title: Integrative package for low back pain with leg pain in Korea: a prospective cohort study.
abstract: Back pain significantly affects both patients and society through personal suffering, supporting burden, work loss, and incurred expenses. With no unequivocal support for surgery versus conservative treatment, an integrative approach has become popular in Korea.
  
  
  OBJECTIVE
  To investigate the outcomes of an integrative package for low back pain with leg pain.
  
  
  METHODS
  A prospective cohort study involving patients with low back and leg pain and confirmed disc herniation was carried out at an outpatient clinic in Korea. The treatment package comprised of herbal medicines, acupuncture, bee venom acupuncture, and a Korean version of spinal manipulation (Chuna). Study participants were evaluated at baseline and every 4 weeks for 24 weeks. Low back and leg pain intensity levels were measured on a visual analog scale (0-10), back function was evaluated with the Oswestry Disability Index (0-100), and the overall quality of life was assessed using the SF-36 Health Survey (0-100 in 8 different subcategories).
  
  
  RESULTS
  Out of 150 patients, 128 completed the 24 weeks of therapy. Patients reported improvements in all outcome measures. At the completion of the study, low back pain scores improved by a mean of 3.3 (95% CI=2.8 to 3.8), and leg pain scores improved by a mean of 6.3 (95% CI=5.9 to 6.6). Significant improvements in ODI and SF-36 scores were observed at 4 weeks and sustained throughout.
  
  
  CONCLUSIONS
  This integrative package was effective in the treatment of LBP with leg pain and warrants further rigorous investigations.
authors.affiliation: Asian Medicine and Acupuncture Research, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina, Memorial Hospital, Chapel Hill, NC 27599, USA. jongbae_park@med.unc.edu
authors.forename: Jongbae J
authors.initials: JJ
authors.lastname: Park
authors.forename: Joonshik
authors.initials: J
authors.lastname: Shin
authors.forename: Youngkwon
authors.initials: Y
authors.lastname: Choi
authors.forename: Yousuk
authors.initials: Y
authors.lastname: Youn
authors.forename: Sangho
authors.initials: S
authors.lastname: Lee
authors.forename: Seung-Ro
authors.initials: SR
authors.lastname: Kwon
authors.forename: Hyangsook
authors.initials: H
authors.lastname: Lee
authors.forename: Man-Ho
authors.initials: MH
authors.lastname: Kang
authors.forename: In-Hyuk
authors.initials: IH
authors.lastname: Ha
authors.forename: Imhee
authors.initials: I
authors.lastname: Shin
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D005260:Female; D006801:Humans; D007866:Leg; D017116:Low Back Pain / Q000628:therapy; D008297:Male; D020393:Manipulation, Spinal; D059408:Pain Management; D010147:Pain Measurement; D010349:Patient Compliance; D008517:Phytotherapy; D011446:Prospective Studies; D011788:Quality of Life; D056910:Republic of Korea