Effectiveness and safety of Korean medicine for pain management after musculoskeletal surgery: a retrospective study

Abstract

To assess the effectiveness and safety of Korean medicine in managing postoperative pain. Retrospective, observational study. Medical records of 233 inpatients at a Korean medicine hospital who underwent Korean medicine treatments such as acupuncture, moxibustion, cuppping, bee-venom and herbal acupuncture, electrical therapy, herbal medicine, and carbon-beam therapy after musculoskeletal surgery were reviewed, and numeric ratings for pain were compared between baseline and follow-up. A correlation analysis between pain improvement and therapeutic factors was performed, and a regression analysis was conducted to determine the predictors of pain reduction. Serum laboratory test results at baseline and follow-up were subsequently compared to identify safety. Numeric rating scale scores for pain; presence of infection, drug-induced liver injury (DILI), and drug-induced kidney injury (DIKI) for safety. After Korean medicine treatment, the pain scores decreased from an average of 4.09 to 1.79 in the numeric rating scale (p < 0.001). Frequency of acupuncture therapy during hospitalization showed the strongest positive correlation with pain improvement (r = 0.341, p = 0.000) and was a predictor of pain reduction (adjusted R² = 0.145). Improvements in serum laboratory data to reference limits were observed. All kappa coefficient values, except for white blood cell (WBC) count, were between 0.3 and 0.7, indicating that the follow-up data matched the baseline data. The low kappa coefficient value of WBC count was due to the high ratio of outliers. One (0.43%) and no cases of DILI and DIKI were identified, respectively. Korean medicine could be used for managing pain after musculoskeletal surgery.