OBJECTIVE: To assess the efficacy and safety of Bushen Huoxue Formula (BSHXF) for the treatment of discogenic low-back pain (DLBP). METHODS: This was a parallel, double-blind, randomized, clinical trial performed between May 2019 and June 2020. Seventy patients were assigned by computerized random number table to the treatment group (lumbar traction and BSHXF, 35 cases) or the control group (lumbar traction and placebo, 35 cases). The patients received intervention for 3 weeks. Assessment was conducted before treatment and at week 1, 2, 3 during treatment. Primary outcome was the self-reported score of Oswestry Disability Index (ODI). Secondary outcomes included Visual Analog Scale (VAS), clinical efficacy rate by minimal clinically important difference (MCID) as well as lumbar tenderness, muscle tone and lumbar spine mobility. Adverse reactions were recorded. Follow-up was performed at 1 and 3 months after the end of treatment. RESULTS: In the treatment group, ODI score was significantly decreased compared with baseline (P<0.05) and the control group at 2- and 3- week treatment. Similarly, VAS score decreased compared with the baseline (P<0.05) and was lower than that in the control group at 2- and 3- week treatment (P<0.05). The clinical efficacy rate of the treatment group was higher than that of the control group after treatment [32.35% (11/34) vs. 3.13% (1/32), P<0.05). Moreover, the tenderness, and muscle tone, as well as the back extension and left flexion in lumbar spine mobility in the treatment group at 3-week treatment were significantly improved compared with the control group (P<0.05). Follow-up showed that at 1-month after treatment, the treatment group had better outcomes than the control group with regard to a total score of ODI and VAS scores, as well as clinical efficacy rate (all P<0.05). Moreover, VAS score was still significantly lower than the control group at 3-month follow-up (P<0.05). No adverse reactions were reported during the study. CONCLUSION BSXHF combined with lumbar traction can significantly improve the clinical symptoms including pain intensity, functionality, muscle tone, and lumbar spine mobility in DLBP patients. (Registration No. ChiCTR1900027777).
Humans ; Intervertebral Disc Degeneration/therapy* ; Low Back Pain/drug therapy* ; Lumbar Vertebrae ; Pain Measurement ; Treatment Outcome

This study aims to provide evidence for clinical practice by systematically reviewing the efficacy and safety of Gusongbao preparation in the treatment of primary osteoporosis(POP). The relevant papers were retrieved from four Chinese academic journal databases and four English academic journal databases(from inception to May 31, 2022). The randomized controlled trial(RCT) of Gusongbao preparation in the treatment of POP was included after screening according to the inclusion and exclusion criteria. The quality of articles was evaluated using risk assessment tools, and the extracted data were subjected to Meta-analysis in RevMan 5.3. A total of 657 articles were retrieved, in which 15 articles were included in this study, which involved 16 RCTs. A total of 3 292 patients(1 071 in the observation group and 2 221 in the control group) were included in this study. In the treatment of POP, Gusongbao preparation+conventional treatment was superior to conventional treatment alone in terms of increasing lumbar spine(L2-L4) bone mineral density(MD=0.03, 95%CI[0.02, 0.04], P<0.000 01) and femoral neck bone mineral density, reducing low back pain(MD=-1.69, 95%CI[-2.46,-0.92], P<0.000 1) and improving clinical efficacy(RR=1.36, 95%CI[1.21, 1.53], P<0.000 01). Gusongbao preparation was comparable to similar Chinese patent medicines in terms of improving clinical efficacy(RR=0.95, 95%CI[0.86, 1.04], P=0.23). Gusongbao preparation was inferior to similar Chinese patent medicines in reducing traditional Chinese medicine syndrome scores(MD=1.08, 95%CI[0.44, 1.71], P=0.000 9) and improving Chinese medicine syndrome efficacy(RR=0.89, 95%CI[0.83, 0.95], P=0.000 4). The incidence of adverse reactions of Gusongbao preparation alone or combined with conventio-nal treatment was comparable to that of similar Chinese patent medicines(RR=0.98, 95%CI[0.57, 1.69], P=0.94) or conventio-nal treatment(RR=0.73, 95%CI[0.38, 1.42], P=0.35), and the adverse reactions were mainly gastrointestinal discomforts. According to the available data, Gusongbao preparation combined with conventional treatment is more effective than conventional treatment alone in increasing lumbar spine(L2-L4) bone mineral density and femoral neck bone mineral density, reducing low back pain, and improving clinical efficacy. The adverse reactions of Gusongbao preparation were mainly gastrointestinal discomforts, which were mild.
Humans ; Bone Density ; Low Back Pain ; Medicine, Chinese Traditional ; Osteoporosis/drug therapy*

OBJECTIVE: To compare the clinical therapeutic effect between heat-sensitive moxibustion combined with western medication and simple western medication for low back pain of osteoporosis with kidney- METHODS: A total of 60 patients with osteoporosis were randomized into an observation group (32 cases, 2 cases dropped off) and a control group (32 cases, 3 cases dropped off). In the control group, alendronate sodium tablet and calcium carbonate and vitamin D RESULTS: The VAS scores, ODI scores and TCM clinical symptom scores after treatment were reduced in the two groups ( CONCLUSION Heat-sensitive moxibustion combined with western medication could relieve low back pain, improve BMD in patients of osteoporosis with kidney-
Acupuncture Points ; Hot Temperature ; Humans ; Kidney ; Low Back Pain ; Moxibustion ; Osteoporosis/drug therapy* ; Yang Deficiency/drug therapy*

OBJECTIVE: To evaluate the efficacy of lumbar transforaminal epidural block (LTEB) for treatment of low back pain with radicular pain. METHODS: We retrospectively analyzed the clinical data of 78 patients with low back pain and radicular pain admitted to the Department of Orthopedics of Beijing Chuiyangliu Hospital from March, 2017 to April, 2019. Thirty-three of the patients received treatment with LTEB (LTEB group), and 45 received comprehensive conservative treatment including traction, massage, acupuncture and physiotherapy (control group). The demographic and clinical data of the two groups were compared. The patients were followed up for 3 to 24 months, and numerical rating scale (NRS) and Oswestry disability index (ODI) scores of the patients were evaluated before the treatment and at 2 weeks, 1 month and 3 months after discharge to assess the efficacy of the treatment. RESULTS: The mean operation time of LTEB was 25.7 7.5 min (15-45 min). After the operation, 5 patients developed weakness of the lower limbs but all recovered within 24-72 h. The patients receiving LTEB all showed significantly decreased NRS scores for low back and radicular pain and ODI scores after the operation ( CONCLUSIONS As a minimally invasive approach, LTEB is effective for treatment of low back pain with radicular pain and can produce good short-term effects of pain relief and functional improvement.
Humans ; Injections, Epidural ; Low Back Pain/drug therapy* ; Lumbar Vertebrae ; Radiculopathy/drug therapy* ; Retrospective Studies ; Treatment Outcome

PURPOSE: This research was conducted to compare the effects of drug therapy, physical therapy, and exercise on pain, disability, and depression in patients with chronic low back pain. METHODS: The research design of this study was a nonequivalent control group pretest-posttest design. The subjects of this study were 28 patients for the drug therapy & physical therapy, 24 patients for the drug therapy & exercise, and 22 patients for the physical therapy & exercise. Data was collected by MVAS, Oswestry disability questionnaires, and questionnaires of depression. It was analyzed by paired t-test for effectiveness, ANOVA, and Scheffe for comparison of the effects of the 3 experimental treatments, using SPSS/WIN 12.0. RESULTS: There were no effects of drug therapy & physical therapy on pain, disability, and depression. However, there were effects of drug therapy & exercise and the physical therapy & exercise on pain, disability, and depression. The effects of physical therapy & exercise on pain, disability, and depression were the greatest, but there was no statistically significant differences between the drug therapy & exercise and the physical therapy & exercise. CONCLUSIONS: Exercise is regarded as a more effective and easily accessible nursing intervention to apply alone than drug therapy or physical therapy simultaneously in reducing pain, disability and depression.
Adult ; Depression ; Disability Evaluation ; *Exercise Therapy ; History, Ancient ; Humans ; Low Back Pain/drug therapy/nursing/*therapy ; Male ; Models, Nursing ; Pain ; *Physical Therapy Modalities ; Questionnaires

STUDY DESIGN: Retrospective study. PURPOSE: To determine whether low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy could prevent the transition of acute low back pain to chronic low back pain. OVERVIEW OF LITERATURE: Inadequately treated early low back pain transitions to chronic low back pain occur in approximately 30% of affected individuals. The administration of non-steroidal anti-inflammatory drugs is effective for treatment of low back pain in the early stages. However, the treatment of low back pain that is resistant to non-steroidal anti-inflammatory drugs is challenging. METHODS: Patients who presented with acute low back pain at our hospital were considered for inclusion in this study. After the diagnosis of acute low back pain, non-steroidal anti-inflammatory drug administration was started. Forty patients with a visual analog scale score of >5 for low back pain 1 month after treatment were finally enrolled. The first 20 patients were included in a non-steroidal anti-inflammatory drug group, and they continued non-steroidal anti-inflammatory drug therapy for 1 month. The next 20 patients were included in a combination group, and they received low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy for 1 month. The incidence of adverse events and the improvement in the visual analog scale score at 2 months after the start of treatment were analyzed. RESULTS: No adverse events were observed in the non-steroidal anti-inflammatory drug group. In the combination group, administration was discontinued in 2 patients (10%) due to adverse events immediately following the start of tramadol administration. At 2 months, the improvement in the visual analog scale score was greater in the combination group than in the non-steroidal anti-inflammatory drug group (p<0.001). CONCLUSIONS: Low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy might decrease the incidence of adverse events and prevent the transition of acute low back pain to chronic low back pain.
Anti-Inflammatory Agents, Non-Steroidal ; Diagnosis ; Drug Therapy ; Humans ; Incidence ; Low Back Pain* ; Retrospective Studies ; Spine ; Tramadol* ; Visual Analog Scale

The use of opioids for the treatment of chronic non-cancer pain has become more widespread recently. Available data support the short-term use of opioids in clearly defined nociceptive and neuropathic pain states. Their use in 'pathological' pain states without a clear diagnosis, such as chronic low back pain, is more contentious. A decision to initiate opioid treatment in these conditions requires careful consideration of benefits and risks; the latter include not only commonly considered adverse effects such as constipation, but also opioid-induced hyperalgesia, abuse, addiction and diversion. Ideally, treatment goals should not only be relief of pain, but also improvement of function. Opioid treatment of chronic non-cancer pain requires informed consent by, and preferably a treatment contract with, the patient. Treatment should be initiated by a trial period with defined endpoints using slow-release or transdermal opioids. Ongoing management of the patient requires ideally a multi-disciplinary setting. Treatment should not be regarded as life-long and can be discontinued by tapering the dose.
Analgesics, Opioid ; adverse effects ; therapeutic use ; Humans ; Hyperalgesia ; chemically induced ; Low Back Pain ; drug therapy ; Pain, Intractable ; drug therapy ; Substance-Related Disorders ; prevention & control

OBJECTIVETo compare the difference in the therapeutic effect on lower back myofascitis between the combined therapy of penetration needling on yang meridian of the back and electroacupuncture and the western medication of Ibuprofen capsules, and probe into a better method of treatment for lower back myofascitis.

METHODSSixty cases of lower back myofascitis were randomly divided into two groups. 30 cases in observation group were treated with penetration needling combined with electroacupuncture on the back shu points on the first line of the Bladder Meridian and the points of the corresponding levels on the Governor Vessel. 30 cases in control group were treated with Ibuprofen capsules. The treatment session was 30 days. The therapeutic effects were compared and the Visual Analog Scales (VAS) and Oswestry disability index were detected before and after treatment in two groups separately.

RESULTSThe total effective rate in observation group was 96.7% (29/30), which was superior to that (73.3%, 22/30) in control group. VAS and Oswestry disability index decreased in either group (P < 0.01, P < 0.05). The improvement extent in observation group was superior to that in control group (P < 0.05).

CONCLUSIONThe therapy of penetration needling on yang meridian of the back combined with electroacupuncture has the advantageous therapeutic effect on lower back myofascitis as compared with the medication of Ibuprofen capsules, which can release pain and improve the functional disturbance effectively.

Adult ; Electroacupuncture ; Fasciitis ; therapy ; Female ; Humans ; Ibuprofen ; therapeutic use ; Low Back Pain ; drug therapy ; therapy ; Male ; Meridians ; Middle Aged ; Pain Measurement ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the combination of drop in canales sacralis with acupotomy dissolution in the treatment of lumbocrural pain caused by slipped discs.

METHODSOne hundred and thirty-nine patients with lumbocrural pain caused by slipped discs were randomly divided into 3 groups: cases in Group A were treated by the drop in canales sacralis, in Group B by acupotomy dissolution and in Group C by the combination of canales sacralis drop with acupotomy dissolution. MacNab score and VAS score were assayed before treatment and 1 week, 3 and 6 months after treatment.

RESULTThe effective rates in Groups A, B and C at 1 week, 3 and 6 months after treatment were 71.4%, 75.5%, 79.6%; 75.0%, 79.6%, 81.8% and 89.1%, 91.3%, 93.5%, respectively (P < 0.01). The pain intensity in Group C was reduced more markedly at different time points after treatment than that in Group A and Group B (P < 0.01).

CONCLUSIONThe combination of canales sacralis drop with acupotomy dissolution is superior to each method used alone in treatment of lumbocrural pain caused by slipped discs in the short-and long-term.

Acupuncture Therapy ; Female ; Humans ; Instillation, Drug ; Intervertebral Disc Displacement ; complications ; therapy ; Low Back Pain ; drug therapy ; etiology ; therapy ; Lumbar Vertebrae ; Male ; Treatment Outcome

BACKGROUNDVisceral pain is a common cause for seeking medical attention. Afferent fibers innervating viscera project to the central nervous system via sympathetic nerves. The lumbar sympathetic nerve trunk lies in front of the lumbar spine. Thus, it is possible for patients to suffer visceral pain originating from sympathetic nerve irritation induced by anterior herniation of the lumbar disc. This study aimed to evaluate lumbar discogenic visceral pain and its treatment.

METHODSTwelve consecutive patients with a median age of 56.4 years were enrolled for investigation between June 2012 and December 2012. These patients suffered from long-term abdominal pain unresponsive to current treatment options. Apart from obvious anterior herniation of the lumbar discs and high signal intensity anterior to the herniated disc on magnetic resonance imaging, no significant pathology was noted on gastroscopy, vascular ultrasound, or abdominal computed tomography (CT). To prove that their visceral pain originated from the anteriorly protruding disc, we evaluated whether pain was relieved by sympathetic block at the level of the anteriorly protruding disc. If the block was effective, CT-guided continuous lumbar sympathetic nerve block was finally performed.

RESULTSAll patients were positive for pain relief by sympathetic block. Furthermore, the average Visual Analog Scale of visceral pain significantly improved after treatment in all patients (P < 0.05). Up to 11/12 patients had satisfactory pain relief at 1 week after discharge, 8/12 at 4 weeks, 7/12 at 8 weeks, 6/12 at 12 weeks, and 5/12 at 24 weeks.

CONCLUSIONSIt is important to consider the possibility of discogenic visceral pain secondary to anterior herniation of the lumbar disc when forming a differential diagnosis for seemingly idiopathic abdominal pain. Continuous lumbar sympathetic nerve block is an effective and safe therapy for patients with discogenic visceral pain.

Adult ; Aged ; Female ; Humans ; Intervertebral Disc ; drug effects ; pathology ; physiopathology ; Intervertebral Disc Displacement ; complications ; physiopathology ; Low Back Pain ; drug therapy ; Lumbar Vertebrae ; drug effects ; pathology ; physiopathology ; Lumbosacral Region ; Male ; Middle Aged ; Prospective Studies ; Visceral Pain ; drug therapy ; Young Adult