ClinicalTrials.gg
RecruitingNCT06024460Updated Sep 21, 2026

Non-pharmacological Treatment vs Pharmacological Treatment for Non-acute Lumbar Disc Herniation

An interventional study of non-pharmacological treatment strategy and pharmacological treatment strategy in Lumbar Disc Herniation, sponsored by Jaseng Medical Foundation. Recruiting at 4 sites in South Korea. Open to participants aged 19 Years to 69 Years. Per ClinicalTrials.gov, last updated 2026-09-21.

Sponsored by Jaseng Medical Foundation · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Aug 2023; still recruiting 3 years 3 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
200
Allocation
Randomized
Ages
19 Years to 69 Years
Sex
All
01

Study summary

This is a randomized controlled study comparing non-pharmacological treatment to proactive pharmacological treatment for patient with non-acute lumbar disc herniation with moderate or higher levels of pain. The study involves 200 adult patients aged 19-69, with 50 patients from each participating hospital. Patients will be randomly assigned to either the non-pharmacological treatment group or the pharmacological treatment group 1:1 ratio. Specific interventions will be determined by doctors and Korean medicine doctors without predefined treatment strategies. The non-pharmacological treatment include acupuncture, electroacupuncture, spinal manual therapy and motion style acupuncture. The pharmacological treatment include medication prescription, injection, and nerve block. Treatment period is 8 weeks, and f/u for 3 years.

Read the detailed description

This is a pragmatic, multi-centered, randomized controlled, parallel-grouped study aiming to compare the effectiveness of a non-pharmacological treatment strategy and a active pharmacological treatment strategy in managing non-acute lumbar disc herniation with moderate or higher levels of pain persisting for more than one month in adult men and women aged 19 to 69 years.

The study will include 200 patients with lumbar disc herniation, with 50 patients from each of the participating hospitals (Jaseng Hospital of Korean Medicine, Daejeon Jaseng Hospital of Korean Medicine, Bucheon Jaseng Hospital of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine, competitively recruited). The patients will be assigned in a 1:1 ratio to receive either non-pharmacological treatment (100 patients) or active pharmacological treatment (100 patients) in a pragmatic randomized controlled design. The specific interventions for each group will be determined based on clinical judgment by the doctors and Korean medicine doctors involved in the study, without predefining the treatment strategies. The treatment methods, including acupuncture, electroacupuncture, spinal maunal therapy and motion style acupuncture, will be recorded in the case report form for comparative analysis.

For the non-pharmacological treatment group, patients will be recommended to receive non-pharmacological treatment based on TKM. The frequency and specifics of the treatment will be determined by the clinical judgment of the doctors and Korean medicine doctors based on the patient's symptoms, MRI images, and clinical improvement. The treatment will be conducted twice a week for a total of eight weeks, but the frequency may be adjusted according to the patient's condition. Concurrent therapies and adjuvant therapies can be freely chosen by the patients, and the details will be recorded in the case report form.

For the pharmacological treatment group, patients will be educated about proactive pharmacological treatment and recommended to receive pharmacological treatment. The specific pharmacological interventions, such as prescription medication, injection therapy, and nerve block, will be determined by the doctors based on the patient's symptoms, imaging results, and clinical judgment. The details of the prescribed medication, dosage, administration route, and duration will be recorded in the case report form. Similar to the non-pharmacological treatment group, concurrent therapies and adjuvant therapies can be chosen by the patients, and the details will be recorded.

The treatment frequency for the pharmacological treatment group will also be twice a week for a total of eight weeks, with adjustments based on the patient's condition. The effectiveness of the treatment strategies will be assessed through weekly evaluations of the patients' symptoms and treatment progress.

It should be noted that patients are not obligated to strictly follow the assigned treatment strategy, as this is a study recommending a particular treatment strategy rather than enforcing it as a protocol violation.

02

Conditions studied

  • Lumbar Disc Herniation
03

In context

Intervertebral Disc Displacement

474 studies on the registry are indexed under Intervertebral Disc Displacement; 100 are open to participants now.

This study's planned enrollment of 200 is above the median of 63 across 344 interventional studies indexed under Intervertebral Disc Displacement.

Browse Intervertebral Disc Displacement studies →

Lead sponsor

Jaseng Medical Foundation is the lead sponsor of 69 studies on the registry; 11 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
19 Years to 69 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • aged 19 to 69 years.
  • lower back pain that has persisted for at least 1 month.
  • a Numeric Rating Scale (NRS) score of 5 or higher for either lower back pain or radiating leg pain over the past three consecutive days.
  • confirmed lumbar disc herniation on MRI that can explain the lower back pain.
  • who have provided written and agreed to participate in the clinical study.

Exclusion criteria

Exclusion Criteria:

  • diagnosed with specific severe diseases that could be the cause of lower back pain or leg pain (e.g., spinal , acute fractures, and spinal dislocation).
  • showing progressive neurological deficits or severe neurological symptoms.
  • with pain originating from soft tissue disorders other than the spine (e.g., tumors, fibromyalgia, rheumatoid arthritis, gout).
  • with other chronic conditions (e.g., stroke and myocardial infarction, renal disease, diabetic neuropathy, dementia, epilepsy) that may interfere with the treatment effect or result interpretation.
  • taking , drugs, psychiatric medications, or other medications that may impact the study results.
  • acupuncture or nerve block treatment is inappropriate or unsafe, such as those with a history of bleeding disorders, receiving anticoagulant therapy, or diagnosed with uncontrolled diabetes.
  • taken non-steroidal anti-inflammatory drugs (NSAIDs) or other pain-affecting drugs or received acupuncture treatment within the past 5 days.
  • Pregnant women, those planning pregnancy, or breastfeeding women.
  • within 3 months after lumbar surgery.
  • who have not completed participation in another clinical study within the past month or have plans to participate in another clinical study within 6 months from the selection date or during the study participation and follow-up period.

Inability to provide written .

- Other cases where the researchers determine that participation in the clinical study would be difficult.

Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
200 participants (estimated)

Study arms

  • Experimental
    Non-pharmacological treatment strategy

    Interventions: Non-pharmacological treatment include acupuncture, electroacupuncture, spinal manual therapy, and motion style acupuncture treatment. Frequency: Not specified (Twice a week recommended) Duration: Eight weeks.

    Procedure: non-pharmacological treatment strategy

  • Active comparator
    Pharmacological treatment strategy

    Interventions: Active pharmacological treatment involving prescription medication, injection therapy, or other pharmacological interventions. Frequency: Not specified (Twice a week recommended) Duration: Eight weeks.

    Procedure: pharmacological treatment strategy

Interventions

  • Procedurenon-pharmacological treatment strategy

    Acupuncture, elctroacupuncture, spinal manual therapy, motion style acupucnture treatment

  • Procedurepharmacological treatment strategy

    Prescription medication, injection therapy, nerve blocks, or other pharmacological interventions commonly used for managing lumbar disc herniation. This group is treated using the above treatment strategies, and no drug is specified.

06

What researchers measure

Primary outcomes

  1. Oswestry Disability Index (ODI)

    The Oswestry Disability Index (ODI) is a questionnaire used to assess the functional status and degree of disability caused by lower back pain. It consists of 10 items that evaluate various aspects of daily activities and mobility. Each item is rated on a 6-point scale, with higher scores indicating a greater level of disability. From 0 to 100. Higher scores mean a worse outcome.

    Time frame: Week 1, 5, 9, 13, 26, 39, 52, Month 18, 24, 36

  2. Numeric Rating Scale for Pain of Dominant Change (NRS for DC)

    The study will evaluate the intensity of lower back pain and radiating leg pain using the Numeric Rating Scale (NRS). Patients will rate their pain levels on a scale from 0 to 10, where 0 represents no pain and 10 represents the most severe imaginable pain. The NRS for Dominant Change (NRS-DC) will be calculated as the higher value between the change in NRS scores from baseline for lower back pain and radiating leg pain. The NRS-DC will serve as a key evaluation indicator for pain intensity.

    Time frame: Baseline, Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 13, 26, 39, 52, Month 18, 24, 36

Secondary outcomes

  1. Recurrence

    This study will confirm the recurrence of symptoms in patients through a yes or no response.

    Time frame: Week 13, 26, 39, 52, Month 18, 24, 36

  2. Numeric Rating Scale (NRS) for Low Back Pain

    NRS is a pain scale in which the patient indicates their subjective pain as a whole number from 0 to 10. The participants are asked to report their low back pain and discomfort using NRS, where 0 indicates 'no pain or discomfort' and 10 indicates 'the most severe pain and discomfort imaginable.

    Time frame: Baseline, Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 13, 26, 39, 52, Month 18, 24, 36

  3. Patient Global Impression of Change (PGIC)

    Participants rate the improvement after treatment on a 7-point Likert scale (1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.)

    Time frame: Week 9, 13, 26, 39, 52, Month 18, 24, 36

  4. Fear-Avoidance Beliefs Questionnaire (FABQ)

    The fear-avoidance belief questionnaire (FABQ) is a questionnaire based on the fear-avoidance model of exaggerated pain perception. The FABQ measures patient's fear of pain and consequent avoidance of physical activity (PA) because of their fear. Minimum 0 to maximum 66 scores. Higher score means a worse outcome.

    Time frame: Week 1, 5, 9, 13, 26, 39, 52, Month 18, 24, 36

  5. Short Form-12 Health Survey version 2 (SF-12 v2)

    The SF-12 consists of 12 questions across 8 domains, and higher scores indicate better health-related quality of life. Ranging from 0 to 100, higher score means a better outcome.

    Time frame: Week 1, 5, 9, 13, 26, 39, 52, Month 18, 24, 36

  6. EuroQol-5 Dimension (EQ-5D-5L)

    The EQ-5D-5L consists of 5 questions (mobility, self-care, usual activities, pain, anxiety/depression) that ask about the current state of health, and answers each question with 5 likert. (1=I have no problems about, 2=I have slight problems about, 3=I have moderate problems about, 4=I have severe problems about, 5=I am unable to about) Ranging from 0 to 1, higher score means a better outcome.

    Time frame: Week 1, 5, 9, 13, 26, 39, 52, Month 18, 24, 36

  7. Credibility and Expectancy

    The study will measure the level of trust and expectation regarding the effectiveness of the treatment through two questions: On a scale from 0 to 10, how much do you believe that traditional herbal medicine treatment will alleviate your symptoms? On a scale from 0 to 10, how much do you believe that drug therapy will alleviate your symptoms? 0 indicates no belief or expectation, and 10 indicates full belief and high expectation.

    Time frame: Baseline

  8. Intention to Treat

    Evaluate participants' intentions if they are willing to receive non-pharmacological treatment strategies or pharmacological treatment strategies in the future on a scale from 0 to 9. 0 indicates no intention, and 10 indicates full belief and high intention.

    Time frame: Week 9

  9. Work Productivity and Activity Impairment-Specific Health Problem

    Productivity loss will be assesed by WPAI-SHP. Through the WPAI questionnaire, the overall work productivity, which is a concept combining absenteesim and presenteeism, as well as employment will be investigated and used as outcomes.

    Time frame: Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 13, 26, 39, 52, Month 18, 24, 36

  10. Classification of Disc Degeneration

    Classify the degree of disc degeneration based on the Pfirrmann grading system.

    Time frame: Week 1, 26, 52, Month 24, 36

  11. Stages to a Disc Herniation

    Classify the stage of disc herniation as bulging, protrusion, extrusion, or sequestration/migration.

    Time frame: Week 1, 26, 52, Month 24, 36

  12. Herniated Disc Areas

    Measure the area of the most significant transverse plane slice of the herniated disc on MRI.

    Time frame: Week 1, 26, 52, Month 24, 36

  13. Cost Data Survey

    Measure various cost items related to the treatment, including medical costs, non-medical costs, time costs, and productivity loss costs.

    Time frame: Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 13, 26, 39, 52, Month 18, 24, 36

07

Study locations

4 of 4 sites recruiting
08

References and documents

Publications

  • Kim D, Lee YJ, Yang C, Ahn YJ, Kim S, Lee Y, Cho HW, Han CH, Ha IH. Non-Pharmacological and Pharmacological Treatments for Non-Acute Lumbar Disc Herniation: A Protocol for a Multicenter Pragmatic Trial. J Pain Res. 2025 Dec 26;18:7167-7178. doi: 10.2147/JPR.S568386. eCollection 2025. PubMed 41477591 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Aug 2023 (actual). Primary completion is estimated for Dec 2030, 88 months after the start.

Of 178 non-industry interventional studies with no phase under Intervertebral Disc Displacement, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 23. This study's planned 88 months is above that.

Counting every sponsor, half of 191 studies reached it within 12 months; a quarter within 5 and three quarters within 27.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 20, 2023
First posted
Sep 6, 2023
StartActual
Aug 9, 2023
Primary completionEst.
Dec 31, 2030
CompletionEst.
Dec 31, 2030
Last update
Sep 21, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06024460
Lead sponsor
Jaseng Medical Foundation
Responsible party
Sponsor
First posted
Sep 6, 2023
Start date
Aug 9, 2023
Primary completion
Dec 31, 2030 (estimated)
Completion
Dec 31, 2030 (estimated)
Last update
Sep 21, 2026

Study contacts

In-Hyuk Ha, Dr
Contact
hanihata@gmail.com
+82-2-2222-2740
In-Hyuk Ha, Dr
study director · Jaseng Medical Foundation

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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