Characteristics of 601 Low Back Pain Patients: A Korean Medicine Hospital Experience,
Retrospective Chart Review


Dae-Jin Nam
Dept. of Korean Medicine
Graduate school, Daejeon University
(Directed by Prof. Min-Seok Oh, K.M.D., Ph.D.)


Abstract
Objective :
Low back pain(LBP) is one of the most common reason for people in Korea to visit Korean medical institutions. To access actual amounts of use in the treatment of LBP in Korean medicine and to provide objective base line data research regarding the current state of LBP patients’ treatment in Korean medical institutions are in need.

Methods :
The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 601 patients who were hospitalized for treatment of LBP in Cheonan Korean Medicine Hospital, Daejeon University from 1st, January, 2013 to 31th, December, 2013 were anlyzed.

Results :
1. Most frequently given diagnosis was sprain and strain of lumbar(45.93%), followed by herniated nucleus pulposus of L-spine(34.92%), spinal stenosis(9.49%), lumbago with sciatica(6.78%) and fracture of lumbar spine(2.88%).
2. In distribution according to sex, female outnumbered male patients in all disease groups except fracture of lumbar spine.
3. In distribution according to age, sprain and strain of lumbar, HNP of L-spine and lumbago with sciatica were most frequent at 30s, fracture of lumbar spine was most frequent at 50s and spinal stenosis was most frequent at 70s.
4. In distribution according to month, sprain and strain of lumbar was most frequent in October, HNP of L-spine in January, spinal stenosis in June, lumbago with sciatica in February, fracture of lumbar spine in July.
5. The most frequently motive for low back pain was traffic accident(35.4%), followed by none(24.2%), labor(19.66%), trauma(10.68%), overuse(6.78%) and sports injury(3.22%).
6. Patients with no related medical history were 76.95% while patients with related medical history were 23.05%. 94.12% of fracture of lumbar spine patients had related medical history while HNP of L-spine patients(57.77%) had lowest number of patients with related medical history.
7. 0～1week interval between onset and visit to Korean Medicine Hospital was most frequent in all disease groups.
8. 50.85% of patients went through treatment at medical institutions before the admitting to Cheonan Korean Medicine Hospital. 7.29% of patients underwent surgery.
9. The average duration of admission was 16±13.0 days. The average duration of admission of fracture of lumbar spine was 24.3±18.8 days, followed by spinal stenosis(18.7±15.2 days), HNP of L-spine(13.9±10.7 days), lumbago with sciatica(14±14.0 days), and sprain and strain of lumbar(9.1±6.6 days). The average admission days of female was higher than male’s. And age goes up, average duration of admission was longer.
10. The average treatment result was 3.08 and in most(74.59%) of the patients, symptoms were more than improved. The average treatment result of sprain and strain of lumbar was 3.03, followed by lumbago with sciatica(3.08), HNP of L-spine(3.11), spinal stenosis(3.16), and fracture of lumbar spine(3.18)
11. Most frequently prescribed examination was X-ray(65.13%), followed by magnetic resonance imaging(26.68%) and computed tomography(8.18%).
12. Patients who were not prescribed with pain killer(68.47%) outnumbered patients who were prescribed with painkiller(31.53%). Pain medication was most frequently prescribed to fracture of lumbar spine(58.82%), followed by spinal stenosis(44.64%), HNP of L-spine(33.01%), sprain and strain of lumbar(26.94%), lumbago with sciatica(25.00%).
13. Most frequently give Korean medicine treatment was acupuncture(100%), followed by cupping therapy(90.00%), Herb fumigation therapy(62.3%) and moxibustion(52.80%).
14. Most frequently given Korean medicine physiotherapy was infrared(99.40%), followed by interferential current therapy(84.20%), hot pack(83.70%), and US(49.10%).
15. In fracture of lumbar spine and spinal stenosis, most frequently prescribed herb medicine was hwal-hyeol-tang. In herniated nucleus pulposus of L-spine, sprain and strain of lumbar and lumbago with sciatica, most frequently prescribed herb medicine was yo-gak-tongG.

Conclusion :
In this study, people in their 30s, females, within 0～1weeks after onset, motivated by traffic accident, diagnosed with sprain and strain of lumbar, with no medical history related to low back pain, underwent treatment at medical institutions, took the highest percentage from each category of patients who admitted to Korean medicine hospital due to low back pain. In most(74.59%) of the patients, symptoms were more than improved, especially in sprain and strain of lumbar and lumbago with sciatica.

Key words : low back pain, sprain and strain of lumbar, spinal stenosis, fracture of lumbar spine, lumbago with sciatica, herniated nucleus pulposus of L-spine, Korean medicine hospital