Tuina massage is an ancient form of massage that focuses on balancing a person’s energy. Practitioners use various techniques, including kneading, pressing, rolling, and stretching.

Huang Di Nei Jing, a famous ancient Chinese medical text from between the 1st century B.C.E. and the 1st century C.E., is the first known document to define tuina massage. It contains records describing the use of massage techniques to treat certain diseases.

However, archaeologists have found evidence of tuina massage dating back to about 2700 B.C.E.

The practice includes a range of massage and manipulation techniques. During the session, a practitioner may use their hands and arms to massage, knead, press, and stretch the body.

Keep reading to learn more about tuina massage, including its benefits, side effects, and more.

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Originating in China, tuina, which is pronounced “tween-uh,” is the oldest known form of massage. In traditional Chinese medicine, the flow of qi energy, or life force, is fundamental.

Tuina practitioners use massage and manipulation techniques to achieve a therapeutic effect. The massage aims to balance the flow of qi through a person, which proponents claim encourages natural self-healing within the body.

Tuina practitioners use a combination of hand and arm techniques to massage and realign the recipient’s muscles, bones, ligaments, and tendons. These techniques can include kneading, pressing, rolling, shaking, and stretching.

Similar to acupuncture, the practitioner stimulates pressure points in the recipient’s body. They aim to influence the flow of qi through the meridians, which are energy pathways in the body.

Tuina massage can also involve herbal poultices, compresses, and salves. A practitioner may place these on the outside of the body to enhance the therapeutic effects.

Some practitioners may place greater emphasis on specific aspects of the technique. For example:

  • The rolling method: This focuses on soft tissue techniques to address joint injuries and muscle sprains.
  • The one-finger pushing method: This uses acupressure techniques with the aim of treating internal disease.
  • The Nei Gung method: This method involves exercises that generate Nei Gong qi — energy work that starts inside the body and works outward — and specific massage methods to revitalize depleted energy systems.
  • The bone setting methods: This focuses on manipulation methods to realign the musculoskeletal system and may be useful for people with joint injuries and nerve pain.

Tuina falls under the category of complementary or alternative therapies.

Individuals may use it to focus on a specific health concern, such as joint, muscle, or bone pain in the:

  • neck and shoulders
  • hips
  • back
  • arms and legs
  • ankles

According to The World Tui-Na Association, the technique can help with a range of health problems. These include:

  • musculoskeletal disorders, such as frozen shoulder syndrome, herniated disk syndrome, and whiplash
  • circulatory system disorders, such as hypertension and an irregular heartbeat
  • respiratory system disorders, such as asthma and chronic bronchitis
  • digestive system disorders, such as gallbladder inflammation and stomach ulcers
  • reproductive system disorders, such as menstrual irregularities and sexual dysfunction

Unlike some other alternative therapies, there is some scientific evidence to back up these claims.

Musculoskeletal disorders

A 2018 systematic review and meta-analysis in Evidence-Based Complementary and Alternative Medicine suggests that tuina massage can reduce pain and improve function in people with musculoskeletal diseases. However, the authors note that the evidence for pain reduction was stronger than the evidence for improving function.

Chronic fatigue syndrome

According to a 2017 randomized controlled clinical trial in the Journal of Traditional Chinese Medicine, abdominal tuina massage was more effective than acupuncture in treating the symptoms of chronic fatigue syndrome.


A 2021 systematic review and meta-analysis assessed the safety and effectiveness of tuina in treating functional constipation.

The authors reviewed 16 articles involving 1,424 cases. In their paper, they conclude that tuina is beneficial in treating the symptoms of functional constipation. They also note that it caused minimal negative side effects.

Chronic neck pain

In a 2018 study, researchers carried out a randomized controlled trial to assess whether tuina is effective in reducing chronic neck pain.

The results showed that the delivery of six tuina sessions over 3 weeks was a safe, effective, and relatively economical way to treat chronic neck pain.

Diabetic foot

A 2018 clinical observation study in the Journal of Acupuncture and Tuina Science involved 70 people with early stage diabetic foot disease.

The researchers split the participants into two groups: a control group receiving conventional medication and an observation group receiving tuina, a footbath, and traditional Chinese medicine. The researchers noted a beneficial therapeutic effect in the group receiving tuina massage.

Other conditions

Studies are also underway to explore the potential benefits of tuina massage in treating chronic low back pain, autism spectrum disorder, and cancer-related fatigue in people with breast cancer.

While some people use tuina massage to manage pain or treat illness, others simply use the therapy to maintain good health and well-being.

Some people who receive tuina say that it relaxes and energizes them. It may help reduce insomnia, headaches, and stress.

Anecdotal evidence suggests that its main benefit is providing relaxation and bringing an overall feeling of balance. In some cases, it can also reduce pain, which can be useful for people who wish to minimize their use of pain medications.

Tuina is similar to other Eastern types of massage that focus on balancing the flow of energy within the body.

However, it differs from Western massage therapies because practitioners can use it to treat a range of specific health conditions — not only those related to musculoskeletal health.

Other types of massage include:

  • Thai massage: As with tuina massage, Thai massage aims to remove blockages and correct imbalances in the body’s energy flow.
  • Shiatsu massage: Practitioners use this type of massage to treat a range of chronic health problems linked to stress and pain.
  • Sports massage: This aims to help manage musculoskeletal health issues.
  • Swedish massage: Similar to tuina, Swedish massage aims to improve relaxation and circulation, but it is a much gentler form of massage.

Although tuina massage is generally safe and tolerable for most people, it may cause some physical discomfort during a session. It likely will not feel like a gentle and relaxing massage.

A 2017 case study in the European Spine Journal acknowledged the safety and helpfulness of tuina for treating a wide range of health conditions. However, the researchers found a lack of evidence for using tuina for ankylosing spondylitis, an inflammatory spine disease.

Additionally, the person with ankylosing spondylitis in this case study experienced “catastrophic results” after receiving tuina massage during an acute flare-up. This emphasizes the need to consult a doctor before undergoing any form of massage, especially if a person has a specific health condition, is pregnant, or is taking medication.

Originating in China, tuina is possibly the oldest form of massage therapy in the world. Research suggests that it provides benefits for people with musculoskeletal and gastrointestinal health issues, and current trials are exploring whether it is effective in treating other conditions.

Tuina is generally safe for most people, but those with medical conditions should consult a doctor before trying it.