Integrative Korean Medicine Treatment Including Ultrasound-Guided Shinbaro 2 Pharmacopuncture and Motion-Style Acupuncture Treatment for Acute Lumbar Disc Herniation with Foot Drop: A Case Report

Background: Herniated intervertebral disc (HIVD) with radiculopathy and foot drop can lead to substantial functional impairment. Although both pharmacopuncture and motion-style acupuncture treatment (MSAT) have demonstrated therapeutic potential individually, evidence on their combined use remains limited. In this single-case report, we described the clinical course of a patient with HIVD with radiculopathy and foot drop who underwent a novel approach combining ultrasound (US)-guided Shinbaro 2 pharmacopuncture targeting multiple nerve roots with tibialis anterior muscle motion-style acupuncture treatment (TA MSAT). Case Presentation: A 40-year-old man with lower back pain (LBP), radiculopathy, and foot drop attributed to acute HIVD was treated with high-dose US-guided Shinbaro 2 pharmacopuncture and TA MSAT. Outcomes were measured using the Numeric Rating Scale (NRS) for LBP, L5, and S1 radiculopathy; Manual Muscle Testing (MMT) for dorsiflexion and great toe extension; the Oswestry Disability Index (ODI) for lumbar function; the EuroQol Five-Dimension (EQ-5D) Index for quality of life; and the Patient Global Impression of Change (PGIC) for satisfaction. After 14 weeks of treatment, NRS scores for LBP, L5, and S1 radiculopathy decreased from 5 to 1, 8 to 1, and 8 to 1, respectively. MMT grades for dorsiflexion and great toe extension improved from 3 to 5 and 2 to 5, respectively, indicating full functional recovery. ODI and EQ-5D scores improved from 62.22 to 6.67 and 0.344 to 1.0, respectively. The PGIC score was 1, indicating clinical improvement. Conclusions: Our integrative approach involving US-guided pharmacopuncture and TA MSAT demonstrates therapeutic potential for the management of acute HIVD.