Lumbar herniated intervertebral disc in adults from Korean Medicine Clinical Pratice Guideline

This guideline is published at Oct. 2014 in Korea.

Evidence Based Korean Medicine Clinical Practice Guideline Development Committee for Lumbar Herniated Intervertebral Disc(Korea Institute of Oriental Medicine, The society of Korean Medicine Rehabilitation), Korean Medicine Clinical Practice Guideline for Lumbar Herniated Intervertebral Disc in adults(KMCPG_Lumbar Herniated Intervertebral Disc), Daejeon, Korea, 2014.

I'm going to share the summary of the guideline.

Ⅳ. Recommendation of this guideline

1. Treatment

(1) Acupuncture

● Acupuncture treatment is recommended as effective intervention for Lumbar HIVD patients to
relieve pain and improve their bodily functions. (Grade A)

● GB30, BL40, Lumbar Jiaji points, BL50, GB34, BL23, and Ashi points are recommended as
the main acupoints, and GB 30 is also recommended as a point that should be deeply needled.
(Grade A)

● Acupuncture treatment should be performed by taking into account the patients’ characteristics
and symptoms. Practicing ankle-three acupuncture, scalp acupuncture, warm acupuncture, fire
acupuncture, superficial acupuncture, intradermal acupuncture, equilibrium acupuncture, and
Sasang constitutional acupuncture is also recommended. (Grade A)

(2) Pharmacopuncture

● Pharmacopuncture for Lumbar HIVD should be applied to a select group of patients to relieve
their pain and to improve their motor ability and functions. (Grade B)

● The major pharmacopuncture approaches includebee venom pharmacopuncture, anti inflammatory
pharmacopuncture, neutral pharmacopuncture for extravasated blood, and Shinbaro
pharmacopuncture. (Grade B)

● Pharmacopuncture using centipede and scorpion venom may also be considered. (Grade C)

● A therapeutic approach using pharmacopuncture should be considered based on the patient’s
condition and risk of side effects. (Grade B)

(3) Herbal medicine

● Herbal medicine should be considered for relieving the pain of Lumbar HIVD patients and
should be prescribed in keeping with an accurate diagnosis. (Grade B)

● Duhuojisheng Tang is recommended to relieve pain (Grade A), and Cheongpa-Jeon and Sibjotang
may be considered (Grade C).

(4) Chuna (chiropractic)

● Chuna treatment is recommended as an effective option for relieving the pain of Lumbar
HIVD patients and for improving their bodily functions. (Grade A)

● It is recommended that Chuna treatment be combined with acupuncture and herbal medicine
treat¬ments. (Grade A)

(5) Moxibustion

● Moxibustion treatment should be considered for relieving the pain of Lumbar HIVD patients
and for improving their bodily functions, and it should also be combined with acupuncture.
(Grade B)

● The GV3, GV4. BL23, BL50, and BL40 points and the sensitive points of the legs and lower
back should be considered as the main points for applying moxibustion. (Grade B)

(6) Cupping therapy

● Cupping therapy should be considered for relieving the pain of Lumbar HIVD patients, and it
is also recommended that it be combined with acupuncture, herbal medicine, and the tuina
treatment. (Grade B)

● BL40, BL60 GB34, GB31, GB30, and the Ashi points should be considered the main points
for cupping therapy. (Grade B)

What is the TMJ disorder, How to treat?

What is TMJ disorder?

Temporomandibular joint (TMJ) connects the mandible( lower jaw) to the skull and regulates the movement of the jaw. The TMJ is one of the most complex, delicate and highly used joints in a human body. The most important functiuons of the TMJ are mastication and speech. TMJ disorder is a generic term used for any problem concerning the jaw joint.

What causes TMJ disorder?

1.     Stress( stress tighten face and jaw muscles, and clench the teeth.)

2.     postural problem of the head and neck

3.     Injury to the jaw

4.     Aging

5.     Disc dislocation

6.     Grinding and clenching the teeth

7.     Arthritis or Rheumatoid arthritis.

What is the symptom of TMJ disorder?

The most common TMJ disorders are pain dysfunction syndrome, internal derangement, arthritis, traumas.

 

How to treat TMJ?                                                                                   

1. Electro-Acupuncture to cut the pain and discomfort.

2. Massage to relax Pterygoid muscles.

3. Cupping( sometimes when the pain is severe)

4. Self massage to Masseter muscle.

 

 

Lumbar herniated Disc

Approach to lumbar disc

Korean acupuncture and herb Clinic’s lumbar radiculopathy program

normal Lumbar X-ray

Normal Lumbar MRI

 

 

Lumbar Spine is very important for our ordinary life.

Because of the healthy spine, we can run, walk, love, sit, study, etc…

You probably have some concerns that how come acupuncture help lumbar disc?

Let me have some opportunity to explain to you.

 

What do you think of Lumbar disc?

 

Someone thinks that If there is protrusion or buldging on the M.R.I. image. But only image cannot match with the symptom.

Someone Thinks that if there is a symptom of radiculopathy, it could be a lumbar disc. But lumbar radiculopathy can occur when you have a tumor or stenosis. These can make the radiculopathy as well.

 

Lumbar Disc diagnosis must be matched with Image and physical examinations, symptoms and signs. We call it “symptom and sign correlation”

 

There was one study at 2001, Dr. Javic took images of normal people who don’t have any lower back pain. 91%of image was degenerative sign and 64% was buldging, 32% was protrusion, 6% was extrusion!!

 

Consequentially, The image shouldn’t be the priority for the decision to take operation.

Then, What kind of sign or symptom would be the indication of operation?

1. Severe pain isn’t reduced by aggressive treatment such as admission over 1 month

2.Herniated disc compress nerve root excessively, so that muscle weakness and atrophy occurs.

3.Herniated disc compress cauda equina, so there is some problem in urination, defecation. erection

 

How manage Lumbar Disc in Korean Acupuncture and Herb Clinic?

We are using Electro-Acupuncture, cupping, Herbal medications to reduce the pain and inflammation.

And In you place, you are going to have icing on your lower back, and nerve stretching, piriformis muscle compression

Stage1

•     When you have severe pain. And difficulty in ordinary activity

•     ->electro-acupuncture, cupping, herbal medication for inflammation

•     ->bed rest 2-3days

•     ->icing at least 90min. 5times in a day

•     ->nerve mobilization, piriformis muscle compression by tennis ball

Stage 2

When you can sleep without pain relief, and can walk in 5min, slowly

electro-acupuncture, cupping, herbal medication for inflammation

Core strengthening exercise

Icing at least 90min. 3times in a day

Nerve mobilization, piriformis muscle compression and stretching

Stage3

When you can sit over 10min, walk over 20 min. in normal spped

Electro-Acupucnture, cupping, herbal medication for inflammation

Core strengthening exercise

Icing at least 60min. 2-3times in a day

Nerve mobilization, Stretching

Stage4

When you can walk over 40 min in fast speed, or jogging

Acupuncture and cupping-if necessary

Core strengthening exercise

Nerve mobilization- if necessary

Continue rehabilitation exercise for healthy life

 

Our goal is not reducing pain, but, Healthy and happy life

 

 

Shukran.