To stimulate the circulation of blood and qi (“life force”) in the body, traditional Chinese medicine (TCM) practitioners employ a number of methods, including the ancient system of bodywork called tui na (pronounced twee-nah).
Using their fingers, hands, elbows, knees or other body parts, the practitioner applies pressure to the patient’s energy channels, known as meridians, and so-called acupoints, or muscles and nerves, to achieve specific therapeutic effects.
“Based on TCM theories, qi and blood circulate throughout the body, nourishing it and supporting its normal functioning,” says Clara Chan, a TCM practitioner from Balance Health in Hong Kong.
“Blockage of this flow may disrupt one’s internal balance and cause illness and pain. By applying different levels of pressure on particular regions or acupoints or along the meridians, tui na can promote qi and blood flow, remove obstructions in the meridians, relieve stagnation … and restore the body to a natural state of well-being.”
The effects go beyond the area of treatment and can have an impact on a specific system or the whole body, Chan adds.
“This is because the meridian system is like a giant web, linking the different parts of the body together, from the internal organs to the musculoskeletal system. Its pathways make up a comprehensive ‘body map’ that allows communication between various systems [and] supplies vital energy to different parts of the body.”
The words tui and na refer to two techniques. Tui means “to push”. The practitioner places a finger or palm (or sometimes elbow or knee) on the treatment site and pushes it with consistent pressure from one defined point to another.
When applied with gentle pressure, this technique helps alleviate pain and discomfort. When heavier pressure is applied, it may help to unblock the meridians, dissipate blood pooling, regulate tendon and muscle tension, relieve spasms, and promote blood and lymphatic circulation.
Na means “to lift”. The practitioner uses one or both thumbs and his or her index and middle fingers, or thumb and other four fingers, rhythmically lifting and kneading with some pressure.
If appropriate force is used, Chan says, the technique can help unblock the meridians, relieve sweating, alleviate pain, rejuvenate the body and relieve spasms. The technique is normally used on the neck, shoulder and limbs.
“Tui na is sometimes known as acupressure, or an mo ,” Chan says. “‘An’ means to press, while ‘mo’ means to rub in a repeated circular motion. These techniques serve different purposes. Pressing may help loosen tight muscles and rubbing may be used in the upper abdominal area to ease stomach pain.”
Tui na also employs other techniques such as twisting, patting and pulling, adds TCM practitioner Lim Jin Yang, from Oriental Remedies Group in Singapore.
There are 18 techniques, but the goal of each is the same: to restore balance and harmony to the body by unblocking meridians and promoting qi and blood circulation.
Tui na is commonly used to treat chronic and acute pain and numbness. According to Chan, it can help dilate the capillaries and increase body surface temperature, promoting the flow of qi and blood and alleviating qi stagnation and blood stasis, which in TCM is believed to be the cause of pain and numbness.
As tui na stimulates the acupoints and the meridians, it can also regulate the functions of the visceral, or autonomic, nervous system and ease tension in muscles and tendons.
“Musculoskeletal problems including injuries to tissues, bone fractures and joint dislocation are often treated by tui na, in conjunction with acupuncture,” Chan says.
“Research indicates that tui na or acupressure may assist with stress-related disorders like insomnia, constipation , headaches , and other disorders related to the digestive and respiratory system s,” says Chan.
University of Hong Kong researchers found that applying specific acupressure techniques to the head and shoulder area improved the quality of life frail old people in centres for the elderly and care homes.
Those who received regular acupressure treatment over the study period, from 2014 to 2016, experienced better mood and enhanced vitality. Other benefits included improved blood circulation, reduced tension, lowered blood pressure, reduced insomnia and less pain.
The treatment can also help healthy people maintain their physical and emotional well-being by strengthening their body and minimising risk of disease, says Lim.
Lim says that if the techniques are used improperly, or if the patient is tense during the treatment, it might feel a little uncomfortable. “Certified [TCM] doctors are trained to identify the signs (if a patient is feeling uncomfortable) and to deal with the issue in an appropriate and timely manner,” he says.
The discomfort, according to Chan, may range from pain and fatigue to soreness. Some patients may experience minor bruising after a treatment.
If you’re sensitive to pain, you can ask your doctor to use light pressure. The same goes if you bruise easily or have thin skin. If you’re elderly and have severe osteoporosis , be extra careful, since your bones are more brittle, Lim says.
“Tui na may not be suitable for people with fractures or open wounds, bleeding disorders, skin diseases and acute infectious disease,” Chan adds.
“Pregnant women, and patients with cancer and chronic disease should consult their doctor or registered TCM practitioner before undergoing tui na.”
This article was first published in South China Morning Post.