4. Discussion
disability, DLSS, pain
ADVERSE REACTIONS, COMPLICATIONS
As the first-line treatment for DLSS, conservative treatment mainly involves short-term bed rest, medication (including anticonvulsants (such as pregabalin), anti-inflammatory drugs, muscle relaxants, prostaglandin E1 analogs, and antidepressants) use, physical therapy, use of braces, thermal therapy, ultrasound, manual therapy, electrical stimulation, and traction therapy [A previous study reported that the administration of hyaluronic acid-carboxymethylcellulose (HA-CMC) instead of corticosteroids, such as lidocaine and bupivacaine, which are associated with numerous complications, for SNRB prolonged the period of pain improvement [There are many traditional medical and conservative treatments for DLSS in Northeast Asian countries, including Korea. Moreover, various studies have reported that acupuncture—the main tool in oriental medicine—is effective for DLSS [The key findings of this study are as follows. First, CIMS combined with conventional medical treatment provides clinically superior effects in terms of pain control in patients with DLSS. Second, when CIMS was added to the conventional treatment for DLSS, pain control superiority persisted until 6 weeks of the cessation of treatment. Third, CIMS used in the present study included 12 sessions of oriental medical treatment and healing programs over 6 weeks, which were very well adhered to by the patients. In addition, the safety of this approach was confirmed because no adverse reactions were observed in any participant. Most previous studies on acupuncture treatment for LLRP in patients with DLSS have investigated the short-term effects (i.e., during and immediately after treatment), but they have reported persistence of effects even after cessation of treatment. Further, the improvement in pain assessment by VAS in patients in the experimental group that has been maintained over time. A significant improvement in RMDQ was also obtained with respect to the control and with respect to the start of treatment, although not significant, probably due to the number of patients. In the results of the ODI scale assessment, which evaluates more severe disability situations, the differences are similar, although significant between the groups.The present study confirmed that additional CIMS relieves pain more effectively than conventional medical treatment alone. However, although this effect persisted even after the treatment was concluded, the magnitude of the effect gradually decreased after the cessation of treatment. In contrast, the evaluation index indicates that the effects of conventional medical treatment persist over time, indicating a disadvantage of CIMS in realizing the maximum effect at the time of treatment.This study has several limitations. First, this was a preliminary clinical trial (pilot study), and more extensive studies are needed and warranted based on the results presented here. The results of this study can be used in the future to provide clinical information and basic data for large-scale clinical trials. It would be appropriate for them to justify or comment on the trends in the results obtained, even if they are not statistically significant. Post-analysis evaluation of the power of the change in VAS score revealed that the primary validity evaluation variable between the two groups had a high power (0.84). Second, this study only analyzed the short-term effects (6 weeks after termination) of CIMS. Third, this pilot study included a small number of participants; therefore, more significant differences can be confirmed if larger-scale studies are conducted.