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

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 carbonbeam 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 followup 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 R-2 =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.