# Efficacy and safety of Tai Chi for chronic musculoskeletal pain: a systematic review and meta-analysis

## TL;DR

This study reviews evidence that Tai Chi may reduce chronic musculoskeletal pain, particularly for osteoarthritis and low back pain, with no serious side effects.

## Contribution

A systematic review and meta-analysis of Tai Chi's efficacy for chronic musculoskeletal pain in adults, using updated data through 2026.

## Key findings

- Tai Chi reduced pain in osteoarthritis and low back pain compared to control groups.
- No serious adverse events were reported in the included trials.
- Certainty of evidence is limited due to methodological issues and risk of bias.

## Abstract

Tai Chi, a form of complementary intervention emphasizing breathing and mind-body connection, is increasingly recognized for its potential in pain management. This review aims to synthesize current evidence on the efficacy and safety of Tai Chi for chronic musculoskeletal pain management in adults.

Systematic review and meta-analysis.

AMED, EMBASE, MEDLINE, WoS, CBM, CNKI, VIP, Wanfang Databases, CENTRAL, and WHO ICTRP were searched from database inception through May 2025, with an additional supplementary search conducted in January 2026.

We included randomized controlled trials (RCTs) comparing Tai Chi with other interventions for chronic musculoskeletal pain management. The primary outcome was the efficacy of Tai Chi, and secondary outcomes were adverse events associated with Tai Chi for chronic musculoskeletal pain.

Two independent authors screened studies, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias Tool 2. Meta-analysis was performed using RevMan 5.3 software, presenting results with 95% confidence intervals (CI) and Standard Mean Difference (SMD). The certainty of evidence for primary outcomes was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criterion approach.

Thirty-eight RCTs were included in this review. Compared to control groups, Tai Chi was associated with reduced pain in osteoarthritis [SMD = −0.37, 95% CI (−0.57, −0.16)], low back pain [SMD = −1.43, 95% CI (−2.07, −0.80)], fibromyalgia [SMD = −0.96, 95% CI (−1.96, 0.04)], and other disease [SMD = −1.04, 95% CI (−2.14, 0.06)]. Most interventions lasted 12 weeks, and Yang-style Tai Chi and 24-form Tai Chi were most frequently studied. No serious Tai Chi–related adverse events were reported.

Tai Chi appears to be associated with pain reduction in osteoarthritis and low back pain, while effects in fibromyalgia and other musculoskeletal conditions were non-significant, and no serious adverse events were reported in the included trials. The certainty of evidence is limited by methodological limitations and risk of bias; therefore, the findings should be interpreted with caution.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42023426431, Identifier CRD42023426431.