Acupunct Search


J Acupunct Res > Volume 32(4); 2015 > Article
Kim, Kim, Hong, Kim, Park, Kim, Seo, Lee, Seo, Kim, and Kim: Effects of Integrative Korean Medical Treatment for a Failed Epidural Steroid Injections to L-spine Disk Herniation: A Retrospective Case Series



The purpose of this study was to assess the effectiveness of integrative Korean Medical treatments for patients with L-spine disk herniation that showed no response to Epidural Steroid Injections (ESI)


In this study, we reviewed the medical records of ten patients who showed no improvement or relapsed after ESI. The patients each received more than three weeks of integrative treatments at Mokhuri Neck&Back Hospital. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) was measured before and after treatment A statistical analysis to compare before and after treatments was assessed using paired t-test the SPSS 12.0 Windows program


After three weeks of treatment, patients showed a significant decrease in VAS and ODI scores compared to before receiving treatment. VAS scores decreased from 5.3±1.25 to 1.9±0.99 (p<0.001) and ODI scores decreased from 59.8±22.2 to 32.7±14.11 (p<0 001).


Complex Korean Medical treatment showed effectiveness in the treatment of L-spine HIVD patients that showed no response to ESI, and more objective research is needed.

Fig. 1
Changes of VAS (Visual Analog Scale)
*: There is significant stastically significance between average VAS score of PAD 1 and PAD 22. (P<0.001)
Fig. 2
Changes of ODI (Oswestry Disability Index)
*: There is significant stastically significance between average ODI score of PAD 1 and PAD 22. (P<0.001)
Table 1
Composition of Gangchuctang Used in This Study
Scientific name Amounts (g)
Geranii herba 8
Sorbus commixta 8
Archyranthes radix 4
Cibotii rhizoma 4
Acanthopanax sessiliflorum seeman 4
Ledebouriella seseloides 4
Eucommia ulmoides Oliver 4
Atractylodes macrocephala Koidzumi 4
Aralia continentalis Kitagawa 4
Rehmannia glutinosa for hueichingensis 4
Carthamus tinctorius 1.5
Total 49.5
Table 2
Characteristics of Subjects
age sex Diagnosis Hospitalization Period(days) the number of injection
patient 1 37 M HIVD* of L4/5 23 4
patient 2 34 F HIVD of L5/S1 25 3
patient 3 33 M HIVD of L4/5 22 1
patient 4 24 M HIVD of L4/5 31 2
patient 5 49 M HIVD of L4/5 22 2
patient 6 54 F HIVD of L5/S1 34 2
patient 7 20 M HIVD of L4/5 23 3
patient 8 60 F HIVD of L4/5 24 1
patient 9 53 F HIVD of L4/5 22 1
patient 10 32 F HIVD of L4/5, L5/S1 23 2

* HIVD: Herniated InterVertebral Disk.

Table 3
Changes of VAS and ODI average score before and after Korean Medical Conbination Treatments
PAD 1§ PAD 22 PAD 1 PAD 8 PAD 15 PAD 22
patient 1 36 18 4 3 3 1
patient 2 82 54 5 4 3 2
patient 3 92 44 6 4 3 2
patient 4 26 18 5 3 2 1
patient 5 40 18 6 5 4 3
patient 6 74 44 8 6 5 4
patient 7 50 20 4 3 2 1
patient 8 50 25 4 2 2 1
patient 9 76 42 6 5 4 2
patient 10 72 44 5 4 3 2
mean 59.8±22.2 32.7±14.11 5.3±1.25 3.9±1.20 3.1±0.99 1.9±0.99
p-value* 0.000018 0.00000000637

* : p-value by paired t-test in before and after treatment (p<0 05)

ODI: Oswestry Disability Index,

VAS: Visual Analog Scale.

§ PAD: Post Administration Date.



1. Ahn JH, Ahn JC, Ahn JK et al. Orthopaedics. 7th ed. Seoul: Choisin Medical Publishing Co. 2013:865–8.

2. Cherkin DC, Deyo RA, Loeser JD, et al. An international comparison of back surgery rates. Spine. 1994;19(11):1201–6.
crossref pmid
3. Kreiner DS, Hwang SW, Easa JE, et al. An evidence–based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. The Spine Journal. 2014;14(1):180–91.
crossref pmid
4. Leung SM, Chau WW, Law SW, Fung KY. Clinical value of transforaminal epidural steroid injection in lumbar radiculopathy. Hong Kong Med J. 2015;21(05):394–400.
crossref pmid
5. Epstein NE. Unnecessary multiple epidural steroid injections delay surgery for massive lumbar disc: Case discussion and review. Surg Neurol Int. 2015;6(Suppl 14):S383–7.
crossref pmid pmc
6. Zhai J, Zhang L, Li M, et al. Epidural injection with or without steroid in managing chronic low back and lower extremity pain: ameta–analysis of ten randomized controlled trials. Int J Clin Exp Med. 2015;8(6):8304–16.
crossref pmid pmc
7. Kim HS, Kim SY, Kim HJ, Kim ES, Kim YI. The Effect of Acupotomy on Lumbar Herniated Intervertebral Disc: Report of a Case Series. The Acupuncture. 2015;32(3):185–95.
8. Park OJ, Kim SG, Lee JJ, Lee SM, Kim SJ, Cho NG. The Effect of Shinbaro and Bee Venom Pharmacopuncture in Treating Lumbar Disc Herniations. The Acupuncture. 2013;30(5):41–50.
9. Kim SM, Lee SH, Shin YB, et al. The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study. The Acupuncture. 2015;32(2):23–33.
10. Davidson M, Keating J. Oswestry disability questionnaire(ODQ). Australian Journal of Physiotherapy. 2005;51(4):270.
crossref pmid
11. Seidler A, Euler U, Bolm–Audorff U. Physical workload and accelerated occurrence of lumbar spine diseases: risk and rate advancement periods in a German multicenter case-control study. Scand J Work Environ Health. 2011;37(1):30–6.
crossref pmid
12. Sari S, Aydin ON, Güleser G, Kurti , Turan A. Effect of transforaminal anterior epidural steroid injection on neuropathic pain, quality of sleep and life. Ağr i. 2015;27(2):83–8.
13. Çetin MF, Karaman H, Ölmez Kavak G, Tüfek A, Baysal Yildirim Z. Efficacy of transforaminal lumbar epidural steroid injections in patients with lumbar radiculopathy. Ağri. 2012;24(2):77–84.

14. Manchikanti L, Cash KA, Pampati V, Falco FJ. Transforaminal epidural injections in chronic lumbar disc herniation: a randomized, double–blind, active–control trial. Pain Physician. 2014;17(4):489–501.

15. Parr AT, Diwan S, Abdi S. Lumbar interlaminar epidural injections in managing chronic low back and lower extremity pain: a systematic review. Pain Physician. 2009;12(1):163–88.
16. El Abd O, Amadera J, Pimentel DC, Gomba L. Immediate and acute adverse effects following transforaminal epidural steroid injections with dexamethasone. Pain Physician. 2015;18(3):277–86.
17. Lee EK, Choi EH, Lee JE, et al. The clinical study on 137 cases of herniated lumbar disc patients. The Acupuncture. 2008;25(3):127–38.

18. Kim WY, Han SY, Kim KY, Lee JH, Lee HJ, Kim CY. A Clinical Study of 17 Cases of Patients with Big Toe Extensor Muscles Weakness Caused by Lumbar Disc Herniation. The Acupuncture. 2009;26(4):19–27.

19. Park SH, Ro HR, Kim TH, Park JY. The Comparative Study on the Effect of Bee Venom Pharmacopuncture Treatment and Hwangryun Pharmacopuncture Treatment of Cervical Disc Herniation. The Acupuncture. 2013;30(3):117–24.
20. Ju MS, Jeong HU, Kim HG, et al. Anti–nociceptive and anti–inflammatory effects of Geranii Herba. Kor J Herbology. 2010;25(3):97–101.

Article and Issues
For this Journal
For Authors
Submit Manuscript
Editorial Office
Gil Korean Medical Hospital, Gachon University
Keunumul-Ro, Chung-Ku, Inchoen 22138, Korea
Tel: +82-70-7606-6353,4    Fax: +82-32-232-3334    E-mail:                

Copyright © 2019 by Korean Acupuncture & Moxibustion Medicine Society. All rights reserved.

Developed in M2community

Close layer
prev next