The objective of this study was to systematically evaluate the application of Chinese medicine in the treatment of neck and low back pain. The goal was to assess the efficacy, analgesic effect, and safety of Chinese medicine using Cochrane system evaluation standards and conduct a meta-analysis to provide high-quality, evidence-based medical data for clinical practice decision-making.A comprehensive search was conducted in Chinese and English databases, including CBM, CNKI, Wanfang Data Knowledge Service Platform, VIP Chinese Science and Technology Periodical Database, Pubmed, Embase, and the Cochrane Library. The search encompassed randomized controlled trials on the use of Chinese medicine for pain treatment, with a time range from the establishment of each database to October 1, 2021. We have added the referred literature from the online databases for this research. Two researchers independently reviewed the literature, gathered data, and assessed the methodological quality of the included studies using the Cochrane Assistance Network risk of bias tool. Safety, reaction rate, and VAS pain score were of interest. To evaluate Chinese medicine's curative and analgesic benefits for pain illnesses, RevMan 5.4 and Stata 15.1 were used to analyze selected literature using forest plots, funnel plots, Egger and HarbORd linear regression plots, and star charts.Chinese medicine treated pain in 57 investigations. The analysis yielded (1) a curative effect: Chinese medicine outperformed Western medicine, with no publication bias. The sensitivity analysis matched the meta-analysis that has been performed in this work, and it shows that Chinese medicine treated low back pain better than Western medicine. (2) Analgesic effect: Chinese medicine outperformed Western medicine in analgesia, although the literature is limited for such a claim. Chinese medicine was also more analgesic than Western medicine. (3) Safety: No major side effects were reported in 20 investigations on Chinese medicine's safety.This study provides evidence that Chinese medicine can achieve better clinical efficacy and analgesic effects when comparing Chinese and Western medicine in the treatment of neck and low back pain. Furthermore, Chinese medicine demonstrated a favorable safety profile. However, further research is required to explore the use of Chinese medicine specifically for neck pain and to enhance the evidence base for clinical decision-making in pain management.