ipsbcollegemassageresearch

Massage research is an important way to promote an understanding of what bodywork therapists actually do and the results that can be achieved.


 Is
 Tui 
Na 
Effective
 for 
Relieving 
Low
 Back 
Pain?


Leave a comment


Taylor 
Jump

Research 
Case 
Report

IPSB

 Spring
 2010

Abstract

Objective: 
This 
study 
is 
designed
 to 
determine 
if 
Tui 
Na
 massage
 can
 be
 effective 
in
 relieving 
low
 back
 pain.

Methods:
 A 
54
 year 
old
 full‐time 
mother 
and
 house wife
 recently
 twisted 
and 
injured
 her
 low
 back 
and
 her left 
knee
 from
 a 
serious 
fall. 
She 
cannot
 put 
all 
of
 her
 weight 
on 
the
 injured
 leg. 
Five
 sessions, 
60
 minutes each, 
of 
Tui 
Na 
massage 
were 
performed
 once 
a 
week 
for 
5 
weeks
 to 
address 
acupoints
 commonly
 used 
in acupuncture 
for 
low
 back 
pain. 
Range 
of
 motion 
of 
flexion 
of
 the 
upper 
torso 
was
 measured, 
and
 the
 client 
kept 
track 
of 
how
 often
 back 
pain 
occurred,
 what
 activity 
aggravated
 it, 
and
 pain 
level.

Results:
 Pain
 frequency 
and
 intensity 
decreased 
during 
the
 course 
of 
the 
study. 
Flexion 
of 
the
 spinal column increased.

Conclusion: 
Tui
 Na 
was 
shown
 to
 be 
an 
effective 
treatment 
for 
LBP.

Keywords: 
Low 
back
 pain,
 acupoints, Tui 
Na.

Introduction

This
 study
 is 
designed
 to 
determine 
if 
Tui 
Na
 massage 
will 
be 
effective
 in
 relieving
 low
 back 
pain. 

Low back pain
 (LBP) 
is 
described
 as, 
“Pain 
in 
the
 low
 back 
area 
that 
can 
relate 
to 
problems 
with 
the
 lumbar
 spine,
 the 
discs 
between
 the
 vertebrae, 
the
 ligaments 
around
 the
 spine 
and 
discs,
 the
 spinal
 cord 
and
 nerves, muscles 
of 
the
 low
 back,
 internal 
organs 
of 
the 
pelvis 
and 
abdomen, 
or 
the
 skin 
covering 
the
 lumbar 
area” (Medicinenet,
 2002). 

It 
is 
for 
this 
broad
 definition
 that
 approximately 
31
million
 Americans 
experience
 some form
 of 
LBP
 at
 any 
given 
time 
(American 
Chiropractic 
Association, 
2010).

 Deyo, 
Mirza, 
&
Martin 
(2006) produced
 a 
study
 in 
which
 they
 found 
that 
at 
least 
25%
 of 
the
 31,044
 participants 
in 
the
 study
 had
 LBP. Many
 symptoms
 of 
LBP 
include, 
but 
are
 not 
limited
 to, 
pain
 while
 bending 
over, 
stiffness
 of 
the 
back,
 and pain 
down
 the 
leg 
(WebMD, 
2008). 
The
 client 
in 
this 
particular
 study
 injured 
her 
back 
from a 
fall 
and experienced 
pain 
while
 bending 
over 
or 
sitting 
for 
prolonged
 periods 
of 
time.

Rostocki’s 
(2010)
 review
 of 
the 
literature 
found
 that
 there 
are
 over
 50 
different 
treatments
 for 
LBP. 
A
 few different 
treatments 
include
 chiropractic 
manipulation,
 spinal 
decompression, 
acupuncture, electrotherapy,
 transcendental 
meditation, 
and
 hypnotherapy.
 
Few
 of
 the
 50
 treatments, 
like
 those
 listed, actually 
have
 scientific 
evidence 
supporting
 the 
effectiveness 
of
 the
 treatment.
 Surgery
 and
 medication are
 the 
most
 common
 forms 
of
 western
 intervention 
for 
low
 back
 pain
 treatment, 
but
 surgery 
is 
often viewed
 as
 a 
last 
resort 
treatment 
even 
by
 medical 
practitioners. 
Only
 50%
 of 
surgeries
 are
 viewed
 as successful, 
and
 many
 who
 undergo 
surgery 
wish
 they 
had
 not
 received
 the
 surgery 
at 
all.

As 
for 
alternatives
 to
 these 
treatments,
 options
 vary, 
but 
popular 
forms
 are
 massage
 and
 yoga. 
Massage has 
been 
recently 
implemented
 in 
western 
medical 
practice 
and 
has 
proven 
effective 
at 
relieving 
LBP (Furlan, 
Imamura, 
Dryden, 
& 
Irvin, 
2010; 
Cherkin, 
Sherman, 
Deyo, &
 Shekelle, 
2003). 
In 
all 
of 
the
 literature reviewed
 massage 
techniques
 included
 trigger 
point
 therapy,
 Swedish 
massage,
 and
 deep
 tissue
techniques.

Traditional 
Chinese 
Medicine 
(TCM)
 has
 been
 around
 for
 approximately
 4000
 years 
and
 has 
many different 
branches 
and 
applications
 (Mercati, 
1997). 
One
 of 
the 
most
 common
 TCM 
treatments 
is acupuncture. 
Acupuncture 
has
 been
 used
 to 
treat 
many
 different 
disorders 
such 
as 
anxiety, 
frozen shoulder, 
anorexia, 
constipation, 
and
 of 
course,
 LBP
 (Braverman,
 2010).
 Acupuncture
 has
 been
s hown
 to
 have
 significant
 effects
 on 
low
 back
 pain
 as 
opposed
 to
 no
 treatment
 at 
all 
(Furlan, 
Van
 Tulder, 
Cherkin,
  & Tsukayama,
 2005; 
Brinkhaus, 
Witt,
 Jenna,
 Linde, 
& 
Streng, 
2006).

Tui 
Na 
is 
closely
 associated
 with 
acupuncture. 
Instead
 of 
using
 needles, 
the 
therapist 
uses 
thumbs
 and elbows 
to 
affect 
acupoints. 
Common
 techniques 
include
 rolling, 
press
 rubbing,
 chafing,
 kneading, 
and finger 
springing
 (Helm,
 2009). 
There 
is 
very 
little 
research 
which
 includes 
Tui
 Na 
massage
 in
 the 
English language. 
This
 study
 is 
meant
 to 
add 
to 
the
 research 
done
 on
 Tui 
Na 
and 
low
 back 
pain.
 The 
particular massage 
performed 
in 
this 
study 
addressed 
acupoints 
commonly 
used
 in
 acupuncture 
for 
LBP.

The 
client
 filled 
out
 a
 daily 
journal
 recording 
date, 
pain
 level, 
and
 the
 activity 
that
 aggravated 
the
 back. 
The therapist 
also 
used
 a 
goniometer
 to 
measure
 range
 of 
motion 
(ROM)
 of 
low
 back 
flexion.

Methods

Client 
Profile

A 
54
 year
 old 
full‐time 
mother 
and
 house wife
 recently 
injured
 her 
low
 back
 and
 her
 left 
knee
 from
 a serious 
fall. 
The
 client
 twisted 
her 
back
 from
 the 
fall 
and
 now
 almost
 every
 day
 when 
she
 wakes 
up
 she
 has 
to 
stretch 
her
 low 
back 
in 
order 
to 
even 
rise 
out 
of 
bed.
 The
 pain
 is 
continuous
 throughout 
the 
day and
 many 
of 
her 
daily 
activities 
have 
become 
monumental 
tasks 
because 
of
 the
 pain
 she
 endures. Retrieving 
a 
1
lb. 
box 
of
 sugar 
from
 the
 bottom
 shelf 
causes 
excruciating 
pain. 
She
 experiences 
stabbing pain 
whenever 
she
 tries 
to 
stand
 up 
too 
fast 
or 
sometimes
 even
 while
 she’s 
sitting.
 The
 client
 has
 pointed to 
her
 low 
back 
area,
 specifically 
the 
quadratus
 lumborum
 muscle, 
iliac 
crest, 
and
 sacrum
 on
 both 
sides 
as the 
area
 of 
the
 stabbing 
pain.

She
 also 
experiences 
tightness 
in 
her 
right
 knee
 from
 the 
fall, 
but
 explains 
that 
the 
pain
 is 
bearable. 
This tightness 
is 
felt 
in 
the 
hamstring 
of 
her 
right 
leg. 
She
 cannot
 put
 all 
of
 her 
weight
 on
 that 
leg 
so 
she
 walks with 
a 
slight 
limp.

Pain 
medication 
has 
become
 a
 daily 
occurrence 
for 
this 
client, 
although 
none 
are 
prescribed
 (Motrin 
and Aleve 
are
 the
 preferred 
choices). 
Since 
the
 fall 
she 
has 
been 
through 
physical 
therapy, 
electrical
 stimulation 
and 
other 
forms
 of 
massage
 (Swedish).
 The
 physical
 therapy 
definitely 
helped
 to 
improve
 her mobility 
immediately
 after
 the
 fall, 
but
 neither 
of 
the 
other 
therapies 
have
 helped 
her 
at 
all. 
The
 client
 also experiences 
neck
 and
 shoulder 
pain
 and
 occasionally 
the
 right
 arm
 goes
 numb
 and
 limits 
day‐ to‐day activity.

She
 is
 allergic 
to 
grasses 
and
 pollen
 as 
well 
as 
the 
smell 
of 
eucalyptus.
 The
 pain 
in 
her 
back
 is 
increased when
 she 
is
 exposed 
to 
the 
smells 
as 
she
 begins 
to 
sneeze 
excessively.

She 
has
 had
 abdominal 
surgery, 
a
 hysterectomy,
 and
 two 
caesarean
 sections. 
The
 abdominal 
surgery, performed
 in 
2003, 
was
 to 
disconnect
 her 
small 
intestine
 that 
managed 
to 
attach 
to 
her 
bladder. 
The
 first caesarean 
was
 performed
 in
 1984. 
The 
hysterectomy 
was 
performed
 during 
her
 second
 caesarean
 surgery in 
1986. 
She
 does 
not 
feel 
any 
discomfort 
from
 previous
 surgeries 
and 
has
 been
 cleared 
by
 her
 medical physician
 to 
receive 
massage.

Her 
goal 
during
 this
 study
 was 
to 
no 
longer 
deal 
with 
daily 
low
 back 
pain.
 She
 wanted
 to 
be
 able
 to 
bend over, 
sit 
down, 
and 
lie
 down
 without
 having 
to 
worry 
about
 excruciating 
pain.

Treatment 
Protocol

Five
 sessions, 
60 
minutes 
each, 
of
 Tui 
Na 
massage 
were
 performed
 once 
a 
week
 for 
5
 weeks. 

The
 techniques 
used 
were 
as 
follows:

Prone:

1) 
1 
minute
 Palpate 
for 
Ash i
points.

2)
 15
 minutes
 Tui
 Na
 rolling
 on
 quadratus 
lumborum, 
sacrum,
 gluteal 
muscles,
 ham strings 
and
 calves.

3)
 2 
minutes 
place 
fire
 cups
 on 
Ashi
 Points

4) 
5
 minutes 
grasping 
low
 back, 
gluteal 
muscles, 
and
 legs,
 UB
40, 
UB
39, 
GB
30, 
K
10, 
K
3.

5) 
2 
minutes
 moderate 
kneading 
back
 and 
thighs.

6) 
5
 minutes 
press 
rub 
UB
23, 
UB
25,
 Du
3, 
Du
4, 
Ashi 
Points, 
UB
40,
 UB
39, 
K10,
 K
3

7) 
1 
minute
 remove
 fire 
cups

8) 
10
 minutes 
rolling
 low
 back,
 gluteal
 muscles, 
and 
hamstrings.

9) 
3 
minutes 
grasping 
cupped
 areas

10) 
2 
minutes 
pok
 on 
low
 back
 and
 legs

Supine:

11) 
10 
minutes
 rolling 
quadriceps

12)
 5 
minutes 
passive 
movement 
of 
hip
 joint 
w/ 
traction.

Measurement 
Tools

The 
practitioner
 used
 a
 goniometer
 to 
measure 
flexion 
of 
the
 upper
 torso 
in 
relation 
to 
a
 vertical
 wall (range
 of 
motion). 
The 
client
 filled
 out 
a 
continuous
 journal 
indicating 
how 
often
 back
 pain 
occurred,
 what activity 
aggravated 
it, 
and
 pain
 level.

Pain 
Scale

0
  


No
Pain

1‐2 




Mild 
Pain

3‐5 




Moderate
 Pain

6‐8
 



Severe 
Pain

9‐10 


Excruciating
 pain

Results

The
 treatment
 protocol 
was
 to
 meet 
with 
the
 client 
once 
a 
week 
for 
5 
weeks
 the
 same
 day 
and
 time
 every
week. 
ROM
 tests 
were
 performed
 before 
and 
after 
each
 treatment.

Baseline 
week: 
The
 client 
reported 
5 
incidents 
of 
pain 
rating
10, 
mostly
 when
 sleeping 
and
 getting
 dressed
throughout
 the
 week. 
She 
experienced 
moderate
 discomfort 
doing 
daily 
tasks, 
bending
 over,
 cooking, walking ,
 etc. 

ROM:
 16°.

Session 
1:
 The
 client 
showed
 up 
with
 great
 excitement. 
She
 had 
experienced 
5 
instances
 that
 day
 in
 which
she
 had
 to 
stop 
what
 she
 was
 doing 
because
 of
 the
 pain. 
There
 was
 a
lot 
of
 stagnation
 in 
the 
right
 hip
 and
right 
leg.
 Before 
ROM:
 18°

/

After 
ROM:

 92°.
 During
 the 
following
 week
 the 
client 
experienced
 many
incidents 
of 
pain, 
mostly 
in 
the 
morning 
while
 getting 
out
 of 
bed
 and
 getting 
ready
 for
 the
 day.

 Shaving
proved
 very
 difficult 
and 
was
 reported 
as 
the
 only 
10
 throughout 
the 
week. 
Putting 
on 
socks
 often
produced
 a 
9
 on 
the 
pain
 scale.
 The
 client 
often
 reported
 a
 pain 
rating 
of 
8‐9 
(6 
times). 
No 
pain 
in
 left 
knee
all 
week.
 
She
 took
 3
 aspirin 
during 
the
 week.

Session 
2: 

The
 client
 showed
 up 
with 
very
 minimal 
energy. 
She 
had
 done 
a 
lot
 of 
gardening 
before
 showing 
up 
for 
the 
massage. 
She 
experienced
 3
 instances 
during
 the
 day
 in
 which
 the
 pain
 caused
 her 
to
 stop 
what
 she
 was
 doing.
 She
 has 
decreased
 tightness
 in
 right 
leg 
and
 right 
hip,
 very
 sensitive 
points
 in
 left 
hip 
and
 her 
low
b ack.
 Before 
ROM:

 52°

/

After 
ROM:

 76°.
 The
 following
 week
 the 
client
 spent
 a 
lot
 of 
time 
gardening, 
which 
she
 hadn’t
 been
 able 
to 
do 
before. 
Throughout 
the 
week 
client 
reported
 regular
pain 
ratings 
of 
7‐9
 (6
 times),
 usually 
when
 getting
 out
 of 
bed
 and
 putting
 on
 socks. 
Sleeping 
was
 the 
only
incident
 of 
10
 on 
the
 pain
 scale.
 She
 took
 2
 aspirin 
throughout
 the
 week.

Session 
3: 
The
 client
 showed
 up 
in 
a 
lot 
of 
pain,
 and
 had
 increased
 amounts
 of 
tightness
 all 
over.
 Two
 days
before
 treatment
 she
s pent
 6 
hours
 shopping
 and
 walking
 around
 the 
mall. 
She
 explained 
that
 yesterday
she 
was 
very
 sore.
 She 
had
 areas 
of 
tightness
 in 
her
 UB39,
 UB40,
 and
 K10
 points.
 
Bl
37 
point
 was
 also
 very tender
 for
 the
 client.
 
Before 
ROM:

 65°

/

After 
ROM:
 
72°.

 The
 following
 week
 the
 client
 experienced 
a 
pain
rating
 of
 7 
(5 
times), 
usually 
while
 getting 
out
 of 
bed
 and 
getting
 dressed;
 getting
 dressed 
produced
 pain of
 10.
 Took
 1 
aspirin 
all 
week
 and
 had
 2 
days 
of 
no 
pain 
incidents
 at 
all.

Session
 4: 

Treatment
 was
 postponed
 by
 3
 days, 
but
 the
 client
 continued
 to 
fill 
out
 record
 of
 pain
 incidents.
 The
 client 
showed
 up
 in 
good
 spirits. 
In
particular 
UB
39,
 UB40
 and 
K10
 on 
the
 right
 leg
 were
 still
very 
stagnant,
 but
 far 
less 
sensitive.
 
Since 
past
 areas 
of 
pain
 were
 no 
longer
 sensitive, 
the
 therapist
 spent
what 
time
 was 
left 
of 
the
 session 
on 
areas 
not
 worked
 on
 before.
 The
 therapist 
worked
 on 
the
 liver
meridian 
of 
both
 legs
 for 
a 
few 
minutes 
and
 found
 areas 
of 
extreme 
tenderness.
 Before
 ROM:

 80°

/

After
 ROM:
 
82°.
 The
 client
 reported
 1 
incident 
of
 pain
 rating
 10 
and 
1 
incident 
of
 pain
 rating 
8
 throughout
 the
following 
week. 
No
 aspirin 
was 
used
 and 
she 
reported 
3 
days 
of
 no
 pain.
 
Putting
 on
 socks
 produced
 pain
rating
 of 
10.
 Waking 
up
 and
 getting 
out
 of 
bed
 became
 much
 easier 
and
 she
 no
 longer
 worried
 about
twisting 
in 
the 
wrong
 direction.

Session
 5: 

The
 client
 had
 increased
 energy 
and 
felt
 as 
good
 as 
she 
had
 felt 
before
 her
 injury.
 The
 client
 was
able
 to
 bend 
over 
before
 session 
and
 not
 feel 
any
 pain, 
but 
fel t
“normal” 
tightness
 in 
hamstrings
 while
bending 
over. 
The 
therapist 
found
 more
 tenderness 
in 
the
 liver 
meridian.
 
Before 
ROM:

 84°

/

 After 
ROM:

 86°. 
The
 client
 stopped
 recording 
journal,
 but
 no
 longer
 felt 
pain
 on
 a 
regular
 basis. 
Once
 throughout
 the
week 
the 
client 
experienced
 pain
 putting 
on 
socks,
 pain 
rating 
10,
 but
 no
 other 
incidents
 throughout
 the
week.

tuina_img1

Discussion
 and
 Conclusion

The
 graphs 
above
 chart 
the
 progress 
of 
the
 client. 
Figure
 1
 shows
 the 
number
 of 
times
 the
 client
 reported
pain
 throughout
 the 
week.
 As
 can
 be 
seen
 the
 number
 of
 times
 she 
reported
 pain
 decreased
 as
 the 
weeks
went 
on. 
Week 
4, 
however,
 shows
 an 
increase 
in
 numbers,
 but 
it 
may
 be
 attributed
 to 
the
 excess 
walking
she 
did 
that 
week.

Figure
 2 
tracks 
the 
client’s 
most 
frequently 
reported
 pain
 rating. 
Week
 one
 the
 client
 reported 
more
 10s
 than 
any
 other 
number.
 
This 
chart 
shows
 a 
steady 
decrease
 in 
how
 much
 pain
 was
 felt 
by
 the
 client.

 Even
though 
Figure 
1 
shows 
an 
increase 
in 
the
 number 
of
 times 
the
 client
 experienced
 pain, 
Figure 
2
 shows
 that
 the 
pain
 intensity
 decreased
 as 
the
 study
 progressed.

Figure
 3 
shows
 the
 amount
 of 
spinal 
flexion
 the 
client 
was
 able
 to 
perform
 before 
and 
after
 treatment.

 As
can
 be 
seen
 the
 client’s 
flexion
 before 
treatment
 steadily 
increased, 
but
 seemed
 to
 begin 
to 
level 
off
 towards
 the 
end 
of 
week 
six.
 
The
 flexion 
measured 
after 
treatment
 seemed
 to 
remain 
around 
the 
same.

 This 
study
 cannot
 conclude 
why
 the
 flexion 
after 
session
 1 
is 
greater 
than
 the
 other 
weeks,
 but
 the
 ROM
 seemed
 to 
level 
off 
at 
the
 end
 of 
treatment.

Tui 
Na
 has 
proven
 to 
be
 an 
effective 
treatment
 for 
LBP.
 It 
has 
improved
 the 
client’s 
mobility 
and
 decreased
 the 
amount
 of 
pain 
the 
client 
endures
 with 
day‐to‐day
 activities. 
The 
client
 has
 continued
 to
 report 
increased
 mobility 
even 
after
 the
 treatment 
has
 stopped. 
It 
is 
possible 
that 
this 
weekly
 treatment
 has
 provided 
the 
client 
with 
long
 lasting 
pain
 relief,
 but 
only 
a
 continued
 study 
would 
be 
able
 to
 draw
 conclusions 
about
 which
 this
 study
 can 
only 
speculate. 

Tui 
Na
 has
 also 
proved
 itself 
as 
a 
safe
 alternative
 to
 any 
sort 
of
 invasive
 treatment
 such
 as 
surgery. 
Only
 a
 continued
 study
 could
 tell 
if
 the
 treatment 
will
 continue
 to
 produce
 long
 term
 effects.

It 
is
 also 
possible 
that 
with
 the
 client
 recording 
and
 cataloguing 
the 
information
 throughout 
the
 study
 that 
it 
has 
increased
 her 
inner 
sense
 and
 knowledge 
of 
her
 own
 body.
 It 
has,
 in
 the
 therapist’s 
view,
 provided
 her
 with 
a 
knowledge 
that 
she 
would 
not
 have
 otherwise 
had.
 The
 recording 
of 
daily
 information
has
 in 
a 
sense 
provided 
the
 therapist 
with 
a 
much
 more
 detailed
 look
 into 
what
 was
 really
 going 
on 
every
day.
 It 
provided 
information 
to 
the
 therapist 
that
 he
 may
 not
 have
 been
 able 
to 
obtain
 otherwise,
 very
specific 
information 
which 
in 
turn 
allowed
 the
 therapist 
to 
focus
 on 
exactly 
where 
areas of 
pain 
and
discomfort 
were 
located. 

As
 a
 side
 note
 the
 therapist 
reports 
that 
providing 
the
 client 
with
 recording
materials, 
such
 as 
a 
journal, 
to 
catalog
 progress 
may
 complement
 the
 healing
 process 
for
 the
 client.

Having
 the
 client 
record
 daily 
activities 
did
 give
 better
 feedback
 for
 the
 therapist 
to 
review
 and
 use
 to
design 
future
 session 
protocols.

Bibliography

Back
 Pain
 Facts 
& 
Statistics. 
(2010). 
American
 chiropractic 
association.
 Retrieved
(2010, 
May
 13)

Braverman,
S.E. 
(n.d.). 
Medical 
acupuncture 
review: 
safety,
 efficacy, 
and
 treatment
 practices.
 Medical
 Acupuncture
 A 
Journal
 for 
Physicians
 by 
Physicians,
 15(3).

Brinkhaus,
 B., 
Witt, 
C.M.,
 Jenna, 
S., 
Linde, 
K.,
 & 
Streng,
 A. 
(2006). 
Acupuncture 
in 
patients 
with
 low
 back
 pain.
 Archives 
of 
Internal 
Medicine,
166(4).

Carter,
 B. 
(2004). 
Acupuncture 
statistics. 
Brian
 Carter’s 
Pulse
 of 
Oriental
 Medicine.

Cherkin,
 D.C.,
 Sherman,
 K.J., 
Deyo,
 R.A., 
& 
Shekelle, 
P.G.
 (2003).
 A 
Review
 of
 the
 evidence
 for 
the
 effectiveness, 
safety, 
and
 cost 
of 
acupuncture,
 massage
 therapy,
 and
s pinal
 manipulation
 for
back
 pain.
American 
College 
of
 Physicians,
 138(11).

Deyo, 
R.A., 
Mirza,
 S.A., 
& 
Martin, 
B.I. 
(2006).
 Back
 pain
 prevalence 
and
 visit 
rates: 
estimates
 from
 national 
us
surveys, 
2002.
 Lippincott 
Williams
 & 
Wilkins, 
31(23).

Furlan, 
A.D.,
 Imamura, 
M.,
 Dryden,
 T., 
Irvin, 
E.
 Massage 
for 
low‐back 
pain.
 Cochrane
 Database
 of
 Systematic
 Reviews
 2008,
 Issue 
4.

Furlan,
 A.D., 
van
 Tulder, 
M.W.,
 Cherkin, 
D.,
 Tsukayama,
 H., 
Lao,
 L., 
Koes,
 B.W.,
 Berman,
 B.M.
 Acupuncture
and
 dry 
needling 
for 
low 
back
 pain.
 Cochrane
 Database 
of 
Systematic 
Reviews
 2005,
 Issue
 1.

Helm,
 B. 
(2009). 
Tui 
na 
structural
 disorders 
therapy 
treatments. 
San
 Diego,
 CA:
 Taoist 
Sanctuary.
 Medicinenet.com
 (2002). 
Retrieved
 from
 http://www.medterms.com/script/main/art.asp?articlekey=20587
(2010,
May
14)

Rakel, 
D.
P., 
& 
Faass, 
N.
 (2006). 
Complementary 
medicine 
in
 clinical
 practice.
 Sudbury,
 MA:
 Jones
and
 Bartlett
Publishers.

Rostocki, 
A. 
(2006,
 May 
10). 
Cure 
back 
pain.org.
 Retrieved 
from
 http://www.cure‐back‐pain.org/cure‐ back‐pain.html

 (2010, 
May
1)

Webmd
(2008).
Low
back
pain
symptoms.

page10image8552

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s