Chronic musculoskeletal pain, particularly knee osteoarthritis (OA) and chronic low back pain (cLBP), is a major public health burden that often leads to reduced mobility, quality of life, and increased healthcare costs.
The low-impact, slow-movement practice of Tai Chi, which integrates balance, flexibility, and mindful body awareness, is increasingly studied as a complementary therapy for these conditions.
This article summarizes current scientific evidence on Tai Chi’s effectiveness for knee OA and low back pain.
Tai Chi and Osteoarthritis
Among people with knee OA, randomized trials and systematic reviews provide consistent support for Tai Chi. A 12-week randomized controlled trial involving older adults with symptomatic knee OA found that participants in a Tai Chi group experienced significantly greater improvements in pain, physical function, mood, and quality of life compared with a wellness-education control group.
A systematic review of Tai Chi for knee OA concluded that the practice had “some effect on reducing pain and improving physical function and performance in KOA” and was generally safe.
Moreover, a meta-analysis reported clinically important improvements in pain, stiffness, and physical function for knee OA with Tai Chi compared with control conditions.
Key takeaways:
Typical programs last 8–12 weeks, usually 1–2 times per week plus home practice.
The strongest effects are for pain relief, mobility, and physical function.
Tai Chi is low-risk and accessible for older adults with osteoarthritis.
Evidence for Chronic Low Back Pain
Research on Tai Chi for chronic low back pain is less extensive but still promising. A meta-analysis examining Tai Chi (and Qigong) in adults with chronic low back pain found significant reductions in pain intensity and disability.
Another systematic review concluded that Tai Chi alone or as an adjunct to conventional therapy may decrease pain and improve functional disability for patients with low back pain.
Clinical guidance documents also identify Tai Chi as a safe and potentially effective movement therapy for older adults with back pain.
Key practical points:
Interventions vary from 10–20 weeks, often with group sessions and home practice.
Benefits include reduced pain, better function, improved posture, and balance.
Combining Tai Chi with standard care maximizes its effectiveness.
How Tai Chi Works
Researchers propose several overlapping mechanisms by which Tai Chi may help osteoarthritis and low back pain:
Muscle strength and joint support: Slow, controlled movements strengthen lower-limb and core muscles, which support the joints and spine.
Balance and proprioception: Coordinated movements and mindful focus improve body awareness and reduce the risk of awkward motions contributing to pain.
Mind-body integration: Tai Chi includes mindful breathing and attention to body sensations, which may reduce stress and improve pain-coping.
Physiological regulation: Evidence suggests Tai Chi may reduce inflammation and regulate the autonomic nervous system, thereby reducing chronic pain.
Safety and Practical Guidance
Tai Chi is generally very safe for individuals with knee osteoarthritis or chronic low back pain. Because it is low-impact and modifiable, many older adults or people with pain conditions can participate. Adverse events are rare and usually mild, such as temporary muscle soreness.
Guidance for practice:
Aim for 2–3 sessions per week, each lasting 30–60 minutes, over at least 8–12 weeks.
Learn from a certified instructor to ensure safe form and pacing.
Combine Tai Chi with standard pain management strategies, such as physiotherapy and strengthening exercises.
Focus on Yang-style or modified forms used in clinical studies.
Limitations and Future Research
While evidence is encouraging, studies differ in Tai Chi style, frequency, and control conditions, which makes pooling results difficult. Long-term follow-up beyond 6–12 months is limited, and more large-scale randomized trials comparing Tai Chi with standard exercise therapy are needed. Research on joints other than the knee, such as the hip or hand, also remains sparse.
Conclusion
Tai Chi offers a safe, accessible, and evidence-informed option for people with knee osteoarthritis and chronic low back pain. While the magnitude of pain reduction may be moderate, the improvements in mobility, balance, and mental well-being are meaningful. Incorporating Tai Chi into a holistic pain management plan is supported by current research and can help improve long-term function and quality of life.










