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  • The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study

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Complementary medicine
Research
The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study
  1. Joon-Shik Shin1,
  2. Jinho Lee1,
  3. Me-riong Kim1,
  4. Byung-Cheul Shin2,
  5. Myeong Soo Lee3,
  6. In-Hyuk Ha1
  1. 1Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
  2. 2Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
  3. 3Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
  1. Correspondence to Dr In-Hyuk Ha; hanihata{at}gmail.com

Abstract

Objectives This study aimed to assess the efficacy and safety of an integrative complementary and alternative medicine (CAM) approach in the management of lumbar herniated disc (LHD) with sciatic pain and investigate pain relapse, use of medical care and surgery rates in patients who actively chose non-surgical CAM treatment for LHD.

Study design/Setting This prospective observational study was undertaken at a Korean medicine hospital outpatient setting in Korea.

Participants A total of 128 consecutive patients with LHD with a numeric rating scale for leg pain of ≥5 completed 6 months of CAM treatment after recruitment from November 2006, and 73/128 participants (57%) attended follow-up 3 years later.

Interventions 6 months of CAM treatment (herbal medicine, acupuncture, bee venom pharmacopuncture, and Chuna manipulation).

Primary outcome measures Visual analogue scale (VAS) for low back and leg pain, Oswestry Disability Index (ODI), and Short Form (SF)-36 Health Survey.

Secondary outcome measures Neurological impairment (muscular weakness, sensory loss, Straight Leg Raise test), MRIs, recurrence of low back pain and/or radiating pain, and use of medical care.

Results 92 patients could be assessed for surgical state, of whom 4 replied that they had received surgery. 73 patients attended the 3-year follow-up. The baseline VAS of back pain (4.37±2.70) decreased after treatment (0.90±1.01; p<0.001) and was maintained at 3 years (1.12±1.64; p=0.19). The baseline VAS of leg pain (7.57±1.40) also decreased on treatment (0.82±1.18; p<0.001) and was sustained at 3 years (0.99±1.58; p=0.34). ODI scores declined from 40.74±16.15 to 9.84±9.67 (p<0.001), then decreased further to 6.30±7.19 (p<0.01). SF-36 scores increased from 34.96±13.30 to 69.20±14.96 (p<0.001), reaching 76.19±14.45 (p<0.001) at 3 years. 37 patients reported recurrence of pain and most chose CAM treatment for management of relapse symptoms.

Conclusions Although the absence of a control group prevents validation of effectiveness, many patients showed favourable long-term outcomes.

Trial registration number ClinicalTrials.gov Identifier: NCT01989403.

  • COMPLEMENTARY MEDICINE
  • PAIN MANAGEMENT

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-005801

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