Tuina, an important component of traditional Chinese medicine (TCM), is an ancient art of manipulative therapy and healing that has been practised in China for more than 2,000 years. It is one of the most popular TCM treatments used in treating superficial trauma, injuries and musculoskeletal problems. Based on the theory of organs and meridians, it involves applying pressure to acupoints on the body such as the temples, specific muscles or nerves.
In modern China, many hospitals include tuina as a standard part of their treatments, with specialization for infants and adults in the areas of orthopedics, traumatology, cosmetology, rehabilitation, and sports medicine. It is also taught as a part of the curriculum at some hospitals and acupuncture schools in the West.
Techniques of Tuina
One tuina session can last from 30 minutes to an hour. Practitioners use brushing, kneading, rolling, pressing and rubbing on areas of the body to help relax muscles and alleviate pain, swelling and build-up of toxins in the body.
The principles of TCM say that health problems occur when the flow of “qi” is blocked at any point along a meridian. Tuina works by removing the blockages that interrupt the “qi”, or “vital energy” within the body, improving blood circulation in the meridians and muscles, establishing a harmonious flow of “qi” throughout the body, bringing it back to balance. Efficacy of the treatment does not depend on the amount of strength used, but rather, excellent control of strength and pressure based on TCM principles.
As tuina targets problematic areas of the body, it is important to get a detailed diagnosis by a certified tuina practitioner in a professional clinic or hospital to ascertain the root cause of the problems. The practitioner will probably ask you a few questions, such as what were you doing before the injury, how did you get the injury, which are the affected areas, the length of time the symptoms have persisted, are there any swellings and so on before he can decide on the tuina therapy that will best help you recover.
Tuina is often used together with moxibustion, acupuncture, fire cupping, Chinese herbalism, tai chi and qigong to speed up the healing process and maintain overall wellness of the body.
Benefits of Tuina
Tuina is suitable for anyone who wants to avoid the side effects of drugs or any chemicals to alleviate their pain. It works directly on the problem areas, and is particularly effective for tendon- and bone-related injuries or pains. It can be used for a variety of ailments, including arthritis, back pain, carpal tunnel syndrome, chronic fatigue syndrome, constipation, fibromyalgia, headache and migraine, insomnia, menstrual cramps, migraines, muscle spasms and all kinds of musculoskeletal problems.
Tuina is also great for reducing stress and fatigue. This is its greatest advantage – focusing on maintaining overall balance with both physical and mental health. For example, according to studies and research, tuina could be effective for chronic fatigue syndrome. In a study of 90 patients with this syndrome, they were split into three groups: one group underwent tuina, one group practiced tai chi, an internal Chinese martial arts practiced for defense and health benefits, and another group received Fluoxetine, an antidepressant medication used to treat chronic fatigue. After a month, the tuina group showed the greatest improvements in free radical metabolism, which may reduce fatigue.
However, tuina is not suitable as a treatment method for certain conditions such as bone fractures, ligament tears, fevers, infections, acute spine injuries, spinal cord compression and malignant tumours. It is critical for those with cancer, heart disease and arthritis to consult their physician or doctors prior to undergoing tuina.
Tuina and Other Forms of External Therapies
Thai massage, much like tuina, also helps to relieve blockages and correct imbalances in the flow of energy. A unique characteristic of Thai massage is the fact that it is performed on the floor, and the therapist uses their hands, knees, legs and feet to move the client into various yoga-like stretches.
Swedish massage is known for its ability to relax the entire body. It also helps to increase oxygen levels in the blood, decrease muscle toxins, and improve overall circulation and flexibility. Unlike tuina, Swedish massage uses long gliding strokes to rub the muscles in the direction of blood returning to the heart. A study published in The Journal of Alternative and Complementary Medicine measured the blood samples of 53 healthy adults who received a Swedish massage and found a significant decrease in the hormone arginine-vasopressin— a hormone that regulates water retention and blood pressure.
Possibility of Death Due to Tuina
Tuina has been getting more popular among young professionals with shoulder and neck aches in Singapore, as it is seen as less invasive than treatments such as acupuncture. In 2016, a 26-year-old Singaporean woman suffered seizures halfway through a two-hour tuina session, went into a coma and died on the same day. As a result, Singapore’s Health Ministry advised anyone who wanted to undergo a tuina massage to first consult a registered TCM practitioner on their suitability for their condition before they undergo the treatment.
Though death during tuina are very, very rare, though injuries can happen sometimes if the practitioner has not been well trained. Practitioners stressed the importance of people declaring their medical history to their therapist before undergoing such treatment to prevent injuries or even death. Potential side effects could include minor bruising, transient increase in pain, dizziness and nausea, in which case you should consult a doctor if the symptoms persist.
Tuina is often used when acupuncture is inappropriate, such as with children. We usually refer to this as “paediatrics tuina” or “Chinese pediatric massage therapy.” In countries such as Singapore, paediatric tuina has been gaining popularity among parents that are looking for options to help them manage and prevent common childhood ailments that do not involve oral medication or acupuncture needling pains. Since 2014, TCM company Eu Yan Sang has seen a rise of more than 100% in child patients.
Paediatrics tuina generally addresses problems such as indigestion, teeth grinding, restless sleep, bed wetting, constipation, cough, asthma, enuresis, vomiting, diarrhoea, abdominal pain and dysplasia. Children at a stage of rapid development or who are susceptible to illnesses can use tuina to improve the body’s well-being.
As a child’s meridian points are different from an adult, acupuncture points in an adult correlate not to similar points, but to a line or an area in a child. Paediatric tuina combines massage, acupressure and other forms of body manipulation to stimulate various acupoints specific to children, thus regulating the organ functions, treating and preventing diseases. Such tuina is the most effective for those aged six months to seven years of age. In general, the younger the child, the more effective it is.
The TCM practitioner will need to know the child’s medical history and symptoms, examine him and check his pulse before doing the treatment, which could last 10 to 20 minutes depending on the condition. Usually, it is good for the child to get treated once or twice a week. You must also take into account that different kids may react differently to such TCM treatments.
More and more people are using tuina to alleviate pain and treat their illnesses. The most important thing is to talk to your TCM practitioner before you undergo any tuina treatment. If you feel uncomfortable in any way, stop immediately and consult your doctor. Note that using tuina in place of standard care for a major condition may have serious consequences.