Editor's note: Neck and back pain are very common reasons for health care visits, affecting millions worldwide. In this article, Yu Han, deputy chief physician and director of the Preventive Medicine Department at the Institute and Hospital of Traditional Dai Medicine of Xishuangbanna Dai Autonomous Prefecture, southwest China's Yunnan Province, demonstrates how the enduring wisdom of Dai medicine leverages natural, non-invasive healing to address modern ailments like chronic pain. Dr Yu specializes in indigenous Dai medicine treatments for bone and joint diseases, chronic pain, and preventive wellness.

"My neck hurts so much I can't even turn my head. Patches and massages didn't work. Can you help?" said Mr. Wang, 48, who came into our clinic in December with severe neck pain. 

After years in a sedentary desk job, his cervical and lumbar issues had become a recurring problem. At its worst, he could barely lift his arm.

After examining him, a doctor prescribed tuoca therapy from Dai medicine, a technique in which specially prepared herbal powder is steamed in a cloth bag and gently dragged (tuo) and pressed (ca) along the muscles and meridian pathways of the body over the affected areas to relieve pain.

After just three sessions, Wang's stiffness and pain eased greatly. Before treatment, sitting for just 15 minutes would leave his back stiff, his neck and shoulders sore, and his arms tingling. Now he can work at his desk for one or two hours without discomfort, move his head freely, bend over easily, and carry on his daily tasks pain-free.

Patients like Wang, who suffer from bone and joint pain, are among the main beneficiaries of tuoca therapy, known as zanya in the indigenous language of the Dai people, one of the 56 ethnic groups in China.

Recorded on palm-leaf manuscripts over 2,500 years ago, tuoca therapy remains one of the ten core external therapies in Dai medicine. Practical and effective, it has long been used in folk medicine for disease prevention and relief, and remains a vital part of Dai external treatment today.

With the ongoing development of modern Dai medicine, tuoca therapy has also been refined. While traditional practice often used single herbs or simple combinations, today's approach applies the Dai theory of "four elements and five aggregates" to tailor herbal formulas to specific conditions.

The procedure itself has been standardized with clear guidelines on pressure, direction, and duration, preserving the essence of the tradition while enhancing its safety and effectiveness.

The therapy works through three complementary mechanisms: herbal penetration, physical stimulation and meridian conduction. In Dai medicine, neck and back pain is believed to have often resulted from imbalance in the "four elements" – wind, fire, water and earth – where "wind" for movement stagnates and "water" for fluids accumulates, blocking meridians. 

Dragging the warm herbal bag along the muscle-meridian pathways allows heated medicine to penetrate the skin, re-balance the elements, and dispel cold and dampness. The physical motion also helps unblock meridians, promote the flow of "wind," and improve "water" metabolism. Together, these actions address both local symptoms and the body's overall condition.

Patients trust tuoca therapy not only for its quick pain relief, but also for its gentle, non-invasive nature. Each session takes only 15 minutes. There are no needles or oral medication, leaving the body relaxed and comfortable. It is safe for all age groups. Since the herbs are applied externally, there is no gastrointestinal irritation.

Unlike invasive treatments from Western medicine, the therapy is based on natural healing principles, making it a good option for those with joint issues and chronic pain, or anyone interested in preventive wellness. That is why it remains a popular part of Dai preventive medicine.

However, the tuoca therapy should be administered by a trained practitioner after proper diagnosis. It is not recommended for pregnant women, people with skin ulcers, or those allergic to herbal ingredients.