Background Cervical disc herniation (CDH) often accompanies radiculopathy causing pain in the neck and upper extremities that interferes with daily life. The prevalence of CDH is increasing. The treatment methods recommended are primarily conservative.
Methods In this prospective, single-arm, multicenter, observational study there were 120 patients diagnosed in the past 12 months with CDH (disc protrusion or more severe conditions) accompanied by radiculopathy. Patients received integrative Korean medicine treatment (acupuncture, electroacupuncture, pharmacopuncture, herbal medicine, cupping therapy, and Chuna therapy), approximately twice a week for 2 months, and outcomes were measured. The numeric rating scale, and visual analog scale were used for assessing neck and arm pain, and the neck disability index, patient global impression of change, EuroQol-5-dimension, work productivity and activity impairment questionnaire, and range of motion assessed how pain affected daily activities.
Results Out of 120 patients, 115 completed 2-months treatment, and 114 responded at the 1-year follow-up. The numeric rating scale score for neck or arm pain showed a reduction of 3.96 points (95% CI, 3.63, 4.29) from baseline to 8 weeks, which further improved (95% CI, 4.09, 4.75) at 1 year. Similarly, the visual analog scale score for neck and arm pain, quality of life measures, and function-related measures also showed improvement from baseline, maintaining these gains at 1 year.
Conclusion This observational study suggested that using Korean medicine treatment, a conservative treatment method, as the intervention, may provide long-term benefits in reducing pain and improving function and quality of life for patients with CDH accompanied by radiculopathy.
Background Low-level laser treatment (LLLT) is used to treat low back pain (LBP) however, its effects on lumbar disc herniation (LDH) remain unclear. The safety and effectiveness of LLLT for LDH was determined using a systematic review of randomized clinical trials.
Methods Studies on LLLT in adults with LDH were identified from 12 worldwide databases. A risk of bias assessment and a meta-analysis with categorization according to the type of control used (inactive, active, or add-on) was performed. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation.
Results The quantitative analyses included five studies. LLLT was significantly more effective at treating LDH [leg pain visual analog scale (VAS) mean difference (MD): -1.90, 95% confidence interval (CI): -2.01, -1.80, I2 80%; LBP VAS MD: -0.79, 95% CI: -0.87, -0.71, I2 80%] than inactive controls (placebo or sham). The quality of the evidence ranged from “low” to “very low.” As an add-on to usual care, LLLT significantly improved pain intensity and disability compared with usual care (leg pain VAS MD: -2.52, 95% CI: -2.65, -2.40, I2 97%; LBP VAS MD: -1.47, 95% CI: -1.58, -1.36; Oswestry Disability Index MD: -4.10, 95% CI: -4.55, -3.65, I2 6%). However, the quality of the evidence ranged from “moderate” to “low.”
Conclusion LLLT significantly improved outcomes compared with the inactive controls, but was not more effective than usual care for LDH. In combination with usual care, LLLT was significantly more effective than usual care alone highlighting the potential of LLLT.
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