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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Mar 29, 2026
Date Accepted: Jun 20, 2026

The final, peer-reviewed published version of this preprint can be found here:

Comparison of Traditional Chinese Manual Therapy (Tuina) and Extracorporeal Shock Wave Therapy in Patients With Nonspecific Neck Pain: Protocol for a Randomized Controlled Trial

Li H, Zhao L, Zhao Z, Mu J, Ma H

Comparison of Traditional Chinese Manual Therapy (Tuina) and Extracorporeal Shock Wave Therapy in Patients With Nonspecific Neck Pain: Protocol for a Randomized Controlled Trial

JMIR Res Protoc 2026;15:e96555

DOI: 10.2196/96555

PMID: 42475549

Comparison of traditional Chinese manual therapy (Tuina) and extracorporeal shockwave therapy in patients with non-specific neck pain: a study protocol for a randomized controlled trial

  • Hongyu Li; 
  • Lili Zhao; 
  • Zhenning Zhao; 
  • Jing Mu; 
  • Huisheng Ma

ABSTRACT

Background:

Non-specific neck pain (NNP) is a highly prevalent musculoskeletal condition worldwide, yet optimal non-invasive treatments remain to be established. Tuina and extracorporeal shockwave therapy (ESWT) are both commonly used in clinical practice, but comparative evidence is limited.

Objective:

This study aims to compare the clinical efficacy of Tuina versus ESWT in patients with NNP.

Methods:

In this randomised, controlled, single-blind trial, 58 patients with NNP will be allocated in a 1:1 ratio into two groups: Tuina therapy and ESWT. The Tuina group will receive 30-minute sessions three times per week for 4 weeks (12 sessions total). The ESWT group will receive interventions on days 1, 5, 10, 15, 20, 25, and 30 (7 sessions total). The primary outcome measure will be pain intensity measured by the Visual Analog Scale (VAS). Secondary outcome measures will include the Neck Disability Index (NDI), cervical active range of motion (AROM), shear wave elastography (SWE) using musculoskeletal ultrasound, and serum inflammatory factors. All outcome measures will be assessed at baseline, during treatment (2 and 4 weeks), and at the 8-week follow-up, except for SWE and inflammatory factors. SWE will be measured at baseline, 4 weeks, and follow-up; inflammatory factors will be measured at baseline and 4 weeks.

Results:

As of March 30, 2026, 26 participants have been recruited and randomly assigned to the two treatment groups. All enrolled participants have begun treatment, and no withdrawals due to adverse events or treatment dissatisfaction have been reported. Recruitment, intervention, and follow-up are expected to be completed by October 2026, with the final analysis including data from all 58 participants. Preliminary results are anticipated to be submitted for publication in February 2027.

Conclusions:

Our findings will provide a theoretical basis for the clinical treatment of NNP and offer valuable insights to guide clinical decision-making on Tuina and ESWT interventions, helping to identify the most effective treatment strategies for the condition. Clinical Trial: ITMCTR2025001377


 Citation

Please cite as:

Li H, Zhao L, Zhao Z, Mu J, Ma H

Comparison of Traditional Chinese Manual Therapy (Tuina) and Extracorporeal Shock Wave Therapy in Patients With Nonspecific Neck Pain: Protocol for a Randomized Controlled Trial

JMIR Res Protoc 2026;15:e96555

DOI: 10.2196/96555

PMID: 42475549

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