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 TCAM plus Tai Chi for Lumbar Disc Herniation

OBJECTIVE: To evaluate the clinical efficacy of Traditional Chinese Acupoint Massage (TCAM) combined with tailored Tai Chi on pain, disability, and selected quality-of-life domains in patients with lumbar disc herniation (LDH). METHODS: Seventy-two patients with LDH and low back pain (LBP) were randomly assigned to an intervention group (IG, TCAM + tailored Tai Chi, n = 36) or a control group (CG, TCAM alone, n = 36). Interventions were conducted three times per week for 4 weeks. The primary outcome was Oswestry Disability Index (ODI). Secondary outcomes included Visual Analog Scale (VAS, 0-10 points) and selected domains of the 36-item Short Form Health Survey (SF-36). Baseline participant and therapist expectation scores were recorded, and sensitivity analyses were performed adjusting for these scores. ANCOVA adjusted for baseline outcome values, age, sex, and disease duration was used for between-group comparisons. Bonferroni correction was applied for SF-36 subscales. RESULTS: The primary outcome ODI decreased significantly more in the IG than in the CG (from 26.58 ± 7.79 to 9.67 ± 3.10 vs 28.72 ± 9.25 to 15.69 ± 4.26; adjusted mean difference = 3.88, 95% CI 0.50-7.27, P = 0.026). VAS scores improved on the 0-10 scale from 6.47 ± 1.47 to 2.21 ± 0.96 in the IG and from 6.71 ± 1.32 to 2.92 ± 0.99 in the CG, with an adjusted between-group difference of 0.47 (95% CI 0.18-1.43, P=0.012). Among SF-36 subscales, significant between-group differences after Bonferroni correction were observed in Physical Functioning, Bodily Pain, Vitality, and Mental Health. Sensitivity analyses adjusting for expectation scores yielded consistent results. The total effective rate was 94.44% in the IG versus 83.33% in the CG (P = 0.26). CONCLUSION: TCAM combined with tailored Tai Chi significantly improved functional disability, pain intensity, and selected quality-of-life domains compared with TCAM alone over 4 weeks. Sensitivity analyses suggest that these effects are robust and independent of baseline expectation scores. This multimodal physical therapy may be considered a complementary conservative treatment for patients with LBP due to LDH.