Nonspecific low back pain (NSLBP) is a leading cause of disability, and effective non-pharmacological treatments remain limited. Traditional Chinese Exercises (TCE) are increasingly used for NSLBP, but their effectiveness has not been fully established.
Objective
To evaluate the effects of Traditional Chinese Exercises on pain, functional disability, and trunk muscle endurance in patients with nonspecific low back pain.
Methods
A systematic review and meta-analysis of randomized controlled trials was conducted according to PRISMA guidelines. Chinese and English databases were searched up to 2025. Pain, disability, and trunk muscle endurance were synthesized using random-effects models.
Results
Eighteen randomized controlled trials involving adults with NSLBP were included. Traditional Chinese Exercises were associated with improvements in pain, functional disability, and trunk muscle endurance compared with control interventions. Higher intervention frequency and shorter duration were associated with greater effects, although heterogeneity was substantial.
Conclusion
Traditional Chinese Exercises may improve pain, function, and trunk muscle endurance in patients with nonspecific low back pain. However, due to heterogeneity and methodological limitations, the findings should be interpreted with caution.
Trial registration
The study protocol was registered in PROSPERO, the international prospective register of systematic reviews, under registration number CRD42025632131.
MaherCUnderwoodMBuchbinderR. Non-specific low back pain. Lancet2017; 389: 736–747.
2.
BaoQ. Risk factors and treatments of non-specific low back pain. Theor Nat Sci2023; 3: 623–628.
3.
FleckensteinJFloesselPEngelT, et al.Individualized exercise in chronic non-specific low back pain: a systematic review with meta-analysis on the effects of exercise alone or in combination with psychological interventions on pain and disability. J Pain2022; 23: 1856–1873.
4.
QaseemAWiltTJMcLeanRM, et al.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med2017; 166: 514–530. Journal Article; Practice Guideline.
5.
CamposVMSPrudenteTPLeãoLL, et al.Analyses of different prescriptions for health using artificial intelligence: a critical approach based on the international guidelines of health institutions. Health Inf Sci Syst2025; 13: 52.
6.
PenistonJH. A review of pharmacotherapy for chronic low back pain with considerations for sports medicine. Phys Sportsmed2015; 40: 21–32.
7.
DehzadMJGhalandariHAminiMR, et al.Effects of curcumin/turmeric supplementation on lipid profile: a GRADE-assessed systematic review and dose–response meta-analysis of randomized controlled trials. Complement Ther Med2023; 75: 102955.
8.
OliveiraCBMaherCGPintoRZ, et al.Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J2018; 27: 2791–2803.
9.
TereshchenkoSY. NON-SPECIFIC BACK PAIN: DIAGNOSIS AND THERAPY FROM THE POSITION OF EVIDENTIAL MEDICINE (REVIEW OF LITERATURE). Sib J Life Sci Agric2022; 14: 392–401.
10.
WielandLSSkoetzNPilkingtonK, et al.Yoga treatment for chronic non-specific low back pain. Cochrane Db Syst Rev2017; 2017. DOI: 10.1002/14651858.CD010671.pub2
11.
ZhangYLoprinziPDYangL, et al.The beneficial effects of traditional Chinese exercises for adults with low back pain: a meta-analysis of randomized controlled trials. Medicina (Kaunas, Lithuania)2019; 55: 18.
12.
WangXXiongHDuS, et al.The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: a systematic review. Front Aging Neurosci2022; 14: 935925.
13.
NovikovAYShaiakhmetovARNovikovYO. The application of physical therapy and balneology of the patients with non-specific low back pain (literature review). Russ Osteop J2020: 130–136. DOI: 10.32885/2220-0975-2020-3-130-136.
14.
HuangCMayerPKWuM, et al.The effect of Tai Chi in elderly individuals with sarcopenia and frailty: a systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev2022; 82: 101747.
15.
HanLWangJZhuY, et al.Traditional Chinese exercise in chronic obstructive pulmonary disease: an overview of systematic reviews. Medicine (Baltimore)2024; 103: e38700.
16.
MaZLeiHTianK, et al.Baduanjin exercise in the treatment of hypertension: a systematic review and meta-analysis. Front Cardiovasc Med2022; 9: 936018.
17.
VanderlindenJBoenFvan UffelenJGZ. Effects of physical activity programs on sleep outcomes in older adults: a systematic review. Int J Behav Nutr Phy2020; 17: 11.
18.
BiJ. Traditional Chinese medicine for the treatment of geriatric heart disease: a review. Acta Cardiol Sin2025; 41: 169–182.
19.
LiuCSohKGLohSP, et al.Effects of health qigong on cervical spondylosis: a systematic review. Complement Ther Med2025; 92: 103180.
20.
ZhangXJiangWChenZ, et al.Effects of Yi Jin Jing on enhancing muscle strength and physical performance in older individuals: a systematic review and meta-analysis. Front Med (Lausanne)2024; 11: 1441858.
21.
HongYTianZJiZ, et al.A systematic review of the effect and mechanism of Daoyin therapy on improving mild cognitive impairment in older adults. Ageing Res Rev2024; 101: 102526.
22.
FuTLaneNELeeS, et al.Editorial: rehabilitation and alternative medicine in the healthcare for chronic rheumatic pain disorders. Front Med (Lausanne)2025; 12: 1586105.
23.
ZhangYHuRHanM, et al.Evidence base of clinical studies on Qi Gong: a bibliometric analysis. Complement Ther Med2020; 50: 102392.
24.
FanXSohKGMunCY, et al.Effects of different types of Tai Chi intervention on motor function in older adults: a systematic review. Aging Clin Exp Res2025; 37: 32.
25.
ChiarottoAMaxwellLJOsteloRW, et al.Measurement properties of visual analogue scale, numeric rating scale, and pain severity subscale of the brief pain inventory in patients with low back pain: a systematic review. J Pain2019; 20: 245–263.
26.
JenksAHoekstraTvan TulderM, et al.Roland-Morris disability questionnaire, oswestry disability index, and Quebec back pain disability scale: which has superior measurement properties in older adults with low back pain?J Orthop Sport Phys2022; 52: 457–469.
27.
Del Pozo-CruzBMocholiMHDel Pozo-CruzJ, et al.Reliability and validity of lumbar and abdominal trunk muscle endurance tests in office workers with nonspecific subacute low back pain. J Back Musculoskelet2014; 27: 399–408.
28.
HallAMMaherCGLamP, et al.Tai chi exercise for treatment of pain and disability in people with persistent low back pain: a randomized controlled trial. Arthritis Care Res (Hoboken)2011; 63: 1576–1583. Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't.
29.
LiuJYeungAXiaoT, et al.Chen-Style Tai Chi for individuals (aged 50 years old or above) with chronic non-specific low back pain: a randomized controlled trial. Int J Environ Res Public Health2019; 16: 517. DOI: https://doi.org/10.3390/ijerph16030517
30.
WangRZhuDWangL, et al.Tai Chi Quan versus physical therapy on pain and cognitive performance for elderly people with chronic low back pain: study protocol for a randomized controlled trial. Front Aging Neurosci2022; 14: 900430.
31.
WeifenWMuheremuAChaohuiC, et al.Effectiveness of Tai Chi practice for non-specific chronic low back pain on retired athletes: a randomized controlled study. J Musculoskelet Pain2013; 21: 37–45.
32.
YanZWYangZYangJ, et al.Tai Chi for spatiotemporal gait features and dynamic balancing capacity in elderly female patients with non-specific low back pain: a six-week randomized controlled trial. J Back Musculoskelet Rehabil2022; 35: 1311–1319. DOI: 10.3233/BMR-210247.
33.
TongX. Effects of the modified Tai Chi “Shan Tong Bei” method on the lumbar multifidus function in patients with chronic nonspecific low back pain. Master’s thesis, Chengdu University of TCM, 2017.
34.
DingYWangJY. Therapeutic effects of standing Baduanjin on middle-aged and elderly patients with chronic low back pain. Chin J Gerontol2014; 34: 2690–2691.
35.
LiM. Comparison study on the intervention effects of Tai Chi and Pilates in patients with nonspecific low back pain. Master’s thesis, Yanshan University, 2024.
36.
WangJBYangQTChenLF, et al.Study on the effects of Baduanjin on pain symptoms in patients with chronic low back pain. J Shanxi Univ Chin Med2023; 24: 754–757.
37.
YaoCLiZZhangS, et al.Effects of Wuqinxi in the patients with chronic low back pain: a randomized controlled trial. Evid Based Complement Alternat Med2020; 2020: 1428246.
38.
NingXMWuLWangT, et al.Clinical study on the treatment of nonspecific low back pain with Wuqinxi combined with core strength training. J Trad Chin Orthop Traumatol2015; 27: 25–28.
39.
WuL. Clinical study on chronic nonspecific low back pain based on the concept of muscle imbalance. Master’s thesis, Chengdu University of TCM, 2016.
40.
MingshengLLiliZXiayingC, et al.Effect of Yijinjing psychosomatic exercise on physical and mental func-tions of patients with chronic non-specific low back pain. China Modern Med2023; 30: 8–13.
41.
ZhangK. Study on the effect of practicing Yijin Zhuanggu Gong on improving low back pain in male taxi drivers. Master’s thesis, Beijing Sport University, 2016.
42.
BlödtSPachDKasterT, et al.Qigong versus exercise therapy for chronic low back pain in adults–a randomized controlled non-inferiority trial. Eur J Pain2015; 19: 123–131. Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't.
43.
PhattharasupharerkSPurepongNEksakulklaS, et al.Effects of Qigong practice in office workers with chronic non-specific low back pain: a randomized control trial. J Bodyw Mov Ther2019; 23: 375–381. Journal Article; Randomized Controlled Trial.
44.
LiB. Study on the effects of health qigong in alleviating pain in patients with chronic nonspecific low back pain. Master’s thesis, Inner Mongolia Normal University, 2023.
45.
ZhangHY. Experimental study on the intervention effects of Baduanjin combined with Zhan Zhuang on nonspecific low back pain. Master’s thesis, Beijing Sport University, 2020.
46.
HigginsJPTThomasJChandlerJ, et al.Cochrane handbook for systematic reviews of interventions, 2022.
47.
XingXYingWPingyanC. Sample size estimation strategies in the absence of information on the standard deviation of differences in paired designs. Chin J Health Stat2021; 38: 181–187.
48.
HigginsJPWhiteIRWoodAM. Imputation methods for missing outcome data in meta-analysis of clinical trials. Clin Trials2008; 5: 225–239.
49.
HuangQLuXHeT, et al.Psychological effects of traditional Chinese mind-body exercises for low back pain: a protocol for meta-analysis. Medicine (Baltimore)2021; 100: e25605.
50.
ChengXGaoYChenX, et al.Rehabilitative effects of Baduanjin in Chinese stroke patients: a systematic review and meta-analysis. Prev Med Rep2024; 41: 102703.
51.
CastroJPKierkegaardMZeitelhoferM. A call to use the multicomponent exercise Tai Chi to improve recovery from COVID-19 and long COVID. Front Public Health2022; 10: 827645.
52.
WeiGXLiYFYueXL, et al.Tai Chi Chuan modulates heart rate variability during abdominal breathing in elderly adults. Psych J2016; 5: 69–77.
53.
XiaoCZhaoYLiG, et al.Clinical efficacy of multimodal exercise telerehabilitation based on AI for chronic nonspecific low back pain: randomized controlled trial. JMIR Mhealth Uhealth2025; 13: v13i10294e56176.
