Chinese Association for the Study of Pain: Expert consensus on diagnosis and treatment for lumbar disc herniation

Cheng, Zhixiang; Zheng, Yongjun; Feng, Zhiying; Fang, Hongwei; Zhang, Jinyuan; Wang, Xiangrui

doi:10.12998/wjcc.v9.i9.2058

Cited by 20 publications

(16 citation statements)

References 48 publications

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“…The inclusion criteria were as follows: the condition was consistent with the relevant criteria in the Chinese Expert Consensus on Pain in the Diagnosis and Treatment of Lumbar Disc Herniation [ 7 ], and the diagnosis was confirmed after diagnosis; the age ranged from 18 to 75 years; there were symptoms of abdominal muscle tenderness and smaller lumbar curvature; acupuncture and needle-knife treatment were performed for the first time; the cognitive ability, comprehension ability, communication ability, and language communication ability were normal; and the compliance was good. Exclusion criteria were as follows: low back pain due to other diseases; patients combined with lumbar disc herniation calcification, radiculitis, spinal stenosis, and lumbar tuberculosis; patients with pregnancy or lactation; patients with mental disorders or malignant tumors; and patients combined with severe organ dysfunction.…”

Section: Methodsmentioning

confidence: 99%

Effects of Acupuncture and Moxibustion Combined with Needle-Knife on Pain and Lumbar Function in Patients with Lumbar Disc Herniation

Peng¹,

Zheng

Luo

2022

Journal of Healthcare Engineering

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This study aimed for the analysis of the effect of acupuncture and moxibustion combined with needle-knife on pain and lumbar function in patients with lumbar disc herniation. From June 2019 to February 2021, the medical records of 126 patients with lumbar disc herniation admitted to the department of orthopedics of our hospital were selected and divided into the control group (n = 63) treated with acupuncture and moxibustion and the observation group (n = 63) treated with acupuncture and moxibustion combined with needle-knife according to different treatment regimens. After 4 weeks of treatment, the clinical efficacy, pain status, and lumbar function were compared between the two groups. The concentrations of relevant inflammatory factors (IL-6, IL-10, TNF-α, and MMP-2) in peripheral blood of the two patients before and after treatment were measured by enzyme-linked immunosorbent assay (ELISA). After treatment, the overall response rate was 93.65% in the observation group, which was higher than 80.95% in the control group ( P < 0.05 ); the visual blurred score (VAS) scores of lower limbs and waist in the observation group were lower than those in the control group, while the expression of pain mediators serotonin (5-HT) and prostaglandin E2 (PEG2) was also lower than that in the control group ( P < 0.05 ); the Oswestry disability index (ODI) in the observation group was lower than that in the control group, while the Japanese Orthopedic Association assessment treatment score (JOA) was higher than that in the control group ( P < 0.05 ). After treatment, the concentration levels in peripheral blood (IL-6, IL-10, TNF-α, and MMP-2) were significantly lower in the observation group than in the control group ( P < 0.05 ). Acupuncture and moxibustion combined with needle-knife is effective in the treatment of lumbar disc herniation, which helps to improve the clinical efficacy, relieve pain symptoms, promote the improvement of lumbar function, and contribute to the reduction of inflammatory factors.

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Section: Methodsmentioning

confidence: 99%

Effects of Acupuncture and Moxibustion Combined with Needle-Knife on Pain and Lumbar Function in Patients with Lumbar Disc Herniation

Peng¹,

Zheng

Luo

2022

Journal of Healthcare Engineering

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“…The diagnostic criteria [ 2 ] are: Lower limb radiative pain, of which the pain location was consistent with the corresponding affected innervation area Lower limb sensory abnormalities, with decreased superficial sensation of the skin in the corresponding affected innervated area Positive result of Lasegue test, Bragard test, Lasegue test of the unaffected side, or femoral nerve stretching test Weaker tendon reflex than that of the unaffected side Muscle weakness Intervertebral disc herniation indicated by lumbar MRI or CT, of which the nerve compression was consistent with the symptoms, signs of the affected nerves In the first five criteria, patients could be diagnosed as LDH when meeting three of them combined with item 6 …”

Section: Methodsmentioning

confidence: 99%

“…Low back pain is the initial symptom of LDH, which is generally in the lumbosacral part, mostly soreness and swelling pain, which can radiate to the buttocks. It occurs repeatedly, aggravates after sitting, standing for a long time, or fatigue, and relieves after rest [ 2 ]. Clinically, low back pain may be induced by multiple factors.…”

Section: Introductionmentioning

confidence: 99%

Ma’s bamboo-based medicinal moxibustion therapy of low back pain in lumbar disc herniation: study protocol for a randomized controlled trial

Wang

Xue

Chen

et al. 2022

Trials

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Background Lumbar disc herniation (LDH) is a common and frequently occurring disease in clinics. Low back pain and sciatica are the presenting symptoms of LDH. To some extent, it can be considered that measures with the capability to improve low back pain or sciatica have the potential to treat LDH. Ma’s bamboo-based medicinal moxibustion therapy can effectively reduce the degree of low back pain and has been widely used. Studies of small sample size have seen significant improvement on pain relief. The aim of this trial is to evaluate the clinical efficacy and safety of Ma’s bamboo-based medicinal moxibustion therapy in the treatment of LDH low back pain. Methods/design The trial is a multicenter, randomized, parallel-group, non-inferiority study. Three hundred and twelve patients will be randomly assigned to a Ma’s bamboo-based medicinal moxibustion group (n=156) and an acupuncture group (n=156). Patients in each group will receive treatment every day, 6 times a week, 12 times in total. Follow-up will be conducted 14 days after treatment. The primary outcome will be the visual analog scale(VAS) at baseline, after 6 times of treatment, end of treatment, and follow-up. The secondary outcomes will include Oswestry disability indexes (ODI), modified Japanese Orthopaedic Association low back pain (M-JOA) score, serum β-endorphin (β-EP), and serum substance P (SP). β-EP and SP, as well as safety evaluation indexes (routine blood, liver, and kidney function and electrocardiogram), will be measure at baseline and after the end of treatment. The number, nature, and severity of adverse events will be recorded. Discussion The results of the trial will compare the efficacy of low back pain in LDH between Ma’s bamboo-based medicinal moxibustion group and the acupuncture group and will be expected to make a systematic and objective evaluation of the clinical efficacy and safety of Ma’s bamboo-based medicinal moxibustion therapy. Trial registration ChiCTR2000038725. Registered on 29 September 2020.

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“…In most evidence-based clinical guidelines, ESWT has still not been recommended or presented as a therapeutic option for CLBP due to the lack of sufficient evidence [40][41][42][43][44]. The only exception is the expert consensus by Chinese Association for the Study of Pain (CASP), in which ESWT has been listed as an alternative for treating back pain due to disc herniation [45]; however, the strength of this recommendation is questionable due to very low quality evidence [19,37,46].…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Extracorporeal Shockwave Therapy for Treating Chronic Low Back Pain: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

Yue

Sun

Chen

et al. 2021

BioMed Research International

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Objective. To assess the effectiveness and safety of extracorporeal shockwave therapy (ESWT) for the treatment of chronic low back pain (CLBP). Methods. This was a systematic review and meta-analysis of randomized controlled trials (RCTs) designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement standard. We identified relevant studies by searching multiple electronic databases, trial registries, and websites up to April 30, 2021, and examining reference lists. We selected RCTs that compared ESWT, in unimodal or multimodal therapeutic approaches, with sham ESWT or other active therapies. Two investigators independently extracted data and assessed the risk of bias and quality of the evidence. The main outcomes were pain intensity and disability status, examined as standardized mean differences (SMD) with 95% confidence intervals (CI). The risk of bias was assessed by using Cochrane Back and Neck (CBN) Group risk of bias tool and Jadad score, and GRADE was applied to determine the confidence in effect estimates. Heterogeneity was explored using sensitivity analysis and meta-regression. Results. Ten RCTs, including a total of 455 young to middle-aged individuals (29.2–55.8 years), were identified. Compared with control, the ESWT group showed lower pain intensity at month 1 ( SMD = − 0.81 , 95% CI −1.21 to −0.42), as well as lower disability score at month 1 ( SMD = − 1.45 , 95% CI −2.68 to −0.22) and at month 3 ( SMD = − 0.69 , 95% CI −1.08 to −0.31). No serious shockwave-related adverse events were reported. Conclusion. The use of ESWT in CLBP patients results in significant and quantifiable reductions in pain and disability in the short term. However, further well-conducted RCTs are necessary for building high-quality evidence and promoting the application of ESWT in clinical practice.

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Chinese Association for the Study of Pain: Expert consensus on diagnosis and treatment for lumbar disc herniation

Cited by 20 publications

References 48 publications

Effects of Acupuncture and Moxibustion Combined with Needle-Knife on Pain and Lumbar Function in Patients with Lumbar Disc Herniation

Effects of Acupuncture and Moxibustion Combined with Needle-Knife on Pain and Lumbar Function in Patients with Lumbar Disc Herniation

Ma’s bamboo-based medicinal moxibustion therapy of low back pain in lumbar disc herniation: study protocol for a randomized controlled trial

Extracorporeal Shockwave Therapy for Treating Chronic Low Back Pain: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

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