3.3.2. Herbal Medicine + Usual Conventional Therapy vs. Usual Conventional Therapy

The level of evidence and recommendations were derived based on 22 RCTs [40,83–103] that observed the combination effect of herbal medicine and conventional treatment for LHIVD in terms of pain, function, and overall symptom improvement.

As a result of the meta-analysis, the combination of conventional herbal medicine with usual conventional treatments, such as acupuncture, pharmacopuncture, Tuina manual therapy, Western medicine, injection, physical therapy, and integrated treatment, was more effective in improving the overall symptoms (RR: 1.32, 95% CI: 1.26–1.37, *p* < 0.001), pain (MD, −1.51, 95% CI: −1.57–−1.46, *p* < 0.001), and function (ODI: MD, −5.25, 95% CI: −8.33–−2.17, *p* < 0.001; JOA: MD, 5.89, 95% CI: 5.31–6.46, *p* < 0.001) than usual conventional therapy.

In conclusion, herbal medicine in combination with conventional treatment is recommended for improving the overall symptoms of LHIVD (A/High).
