Traditional Chinese Manual Therapy (Tuina) relieves neuropathic pain by regulating neuroplasticity: A resting-state functional magnetic resonance imaging study.

To determine how traditional Chinese manual therapy (Tuina) alleviates neuropathic pain (NPP) via central neuroplasticity. NPP was induced by chronic compression of the dorsal root ganglion (CCD) in male rats. From post-operative day 4 to day 28, Tuina (5 N, 2 Hz, 10 min/day) was applied at Weizhong acupoint (BL40). Behavioural tests (mechanical withdrawal threshold, MWT; paw withdrawal thermal latency, PWL) were performed on 2 and 1 day before CCD surgery and post-operative day 3, 7, 14, 21 and 28. Resting-state functional MRI was performed before CCD surgery and on postoperative days 7 and 28. CCD surgery induced persistent mechanical and thermal allodynia. Tuina reversed these deficits from day 14 onward. Compared with Sham group, the CCD group exhibited elevated regional homogeneity (ReHo) in the hippocampus, amygdala, brainstem and cerebellum. Tuina further increased ReHo in the amygdala, hippocampus, corpus callosum and temporal lobe between days 7 and 28. ReHo values in pain-related regions negatively correlated with MWT and PWL. Tuina may gradually relieve neuropathic pain by reshaping limbic and sensory-motor networks, offering a neuroplasticity-based rationale for its clinical use.