Hui-Juan Li, Ting Wang, An-Li Huang, Juan Yuan
Current evidence suggests auricular therapy effectively alleviates pain in LDH patients and enhances treatment efficacy. However, due to methodological limitations and low evidence quality for some outcomes, rigorous multicenter RCTs with larger samples are needed to validate these findings.
BACKGROUND: Lumbar disc herniation (LDH) is a common degenerative spinal disorder causing low back pain and radiating pain in lower extremities, significantly impairing quality of life. Auricular therapy, a non-pharmacological approach in Chinese medicine, shows promise for pain management. However, current studies vary in design quality, with limited evidence-based support.
OBJECTIVE: To assess the clinical efficacy and safety of auricular therapy for LDH-related pain through systematic evaluation, providing evidence-based guidance for clinical management.
METHODS: A comprehensive search of major databases (China National Knowledge Infrastructure [CNKI], VIP, SinoMed, Wanfang, PubMed, Web of Science, The Cochrane Library, and Embase) was conducted through December 1, 2025, identifying randomized controlled trials (RCTs) of auricular therapy for LDH. Meta-analysis was performed using RevMan 5.4 software, with evidence quality assessed using GRADE methodology.
RESULTS: Sixteen RCTs involving 1352 patients were included. The auricular therapy group showed significantly greater improvement compared to controls in Visual Analogue Scale (VAS) scores [MD = -1.05, 95% CI (-1.32, -0.78), (p < 0.00001)], Japanese Orthopedic Association (JOA) scores [MD = 3.20, 95% CI (2.16, 4.24), (p < 0.00001)], clinical efficacy rate [RR = 1.12, 95% CI (1.07, 1.18), (p < 0.00001)], and lower incidence of adverse events [RR = 0.27, 95% CI (0.09, 0.77), (p = 0.01)]. The GRADE assessment showed moderate-quality evidence for clinical efficiency, low-quality evidence for JOA scores and adverse events, and very low-quality evidence for VAS scores.
LIMITATIONS: Most included studies had inadequate randomization procedures and lacked allocation concealment. None included long-term follow-up data. All included studies were published in Chinese, limiting global generalizability and potentially missing high-quality international research.
CONCLUSIONS: Current evidence suggests auricular therapy effectively alleviates pain in LDH patients and enhances treatment efficacy. However, due to methodological limitations and low evidence quality for some outcomes, rigorous multicenter RCTs with larger samples are needed to validate these findings.