Abstract
Objective Patients with lumbar disc herniation (LDH) suffer from pain, physical disabilities, and low quality of life. This study was designed to evaluate the effectiveness and safety of acupotomy in patients with LDH. Method Fifty participants with LDH were recruited to this randomized, assessor-blinded, controlled study and randomly assigned to the acupotomy (n = 25) or manual acupuncture (n = 25) group. The acupotomy group received acupotomy four times in 2 weeks, while the manual acupuncture group received manual acupuncture six times in 2 weeks. The follow-up visit was planned in the 4th week (i.e., 2 weeks after the final intervention). The primary outcome was the change in the Visual Analogue Scale (VAS) at follow-up. The changes in the Oswestry Disability Index (ODI), Modified-Modified Schober Test (MMST), and EuroQol Five Dimensions (EQ-5D) questionnaire were also evaluated. An intention-to-treat analysis was applied and adverse events were recorded. Results The acupotomy group showed significant changes in VAS, ODI, and EQ-5D after intervention. VAS and ODI in the 4th week were lower in the acupotomy than in the manual acupuncture group. The acupotomy group showed consistent changes in VAS and ODI in the 1st, 2nd, and 4th week. No serious adverse event was reported in the acupotomy group. Conclusion This study suggests greater therapeutic effects of acupotomy on relieving pain and improving the functional disability associated with LDH than those observed with manual acupuncture.
Highlights
Lumbar disc herniation (LDH) is a state of displaced intervertebral disc material, including the nucleus pulposus or annulus fibrosis, which can cause low-back pain and/or radicular pain, paresthesia, or weakness in the lower limbs [1, 2]
Of the 56 participants with LDH who were interviewed during the recruitment period, 50 met the inclusion criteria and were randomly assigned to the acupotomy group (n = 25) and the manual acupuncture control group (n = 25) (Figure 1)
Of the four participants who dropped out, two participants in the acupotomy group withdrew their consent during their participation in the research, and one was withdrawn due to the side effects of lidocaine
Summary
Lumbar disc herniation (LDH) is a state of displaced intervertebral disc material, including the nucleus pulposus or annulus fibrosis, which can cause low-back pain and/or radicular pain, paresthesia, or weakness in the lower limbs [1, 2]. Current therapies include nonsurgical and surgical methods. The nonsurgical treatments include conservative management and invasive treatments [3, 4]. Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, muscle relaxants, and steroidal drugs are commonly used among others. Nonpharmacological strategies such as acupuncture, physical therapy, and exercise are recommended. If the conservative therapy fails to relieve the symptoms, more invasive treatments such as epidural steroid injection can be applied. When these more invasive procedures fail to control the LDH symptoms, subsequent surgeries are considered
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