Efficacy and safety evaluation of massage combined with traction for lumbar disc herniation: a meta-analysis

Objective To systematically evaluate, through a meta-analysis, the effectiveness and safety of massage combined with traction for the treatment of lumbar disc herniation (LDH). Methods A comprehensive literature search was conducted across multiple Chinese and international databases, including CNKI, Wanfang, VIP (Chinese Science and Technology Journals Database), China Biomedicine (CBM), PubMed, Web of Science, and the Cochrane Library, covering the period from January 2020 to December 2024. Heterogeneity was assessed by the Q test and I 2 statistic, and pooled ORs were calculated using fixed- or random-effects models. Sensitivity analysis and funnel plots were used to assess result stability and publication bias. Results Twelve studies met the inclusion criteria. Meta-analysis showed that tuina combined with traction significantly improved clinical outcomes compared with control interventions, including JOA scores (OR = 4.56, 95% CI: 2.76–6.36, p < 0.00001), VAS scores (OR = −1.47, 95% CI: −2.40 to −0.55, p = 0.0002), ODI scores (OR = −12.73, 95% CI: −23.88 to −1.59, p = 0.03), and lumbar posterior extension scores (exploratory results based on two studies) (OR = 6.51, 95% CI: 3.57–9.46, p < 0.0001). No significant difference was observed for forward bending motion scores. Sensitivity analysis confirmed the robustness of the pooled estimates, while funnel plots suggested potential publication bias. Conclusion This meta-analysis indicates that tuina combined with lumbar traction effectively improves lumbar function and reduces pain severity in patients with lumbar disc herniation.