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This systematic review and meta-analysis examined the safety and effectiveness of Meridian Sinew Tuina — a specialised form of tuina massage that applies deep tissue mobilisation techniques such as plucking, kneading, and pressing along the six hand meridian sinew pathways — in treating upper limb lymphoedema arising after breast cancer surgery. The standard non-surgical treatment for this condition, Complex Decongestive Therapy, often leaves patients with persistent swelling, stiffness, pain, and restricted arm movement, creating a need for additional therapeutic options.
Fifteen randomised controlled trials involving nearly 1,100 participants were included. The pooled results showed that Meridian Sinew Tuina significantly reduced upper limb circumference compared to control treatments, with no meaningful variation between studies for this outcome. A clinical response measure — defined as at least a thirty percent reduction in swelling alongside symptom relief — also strongly favoured Meridian Sinew Tuina. Secondary outcomes at three months, including arm function measured by the Disabilities of the Arm, Shoulder and Hand score, pain intensity, and quality of life, all showed meaningful improvements. No serious adverse events were reported across any of the included trials. Trial Sequential Analysis confirmed that the accumulated evidence was sufficient to draw conclusions about the primary outcome.
The authors note that confidence in findings is reduced by the inability to blind participants or therapists, and by variation in control group design across studies. Meridian Sinew Tuina is therefore positioned as a promising adjunctive option within oncological rehabilitation rather than a standalone replacement for existing care.
Conclusion: Meridian Sinew Tuina appears safe and beneficial as a supportive addition to breast cancer-related lymphoedema rehabilitation, but methodological limitations mean it cannot yet be unconditionally recommended for independent use.
Source: Zhao W, Yang J, Hou Y and colleagues. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology (2026). View on PubMed (PMID 42703097) · doi:10.1080/01443615.2026.2723314