*3.5. Tuina Manual Therapy*

3.5.1. Tuina Manual Therapy vs. Active Control Treatment

The level of evidence and recommendations were derived based on 10 RCTs [48,111–120] that compared Tuina manual therapy and active control treatment for LHIVD in terms of pain, function, and overall symptom improvement.

As a result of the meta-analysis, Tuina manual therapy was effective in improving the overall symptoms (RR: 1.17, 95% CI: 1.12–1.23, *p* < 0.001), pain (MD, 1.09, 95% CI: 1.32–−0.86, *p* < 0.001), and function (ODI: MD, 9.87; 95% CI: 15.68– –4.06; *p* < 0.001; JOA: MD, 4.85, 95% CI: 3.87–5.83, *p* < 0.001) compared to active control treatments, such as Western medicine, injection, and traction treatment.

In conclusion, Tuina manual therapy is recommended for improving the overall symptoms of LHIVD (A/High).
