Alternate Title

  • Tuina

Related Terms

  • Acupoints stimulation, acupressure point K-D2, aromatic acupressure, Asian bodywork therapy, auricular acupressure, automated massage chair, barefoot shiatsu, Bodymind acupressure, finger acupressure, five element shiatsu, G-Jo acupressure, high touch acupressure, integrative eclectic shiatsu, Japanese shiatsu (Namikoshi shiatsu, Nippon shiatsu), Jin Shin acupressure, Jin Shin acutouch, Jin Shin Do®, Ki-Shiatsu®, Korean acupressure point K-D2, Korean hand acupressure, macrobiotic shiatsu, Ohashiatsu, oriental bodywork therapy, Sea-Band, Seitei shiatsu, shiatsu anma therapy, tapas acupressure technique, Tao shiatsu, traditional Chinese medicine, tuina, tuina massotherapy, vaginal acupressure, Watsu, Wu Shu, Zen shiatsu.
  • Not included in this review: Acupuncture, acutherapy, AMMA® therapy, Ampaku, Ampuku® therapy, anma (amma), anmo (an-mo, an mo), Ayurvedic (marma) massage therapy, Chi Nei Tsang, Chinese reflexology, Hoshino therapy®, Kerala kalari massage, Indian head massage, Jin Shin Jyutsu®, Okazaki restorative massage, point holding, SHEN® Therapy, Qi gong, Taoist pressing point massage, Tibetan massage (Ku Nye), Tibetan pulsing, traditional Thai massage (Nuad Bo Rarn).

Background

  • The practice of applying finger pressure to specific acupoints throughout the body has been used in China since 2000 BC, prior to the use of acupuncture. Acupressure techniques are widely practiced internationally for relaxation, wellness promotion, and the treatment of various health conditions. Multiple human studies suggest the effectiveness of wrist-point (P6) acupressure for treating nausea.
  • Shiatsu means finger (Shi) pressure (Atsu) in Japanese. Shiatsu technique involves finger pressure at acupoints and along body meridians. It can incorporate palm pressure, stretching, massaging, and other manual techniques. Shiatsu practitioners commonly treat musculoskeletal and psychological conditions, including neck/shoulder and lower back problems, arthritis, depression, and anxiety. Tuina (Chinese for “pushing and pulling”) is similar to shiatsu but with more soft tissue manipulation and structural realignment. Tuina is a common form of Asian bodywork used in Chinese-American communities.

Evidence Table

    Disclaimer

    These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

    Nausea

    Numerous scientific studies support the use of wrist acupressure at the P6 acupoint (also known as Neiguan) in the prevention and treatment of nausea after surgery, intra-operative nausea (during spinal anesthesia), nausea from chemotherapy, as well as pregnancy related nausea/vomiting and morning sickness. Effects have been noted in children as well as adults.

    Anxiety

    Acupressure may significantly reduce general and pre-operative anxiety. However, these studies have been small and poorly designed, warranting better-quality research.

    Pain

    Acupressure using aromatic essential oils (lavender) may reduce pain intensity, stiffness, and stress in patients with neck pain for up to one month.

    Auricular acupressure may reduce pain and anxiety among hip fracture patients. Acupressure may also aid in the improvement of hemiplegic shoulder pain and motor power among stroke patients.

    Agitated behavior (in dementia)

    Acupressure may decrease verbal and physical agitation among dementia patients. Further study is needed before recommendations can be made.

    Alertness

    Acupressure at stimulation and relaxation points may have different effects on alertness in a classroom setting. Further research is necessary to confirm these findings.

    Asthma (quality of life)

    Preliminary research suggests that patients with chronic asthma who receive acupressure may experience improved quality of life. Further well-designed studies are needed before firm conclusions can be drawn.

    Bed-wetting (children)

    Early research seems promising. Further research is necessary before a recommendation can be made.

    Chronic obstructive pulmonary disease (COPD)

    A combination of acupressure and massage may reduce dyspnea (labored breathing) and anxiety in patients with chronic obstructive pulmonary disease who use prolonged mechanical ventilatory support. Further study of acupressure alone is needed before a recommendation can be made.

    Depression

    Several studies suggest that fatigue and depressive mood may improve with acupressure therapy. Further research is necessary to confirm these findings.

    Drug addiction

    Preliminary evidence suggests that acupressure may be a helpful adjunct therapy to assist with the prevention of relapse, withdrawal, or dependence. Further research is necessary to confirm these findings before a firm conclusion can be reached.

    Dyspnea (shortness of breath)

    A small study of patients undergoing pulmonary rehabilitation reported acupressure to be beneficial for decreasing dyspnea. Larger, well-designed studies are needed before clear conclusions can be drawn.

    Epilepsy (children)

    Preliminary evidence suggests that acupressure may help epileptic seizures among children. Further research is needed to confirm these results.

    Exercise performance

    Preliminary research reports that ear acupressure may reduce muscle fatigue and lactic acid production, thereby possibly improving athletic performance. Additional research is necessary before a firm conclusion can be drawn.

    Facial spasm

    There is preliminary positive evidence from one small study in this area. Further research is needed before a clear recommendation can be made.

    Gastrointestinal motility

    A small study suggests acupressure may improve gastrointestinal motility. Additional research is necessary before a firm conclusion can be drawn.

    Headache

    Self-administered acupressure is reported to help tension or migraine headaches in early studies. More research is needed before a recommendation can be made.

    High blood pressure

    Small studies in men and women report that acupressure may reduce blood pressure. Study results on the effect of acupressure on heart rate have yielded mixed results. Large, well-designed studies are needed before conclusions can be drawn.

    Labor pain

    One study reports that LI4 and BL67 acupressure may reduce labor pain specifically during the first stage of labor. Further study is needed before a recommendation can be made.

    Low back pain

    One study showed that acupressure was effective in reducing low back pain in terms of disability, pain scores, and functional status. The benefit was sustained for six months. More study is needed to make a firm recommendation.

    Menstrual pain

    Based on initial research, acupressure may reduce menstrual pain severity, pain medication use, and anxiety associated with menstruation. Further research is needed before a clear recommendation can be made.

    Palliative care

    Preliminary research in patients with advanced progressive diseases reports that acupressure may improve energy levels, relaxation, confidence, symptom control, thought clarity, and mobility. Further research is necessary to confirm these findings.

    Parkinson’s disease

    Acupressure may benefit several measures of severity of Parkinson’s disease. Further study is needed before recommendations may be made.

    Post-operative pain

    Several studies report that acupressure provides pain relief to patients after surgeries. Research suggests that acupressure may be as effective as intravenous pain medications. However, further evidence is needed from well-designed trials before a firm conclusion can be drawn.

    Sexual dysfunction

    Results from preliminary study suggest a benefit of vaginal acupressure/pelvic massage in the reduction of aspects of sexual dysfunction. Additional studies are needed.

    Sleep apnea

    A small study reports that acupressure may provide early prevention and treatment for sleep apnea. Larger, well-designed studies are needed before conclusions can be drawn. Patients with known or suspected sleep apnea should consult with a licensed healthcare professional.

    Sleep quality

    Preliminary research supports the use of acupressure for improving sleep quality in elderly patients and possibly in healthy adults of all ages. Better-designed trials are needed to support these results.

    Smoking cessation

    Early study indicates that auricular acupressure may help with quitting smoking. Further research is needed to confirm these results.

    Stroke

    Promising early data suggests acupressure may aid in the recovery of post-stroke paralysis.

    Cervical spondylosis

    Results from a meta-analysis do not support use of tuina for cervical spondylosis.

    Weight loss/obesity

    Preliminary evidence suggests that acupressure may not be effective for weight loss but may aid in weight maintenance following weight loss.

*Key to grades:

Tradition

    Disclaimer

    The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Safety

    Disclaimer

    Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

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Attribution

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration ().

Bibliography

    Disclaimer

    Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to . Selected references are listed below.

  • Agarwal A, Ranjan R, Dhiraaj S, et al. Acupressure for prevention of pre-operative anxiety: a prospective, randomised, placebo controlled study. Anaesthesia 2005 Oct;60(10):978-8.
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  • Barker R, Kober A, Hoerauf K, et al. Out-of-hospital auricular acupressure in elder patients with hip fracture: a randomized double-blinded trial. Acad Emerg Med 2006 Jan;13(1):19-23.
    View Abstract
  • Chen HM,Chen CH. Effects of acupressure at the Sanyinjiao point on primary dysmenorrhoea. J Adv Nurs 2004;48(4):380-387.
    View Abstract
  • Cho YC, Tsay SL. The effect of acupressure with massage on fatigue and depression in patients with end-stage renal disease. J Nurs.Res 2004;12(1):51-59.
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  • Harris RE, Jeter J, Chan P, et al. Using acupressure to modify alertness in the classroom: a single-blinded, randomized, cross-over trial. J Altern Complement Med 2005 Aug;11(4):673-9.
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  • Ho CM, Tsai HJ, Chan KH, et al. P6 acupressure does not prevent emesis during spinal anesthesia for cesarean delivery. Anesth Analg 2006 Mar;102(3):900-3.
    View Abstract
  • Hsieh LL, Kuo CH, Lee LH, et al. Treatment of low back pain by acupressure and physical therapy: randomised controlled trial. BMJ 2006 Mar 25;332(7543):696-700.
    View Abstract
  • Maa SH, Sun MF, Hsu KH, et al. Effect of acupuncture or acupressure on quality of life of patients with chronic obstructive asthma: a pilot study. J Altern Complement Med 2003;9(5):659-670.
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  • Puangsricharern A, Mahasukhon S. Effectiveness of auricular acupressure in the treatment of nausea and vomiting in early pregnancy. J Med Assoc Thai. 2008; 91(11):1633-8.
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  • Roscoe JA, Jean-Pierre P, Morrow GR, et al. Exploratory analysis of the usefulness of acupressure bands when severe chemotherapy-related nausea is expected. J Soc Integr Oncol 2006 Winter;4(1):16-20.
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  • Sheehan P. Hyperemesis gravidarum–assessment and management. Aust Fam Physician 2007 Sep;36(9):698-701.
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  • Smith CA, Collins CT, Cyna AM, et al. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev 2006 Oct 18;(4):CD003521.
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  • Stein DJ, Birnbach DJ, Danzer BI, et al. Acupressure versus intravenous metoclopramide to prevent nausea and vomiting during spinal anesthesia for cesarean section. Anesth Analg 1997;84(2):342-345.
    View Abstract
  • Tsay SL, Wang JC, Lin KC, et al. Effects of acupressure therapy for patients having prolonged mechanical ventilation support. J Adv Nurs 2005 Oct;52(2):142-50.
    View Abstract
  • Wang SM, Escalera S, et al. Extra-1 acupressure for children undergoing anesthesia. Anesth Analg. 2008; 107(3):811-6.
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