Objective:To discuss the etiology and prevalence of back pain, the nature and characteristics of tai chi, to review relevant reports on back pain and tai chi, and present the rationale of tai chi as a complementary treatment for back pain. Data Sources: Sources included publications from Medline/ PubMed, Cochrane Library Document and University of New South Wales Medical Library from 1966 to December 2003. Methods of Study Selection:The evidence is reviewed for the efficacy of using tai chi for the treatment of back pain from randomized controlled trials, nonrandomized controlledstudies, observational studies, reviews, discussion and statistical reports, and books published in English. Data Extraction and Synthesis:Data were extracted for the study objective, population characteristics, study setting, type of intervention, study design, outcome assessment, duration of follow-up, and key results. There were 21 studies, 5 reviews, 9 discussion and statistical reports and 5 books. Reports include the etiology and prevalence of back pain, the structure of the deep stabilizing muscles and their relation to back pain, and the benefits of tai chi in balance and strength, cardiovascular and respiratory function, flexibility, symptoms of pain, physical function, and psychological effects. Conclusion: Back pain is a common and costly condition to both the patient and the community. The causes of back pain are complex with much of the etiology not well understood, though recent studies have shown that the deep stabilizing muscles play an important role. Contributing factors include the loss of flexibility, muscular strength and fitness, as well as mental stress. Tai chi is a gentle exercise from ancient China; it has been shown to improve flexibility, muscular strength, fitness and mental relaxation. Its training methods are similar to those used for training the deep stabilizing muscles. Tai chi can be enjoyable to practice, and thus can produce a high rate of compliance. It could be a highly suitable exercise for back pain. More research in this area is needed.
