학술논문

A patient with chronic low back pain stratified at the initial visit by the Keele STarT Back Screening Tool and then treated with acupuncture and saibokuto / 初診時にKeele STarT Back Screening Toolで層別化した慢性腰痛患者に対する鍼・柴朴湯併用治療の1症例報告
Document Type
Journal Article
Source
全日本鍼灸学会雑誌 / Zen Nihon Shinkyu Gakkai zasshi (Journal of the Japan Society of Acupuncture and Moxibustion). 2023, 73(3):186
Subject
acupuncture
chronic low back pain
saibokuto
慢性腰痛
柴朴湯
鍼治療
Language
Japanese
ISSN
0285-9955
1882-661X
Abstract
[Introduction] Psychosocial factors are associated with chronic low back pain (CLBP), but there are no known reports of screening for psychosocial factors and combined acupuncture and Kampo treatment for this. We present the case of a patient with CLBP with neuralgia of the posterior right thigh whose quality of life (QOL) improved after evaluation of psychological factors and treatment with acupuncture and saibokuto.[Case presentation] A 38-year-old woman developed low back pain with neuralgia in the posterior right thigh in August of the X year. She visited a nearby orthopedic clinic and was diagnosed with a lumbar disc herniation. In November she visited a nearby psychiatric clinic because she noticed dizziness, was diagnosed with an adjustment disorder and was prescribed bromazepam. Six months later, she was diagnosed with sciatica by an orthopedic surgeon at our hospital. In the following month, she visited the psychiatrist at our hospital and was diagnosed with depression in April. In April, she also visited our department, hoping for improvement of her low back pain and neuralgia in the posterior right thigh. Neurological and orthopedic manual examinations showed normal results, but pain in the lumbar region when flexing the trunk and baikakuki and kyo-kyo-kuman were noted. The Keele STarT Back Screening Tool classified her under medium risk, and the Roland-Morris Disability Questionnaire (RDQ) showed a score of 16 with a deviation score of 1.22. We administered acupuncture and saibokuto to improve her symptoms. The acupuncture treatment was performed on the right L2/L3 lateral sacral border, piriformis equivalent area, BL37, and BL40. As a result, after the third acupuncture treatment, her RDQ score improved to 2 points and the deviation score to 50.14 points.[Discussion] Our results suggest that acupuncture and saibokuto may improve the QOL of CLBP patients with neuralgia in the lower limbs who have psychological factors.