Acupotomy versus Manual Acupuncture for the Treatment of Back and/or Leg Pain in Patients with Lumbar Disc Herniation: A Multicenter, Randomized, Controlled, Assessor-Blinded Clinical Trial

Abstract

Jeong Kyo Jeong,1,* Eunseok Kim,1,* Kwang Sik Yoon,2 Ju Hyun Jeon,1 Young Il Kim,1 Hyun Lee,2 Ojin Kwon,3 So-Young Jung,3 Jun-Hwan Lee,3,4 Changsop Yang,3 Jae Hui Kang,2 Chang-Hyun Han3,4 1Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon, Republic of Korea; 2Department of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, Cheonan, Republic of Korea; 3Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea; 4Korean Medicine Life Science, University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea*These authors contributed equally to this workCorrespondence: Chang-Hyun HanClinical Medicine Division, Korea Institute of Oriental Medicine, 1672, Yuseongdaero, Daejeon 34054, Republic of KoreaTel [phone]Fax [phone]Email [email protected] Hui KangDepartment of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, 4, Notaesan-ro, Cheonan 31099, Republic of KoreaTel [phone]Fax [phone]Email [email protected]: Acupotomy, which involves the addition of a scalpel function to the conventional acupuncture treatment, has recently been applied as a conservative treatment method for lumbar disc herniation (LDH). This study investigated the effectiveness and safety of acupotomy, compared to manual acupuncture, for the treatment of patients with LDH.Methods: A total of  146 patients diagnosed with LDH were randomly assigned to either the acupotomy group or the manual acupuncture group at a 1:1 ratio. Participants in both groups received four sessions of each intervention over 2 weeks. Outcome assessments based on the visual analog scale (VAS), Roland Morris Disability Questionnaire (RMDQ), Modified-Modified Schober Test (MMST), EuroQol Five Dimensions (EQ-5D), clinically important difference (CID), and patient global impression of change (PGIC) were conducted at baseline and at 2, 4, and 6 weeks post-randomization.Results: The acupotomy group showed significant improvement in VAS and MMST at 2, 4, and 6 weeks than did the manual acupuncture group. RMDQ was significantly different between the two groups at 2 and 6 weeks. In EQ-5D, there was no significant difference between the two groups. The proportion of patients with ≥ 15 mm decrease on the VAS (minimal CID) was significantly higher in the acupotomy group at weeks 2 and 4. Better improvement in the PGIC at week 4 was also observed in the acupotomy group. Post-intervention muscle pain was reported, but there was no serious adverse event related to interventions.Conclusion: In this study, four sessions of acupotomy treatment were found to be effective in improving the pain intensity and range of motion of the lumbar region in patients with LDH. Despite post-treatment muscle pain, acupotomy treatment can be considered a preferred treatment method over manual acupuncture.Trial Registration: This trial has been registered 24 April 2018 in Clinical Research Information Service of South Korea (CRIS-KCT0002824).Keywords: acupotomy, manual acupuncture, lumbar disc herniation, pain intensity, range of motion

Keywords

• acupotomy
• manual acupuncture
• lumbar disc herniation
• pain intensity
• range of motion