Chronic musculoskeletal pain, including all types of osteoarthritis and back pain, has gradually become an international health priority, particularly among the industrialized countries. Exercise is a major form of treatment for these conditions, and of course there are many forms of exercise. Tai Chi has its origin in China, and is a form of exercise that focuses on controlled movements combined with deep breathing.
There are 5 major styles of Tai Chi: Chen, Yang, Wu, Hao and Sun. Each of these has its own unique characteristics, but of course based on the same principles. Yang and Sun styles have become widely used to improve balance and decrease the risk of falls among the senior population. Interestingly, a Sun-style form of Tai Chi is endorsed by The Arthritis Foundation as a means of managing osteoarthritis pain.
A recent analysis of available studies was published in the June issue of "Arthritis Care and Research". This study showed that Tai Chi has positive, although small, effects on self-assessed pain and disability; unfortunately, data for long-term effects is just not available. Perhaps, one must be a regular practitioner of Tai Chi in order to maintain the benefits.
So, are these small effects on pain and disability indicative of a relative failure of Tai Chi as treatment? The answer to this is rather complex.
It could be that patients have lesser expectations for a treatment modality which is typically performed as a group exercise activity, electively attended. However, the fact that Tai Chi is inexpensive and enjoyable may convey a number of psychological and social benefits, supporting the notion that a smaller effect size may be considered worthwhile for such an intervention.
Of course, those with chronic pain also must deal with psychological pain; and Tai Chi did show at least a trend toward small positive effects for overall physical health, tension level, and improved mental health. When mood was specifically examined, the results were not that impressive.
The authors concluded that Tai Chi appears to have a small positive effect for reducing pain and improving disability in individuals with arthritis. However, more studies must be done to examine the effects of Tai Chi on other types of musculoskeletal pain.
More studies need to be done in order to better characterize the benefits of Tai Chi.
In the meantime, the joy that my patients derive from simply participating in Tai Chi causes me to conclude that it is a worthwhile treatment, however unscientific that conclusion might be.
