ACR 2011: The Mind-Body Connection: The Use of Tai Chi to Treat Arthritis and Other Painful Rheumatic Diseases

With more patients and practitioners expressing interest in non-Western modes of healing and other complementary and alternative forms of medicine, researchers are studying whether methods like tai chi are effective in treating arthritis and other painful conditions.

During her presentation on “Arthritis and Traditional Chinese Medicine” at the 2011 ACR/ARHP Annual Meeting, Chenchen Wang, MD, MSc, associate professor of medicine, Tufts Medical Center, Tufts University School of Medicine, briefly compared and contrasted the basic tenets and approaches of Chinese and Western medicine, and reviewed evidence for the efficacy of tai chi for treating fibromyalgia, arthritis, and other painful rheumatic conditions.

Dr. Wang noted that, in her opinion, traditional Chinese medicine is empirical, whereas Western medicine is more experimental and based on animal model. She said that Chinese medicine is a “whole body system,” while practitioners of Western medicine tend to focus on individual body systems. The attempt to achieve “Man-nature harmony” in Chinese medicine results in “whole and multifactorial interaction in medicine, particularly the syndrome differentiation,” with practitioners seeking to “heal the person with illness.” She contrasted this approach with the Western approach of “dealing with local structural problems with causalities, particularly with the disease itself” and “treating the illness of the person.”

Wang noted that research has shown beneficial mind-body effects in patients who use Tai chi for chronic pain, and that the interactions between the brain, mind, body, and emotions facilitated by tai chi may enhance patients’ capacity for self-care. In one study (“A Randomized Trial of Tai Chi for Fibromyalgia”), Wang and colleagues “conducted a single-blind, randomized trial of classic Yang-style tai chi as compared with a control intervention consisting of wellness education and stretching for the treatment of fibromyalgia.” Patients in both groups participated in one-hour sessions, twice a week, for 12 weeks. The researchers measured the change in participants’ Fibromyalgia Impact Questionnaire (FIQ) scores after 12 weeks, and again after 24 weeks. Patients were also administered the Medical Outcomes Study 36-Item Short-Form Health Survey to measure changes in quality of life scores. The patients in the tai chi group “had clinically important improvements in the FIQ total score and quality of life” that were maintain at 24 weeks.

Another study that looked at the effect of tai chi on osteoarthritis (“Tai Chi is Effective in Treating Knee Osteoarthritis: A Randomized Controlled Trial”), Chang and colleagues “conducted a prospective, single-blind, randomized controlled trial of 40 individuals with symptomatic tibiofemoral OA.” Participants were randomized to one-hour tai chi sessions or “attention control (wellness education and stretching)” twice weekly for 12 weeks. The researchers measured participants’ Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores after 12 weeks, along with “WOMAC function, patient and physician global assessments, timed chair stand, depression index, self-efficacy scale, and quality of life.” They repeated the measurements after 24 and 48 weeks. They reported that, compared with the controls, patients assigned to Tai Chi exhibited “significantly greater improvement” in WOMAC pain scores, WOMAC physical function, patient global visual analog scale, physician global VAS, chair stand time, Center for Epidemiologic Studies Depression Scale, self-efficacy score, and Short Form 36 physical component summary. These results led Wang and colleagues to conclude that tai chi “reduces pain and improves physical function, self-efficacy, depression, and health-related quality of life for knee OA.”

She said that these and other studies support the contention that tai chi is a “safe and enjoyable exercise with high adherence that is effective for the treatment of chronic pain, and improves physical function, sleep quality, depression, and quality of life in people with arthritis and chronic pain.”

This activity is not sanctioned by, nor a part of, the American College of Rheumatology.