Sciatica is a symptom, not an illness. It refers to local pain, tingling, or numbness that radiates down the leg from the lower back and pelvis. There can be many causes of sciatic nerve irritation: slipped discs in the spine, bone spurs pressing on nerves, piriformis syndrome (an overactive muscle at the hip), gouty deposits behind the knee, and bone fragments after surgery, just to name a few.
Many times what looks like sciatica is another diagnosis entirely – for example, spinal stenosis occurs when there is scar tissue obstructing spinal nerves. Low back pain with radiation into one leg may be sacroiliac joint dysfunction; inflammation of a facet joint or arthritis in the spine may be causing symptoms to radiate down the leg.
Lastly, a disc can herniate and irritate the nerve root at any place along its path from the back to the leg – and a truly “sciatica” pain felt in one buttock can have a different cause than radiating thigh pain. The point is that any number of conditions could be responsible for sciatica-like symptoms; it would be good if we had more specificity when treating patients with suspected spinal stenosis, sacroiliac dysfunction, or piriformis syndrome.
We need specific diagnostic tests (MRI or CT) to confirm spinal stenosis, for example, and treatment should depend on what’s found except in rare cases where there are no other findings besides sciatica.
How Does Acupuncture Work?
What are the non-specific signs and symptoms of sciatica? Pain, numbness, or tingling radiating from the buttock down into one leg. How does acupuncture work to relieve pain? It may help relax muscles, reduce inflammation and increase blood flow. The idea is that those mechanisms lessen pain signals in the spine and provide better nerve conduction.
Acupuncture may work for all sorts of pain – headache, backache, neck pain, and leg pain such as sciatica. A recent meta-analysis (a statistical analysis of many published studies) found acupuncture to be effective for chronic low back pain, neck pain, and migraine. In addition, acupuncture was more effective for chronic headaches than usual care or sham acupuncture. In sciatica, there are very few reports as no study has been large enough to answer that question.
However, a new study published in the journal Acupuncture in Medicine looked at 13 sciatica patients and found that 8 of them had improvement after acupuncture treatment (4 with complete relief of pain). Therefore, these researchers concluded that acupuncture could relieve sciatica symptoms.
How Does Acupuncture Work for Sciatica?
One study found that acupuncture improved pain and disability scores more than fake acupuncture (needles inserted beside the true acupoints instead of into them) or standard Western medical treatment for sciatica. The placebo used is a commonly used technique in acupuncture studies worldwide. Results are similar with or without the placebo effect; however, this paper was a positive one for acupuncture for sciatica because it compared real acupuncture to both fake and sham (placebo) techniques. Studies suggest that acupuncture can reduce inflammation and improve blood supply to damaged tissue.
This suggests that acupuncture may be helpful for sciatica caused by inflammation or tissue degeneration such as spinal stenosis, a disc herniation that irritates the nerve root, piriformis syndrome, or one of the other causes listed above that is aggravated by inflammation and tissue degeneration. One study found that acupuncture ameliorates sciatic pain by reducing central sensitization, which results in a decreased responsiveness to painful stimuli.
Translated means that treatment with acupuncture decreases the activity in pain pathways in the brain, decreasing pain sensitivity. Another study found that treatment with laser acupuncture coupled with physical therapy reduced symptoms of acute sciatica more than either intervention alone. The laser was used to stimulate nerve conduction in the areas involved, while physical therapy improved mobility and strength.
That study demonstrates how multiple approaches can benefit sciatica – both for pain and for physical therapy. The third study cited in this article found that patients who received acupuncture but not traction improved more than those who only received traction; they also found no improvement from placebo laser therapy. So it’s clear that simply adding an inert intervention (placebo laser) to another treatment doesn’t produce a better outcome than either treatment alone.
Studies like these suggest that acupuncture works for sciatica and can add to the effects of traction or other treatments such as muscle relaxants. Acupuncture is worthwhile for patients with persistent sciatica pain; after consultation, a treatment plan is formulated based on the patient’s constitution, lifestyle, and medical condition. Acupuncture should be considered part of any treatment plan for sciatica, particularly if it is not helped by physical therapy or other treatments. If you are interested in treating your sciatica with acupuncture, call us today at 205-637-1363.
