Long-term effectiveness of an integrative treatment package for radicular pain secondary to lumbar disc herniation (5 year follow-up results)

Although many cures for musculoskeletal pain have been presented, low back pain (LBP) continues to pose a problem for clinical management. Therefore, we report the effectiveness of a non-surgical integrative treatment for radicular pain patients with lumbar disc herniation (LDH) over a 5 year follow up period. We selected 84 consecutive low back pain patients (aged 20-60 years) with radiating leg pain diagnosed with LDH (prolapse∼extrusion) confirmed by magnetic resonance imaging (MRI) since November 2006. The participants had a visual analogue scale (VAS) of radicular pain of 5 or higher. The treatment consisted of herbal medicine, acupuncture, bee venom acupuncture, and Chuna spinal manipulation. Study participants were evaluated at baseline and every 4 weeks for 24 weeks, after which they were followed up once a year for 5 years. The intensity of low back pain (LBP) and sciatica were assessed using the VAS score, and disability and overall quality of life were evaluated with the Oswestry Disability Index (ODI) and SF-36 Health Survey. Of the 84 patients, 6 patients underwent 1 spinal surgery during the follow-up period. The data presented are the results of the 78 non-surgically treated patients. The VAS of LBP was 4.10±2.69 at baseline, which decreased to 0.85±1.10 (P<0.001) after 6 months of treatment and increased slightly to 1.28±1.88 (P=0.03) at the 5 year follow-up. The VAS of sciatica which was 7.65±1.28 decreased to 0.91±1.32 (P<0.001), and was maintained at 0.95±1.75 (P=0.832). The ODI scores went down from 41.95±14.84 to 10.67±9.89, and decreased further to 7.77±9.65 (P<0.001). The SF-36 scores increased from 33.23±13.08 to 66.56±14.75 (P<0.001), and improved to 75.06±15.90 (P<0.001). Therefore, 5-year follow-up results indicate that an integrative package treatment can be effective for LDH-induced radicular pain.