非急性腰椎椎間板ヘルニアに対する非薬物療法と薬物療法

Interventions: Non-pharmacological treatment include acupuncture, electroacupuncture, spinal manual therapy, and motion style acupuncture treatment.

Frequency: Not specified (Twice a week recommended) Duration: Eight weeks.

Acupuncture, elctroacupuncture, spinal manual therapy, motion style acupucnture treatment

Interventions: Active pharmacological treatment involving prescription medication, injection therapy, or other pharmacological interventions.

Frequency: Not specified (Twice a week recommended) Duration: Eight weeks.

Prescription medication, injection therapy, nerve blocks, or other pharmacological interventions commonly used for managing lumbar disc herniation.

This group is treated using the above treatment strategies, and no drug is specified.

The Oswestry Disability Index (ODI) is a questionnaire used to assess the functional status and degree of disability caused by lower back pain. It consists of 10 items that evaluate various aspects of daily activities and mobility. Each item is rated on a 6-point scale, with higher scores indicating a greater level of disability.

From 0 to 100. Higher scores mean a worse outcome.

The study will evaluate the intensity of lower back pain and radiating leg pain using the Numeric Rating Scale (NRS). Patients will rate their pain levels on a scale from 0 to 10, where 0 represents no pain and 10 represents the most severe imaginable pain. The NRS for Dominant Change (NRS-DC) will be calculated as the higher value between the change in NRS scores from baseline for lower back pain and radiating leg pain. The NRS-DC will serve as a key evaluation indicator for pain intensity.

This study will confirm the recurrence of symptoms in patients through a yes or no response.

NRS is a pain scale in which the patient indicates their subjective pain as a whole number from 0 to 10. The participants are asked to report their low back pain and discomfort using NRS, where 0 indicates 'no pain or discomfort' and 10 indicates 'the most severe pain and discomfort imaginable.

Participants rate the improvement after treatment on a 7-point Likert scale (1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.)

The fear-avoidance belief questionnaire (FABQ) is a questionnaire based on the fear-avoidance model of exaggerated pain perception. The FABQ measures patient's fear of pain and consequent avoidance of physical activity (PA) because of their fear.

Minimum 0 to maximum 66 scores. Higher score means a worse outcome.

The SF-12 consists of 12 questions across 8 domains, and higher scores indicate better health-related quality of life.

Ranging from 0 to 100, higher score means a better outcome.

The EQ-5D-5L consists of 5 questions (mobility, self-care, usual activities, pain, anxiety/depression) that ask about the current state of health, and answers each question with 5 likert. (1=I have no problems about, 2=I have slight problems about, 3=I have moderate problems about, 4=I have severe problems about, 5=I am unable to about) Ranging from 0 to 1, higher score means a better outcome.

The study will measure the level of trust and expectation regarding the effectiveness of the treatment through two questions:

On a scale from 0 to 10, how much do you believe that traditional herbal medicine treatment will alleviate your symptoms? On a scale from 0 to 10, how much do you believe that drug therapy will alleviate your symptoms? 0 indicates no belief or expectation, and 10 indicates full belief and high expectation.

Evaluate participants' intentions if they are willing to receive non-pharmacological treatment strategies or pharmacological treatment strategies in the future on a scale from 0 to 9. 0 indicates no intention, and 10 indicates full belief and high intention.

Productivity loss will be assesed by WPAI-SHP. Through the WPAI questionnaire, the overall work productivity, which is a concept combining absenteesim and presenteeism, as well as employment will be investigated and used as outcomes.

Classify the degree of disc degeneration based on the Pfirrmann grading system.

Classify the stage of disc herniation as bulging, protrusion, extrusion, or sequestration/migration.

Measure the area of the most significant transverse plane slice of the herniated disc on MRI.

Measure various cost items related to the treatment, including medical costs, non-medical costs, time costs, and productivity loss costs.