Clinical and Electromyographic Effect of Tui‐Na Massage Versus Positional Release on Postpartum Neck Dysfunction: A Randomized Clinical Trial

ABSTRACT Background and Purpose Neck pain is prevalent in postpartum women due to postural stress and muscle dysfunction. Although postural correction exercises are widely used, adding manual therapy techniques such as positional release and Tui‐Na may enhance outcomes. However, comparative evidence, particularly using surface electromyography (sEMG), remains limited. This study examined the effects of Tui‐Na (TN) versus positional release techniques (PRT) added to postural correction exercises (PCEs) on postpartum neck pain. Methods Sixty women with postpartum neck pain were randomly assigned to three groups for 4 weeks of prescribed treatment. Group A (control) received PCEs, while either PRT or Tui‐Na were added to PCEs for Groups B and C, respectively. The primary outcome was neck pain intensity measured by the Visual Analogue Scale (VAS). Secondary outcomes included the Neck Disability Index (NDI) and upper trapezius electromyographic characteristics (normalized root mean square [RMS] and median frequency [MDF]). A two‐way repeated‐measures MANOVA was used for statistical analysis. Results Significant multivariate effects were observed for group effects ( F  = 4.798, p  < 0.001, partial η 2  = 0.147), time ( F  = 851.51, p  < 0.001, partial η 2  = 0.968), and group‐by‐time interaction ( F  = 3.87, p  < 0.001, partial η 2  = 0.122). Pain intensity was significantly reduced in both groups B ( p  = 0.035) and C ( p  = 0.003) when compared to group A. UT‐MDF was significantly increased in group C when compared to groups A ( p  < 0.001) or B ( p  = 0.02). All groups demonstrated significant within‐group improvements in all outcome measures. Discussion Both Tui‐Na and PRT combined with PCEs improved pain and disability in postpartum women with neck pain. Compared with PRT, Tui‐Na demonstrated greater improvements in pain intensity and upper trapezius EMG frequency characteristics. However, these findings should be interpreted cautiously because of the short intervention period and lack of long‐term follow‐up. Trial Registration NCT07261605