharmacopuncture published before January 2024 were included, regardless of disease type and study design. Meta-analyses were conducted according to the Cochrane systematic review protocol using RevMan 5.4. The Grading of Recommendations, Assessment, Development, and Evaluation method was used for evidence-level rating. Results: From 16 studies with ultrasound-guided pharmacopuncture, 9 randomized clinical trials, 4 chart reviews, and 3 case studies were included. A total of 685 patients from 9 randomized clinical studies were included in the meta-analysis. For all diseases, the percentage of patients showing improvement in pain reduction in the ultrasound-guided pharmacopuncture group was higher than that in the unguided pharmacopuncture (risk ratio [RR]: 1.17; 95% confidence interval [CI]: 1.08–1.26) and usual care groups (RR: 1.23; 95% CI: 1.07–1.41). Subgroup analyses for lumbar disease revealed that the percentage of patients showing improvement was higher in the ultrasound-guided pharmacopuncture group than that in the unguided group (RR: 1.27; 95% CI: 1.13–1.44). Conclusions: Ultrasound-guided pharmacopuncture is clinically effective for pain reduction and improvement of functional outcomes. Furthermore, the intervention groups reported fewer adverse events. For lumbar spine conditions, significant differences in pain reduction and improvement in functional disability outcomes were confirmed 1 week and 1 month after treatment, respectively. To verify the clinical effectiveness of ultrasound-guided pharmacopuncture with high levels of evidence, more high-quality and large-scale randomized controlled trials are needed.

Objectives: We aimed to compare the effectiveness and safety of Chuna manual therapy combined with usual care to those of usual care alone for treating whiplash injuries. Design: A two-arm, parallel, assessor-blinded, multicenter pragmatic randomized clinical trial. Setting: Three hospitals in Korea. Participants: Overall, 132 participants between 19 and 70 years of age, involved in traffic accidents and treated at three hospitals in Korea, >2 but <13 weeks prior to enrollment, with neck pain consistent with whiplash-associated disorder grades I and II and a numeric rating scale score ≥5 were included. Interventions: Participants were equally and randomly allocated to the Chuna manual therapy and usual care (n = 66) or usual care (n = 66) groups and underwent corresponding treatment for three weeks. Primary and secondary outcome measures: The primary outcome was the number of days to achieve a 50% pain reduction. Secondary outcomes included areas under the 50% numeric rating scale reduction curve: pain, disability, quality of life, and safety. Results: The Chuna manual therapy + usual care group (23.31 ± 21.36 days; p = 0.01) required significantly fewer days to achieve 50% pain reduction compared to the usual care group (50.41 ± 48.32 days; p = 0.01). Regarding pain severity, functional index, and quality of life index, Chuna manual therapy and usual care were more effective than usual care alone. Safety was acceptable in both groups. Conclusions: In patients with subacute whiplash injury, Chuna manual therapy showed a rapid rate of recovery, high effectiveness, and safety.

Introduction: Knee osteoarthritis (OA) is a common degenerative joint disease with limited safe, long-term treatment options. Nutritional interventions, such as low-molecular-weight collagen peptides (LMCP), have emerged as promising non-pharmacological strategies for joint health. However, clinical evidence is insufficient. Therefore, we aimed to assess the efficacy and safety of LMCP supplementation in patients with knee OA.Methods: In this double-blind, randomized, placebo-controlled trial, 80 adults aged 40–75 with Kellgren–Lawrence (KL) grade I or II OA received either 3,000 mg/day LMCP or a placebo for 180 days. Primary endpoint included changes in Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain scores. Secondary endpoints included visual analog scale (VAS), WOMAC physical function and total scores, joint space width (JSW), and inflammatory markers. Adverse events (AEs) and patient compliance were monitored throughout the study.Results: LMCP supplementation significantly reduced WOMAC pain compared to the placebo (−1.90 ± 4.14 vs. 0.61 ± 3.97; p = 0.006). Improvements in WOMAC physical function and total scores were greater in the LMCP group than in the placebo group (−4.10 ± 9.64 vs. 0.71 ± 6.47, p = 0.035; −6.24 ± 14.69 vs. −0.45 ± 9.08; p = 0.028, respectively). No significant changes were observed in JSW or inflammatory markers. No AEs occurred.Conclusions: Daily supplementation of 3,000 mg of LMCP for 180 days was safe and effective in relieving joint pain and improving function in patients with KL grade I or II knee OA. LMCP is a promising nutrition-based non-pharmacological therapeutic option, particularly for individuals seeking complementary options to long-term non-steroidal anti-inflammatory drug therapy.Clinical trial registration: The trial was prospectively registered at the Clinical Research Information Service of South Korea (registration number: KCT0005507). The study was conducted at Pusan National University Korean Medicine Hospital (https://cris.nih.go.kr/).

Acupuncture is widely used to reduce pain and improve function in various conditions. Despite ongoing research in ultrasound-guided acupuncture, evidence supporting efficacy remains inconclusive. This study aimed to examine Korean and international research trends, clinical efficacy, and safety of ultrasound-guided acupuncture by performing a scoping review of clinical research on ultrasound-guided acupuncture. Literature searches were conducted across 11 databases, including all clinical studies published before April 2024, without restrictions on condition/disease or type of study. Of the 2,644 identified articles, 25 studies were selected for review, mostly involving patients with musculoskeletal pain, and post-stroke sequelae. Interventions included ultrasound-guided acupuncture, warming acupuncture, dry needling, and electroacupuncture. The effectiveness of ultrasound-guided acupuncture was evaluated using pain, functional disability, and effective rate as outcome measures, and most studies reported significant improvements. This study is the first scoping review to report on trends, clinical efficacy, and safety of ultrasound-guided acupuncture. While it demonstrates potential for treating musculoskeletal disorders, post-stroke sequelae, spinal injuries, and other conditions/diseases, research on its application remains limited to specific conditions/diseases. Furthermore, substantial variations were observed in types of acupuncture, application areas, and treatment frequencies. Future research should focus on high-quality randomized controlled trials with standardized ultrasound frequencies for specific conditions/diseases.