We assessed the efficacy of Kampo medicine for lower extremity symptoms caused by lumbar spinal diseases, such as lumbar spondylosis, spinal canal stenosis, and post-spinal surgery syndrome. In particular, we evaluated its usefulness for lower extremity pain, coldness, and numbness. In addition, the efficacy of antecedent drug selection and pain treatment was also assessed. In accordance with Japanese traditional herbal medical practice, keishikajutsubuto, shimbuto, ryokyojutsukanto, tokishigyakukagoshuyushokyoto, goshajinkigan, and shakuyakukanzoto were prescribed primarily for lower extremity symptoms caused by lumbar disease. Thirty-two of 60 (53%) cases with lower extremity pain, 17 of 34 (50%) cases of pain with coldness, and 4 of 19 cases (21%) of pain with numbness were improved by these drugs. We conclude that the addition of keishikajutsubuto, shimbuto, ryokyojutsukanto, tokishigyakukagoshuyushokyoto, goshajinkigan, and shakuyakukanzoto after antecedent pain therapy was effective in treating lower extremity symptoms caused by lumbar disease.