Acupuncture for Sciatica

How Chinese medicine understands sciatica

In Chinese medicine, sciatica is a type of Bi syndrome, an obstruction of Qi and Blood, that follows a channel down the leg. Where the pain runs matters. Pain down the back of the thigh and calf follows the Bladder channel. Pain down the outside of the leg follows the Gallbladder channel. Points are chosen along the channel that hurts, as well as in the low back and buttock, where the problem usually starts.

The common patterns are:

• Qi and Blood stagnation. Sharp, shooting or stabbing pain, often after lifting or a disc injury, that is worse with sitting and at night. Treatment focuses on moving circulation along the channel.
• Cold and Damp. Heavy, aching pain with numbness, worse in cold, damp weather and better with warmth. Treatment warms and clears the channel.
• Damp-Heat. Burning pain, sometimes with a feeling of heat along the leg. Treatment clears heat rather than adding warmth.
• Kidney and Liver deficiency. Sciatica that keeps coming back over years, with a weak low back and knees. In Chinese medicine the Kidneys support the bones and the Liver the tendons, so treatment also builds you up.

Two people with the same MRI can fit different patterns, which is why their treatment can look different.

This page is about pain that travels down the leg. If your pain stays mostly in your back, see the back pain page.

What treatment involves

Your first visit at the clinic in Keswick starts with questions: exactly where the pain runs, which positions ease it, whether you have numbness or weakness, and what your doctor has told you about the cause. I look at your tongue and take your pulse. It also helps to map where on the leg you feel numbness or tingling, so any change can be tracked.

Acupuncture is usually the main treatment. Needles go into points in the low back and buttock and along the affected channel down the leg. I treat the whole body at every treatment, not only the area that hurts. Acupuncture needles are very fine, typically 0.14 to 0.30 mm. The aim is to ease leg pain and relax the muscles around the low back and hip that tighten to protect the nerve.

Depending on the diagnosis, treatment may also include moxibustion to add warmth for a Cold and Damp pattern, cupping or tuina massage to loosen the low back and buttock muscles, or Chinese herbal medicine: a formula written for your pattern.

Nerve pain often changes more slowly than muscle pain. Plan on 5–10 treatments to judge progress. If your leg becomes weaker at any point, see your doctor.

Between visits

• Limit long sitting. Sitting often aggravates sciatica. Get up every 20 to 30 minutes, and avoid low, soft couches.
• Walk if you can. Short, gentle walks on flat ground are usually better than lying down all day.
• Don’t stretch into sharp pain. Stretches that pull hard on the back of the leg can flare an irritated nerve. Keep stretches gentle.
• Find an easier sleeping position. Lie on your side with a pillow between your knees, or on your back with a pillow under them.
• Keep up your exercises. If a physiotherapist gave you a program, keep doing it and mention it at your visit.

When to see your doctor first

See your doctor before starting treatment, or promptly if you are already coming in, if:

• You have numbness in the groin, buttocks or inner thighs, or new trouble controlling your bladder or bowels. Go to emergency.
• You have sciatica in both legs at once.
• Weakness in your leg or foot is getting worse, or your foot catches or drags when you walk.
• The pain started after a fall, car accident or other injury.
• You have a fever, unexplained weight loss, or a history of cancer.
• The pain keeps getting worse over several weeks instead of settling.