Sciatica refers to pain, numbness or tingling from irritation of the sciatic nerve which is typically felt in the buttocks, hip and down the back or lateral side of the leg.
Symptoms of Sciatica vary considerably from patient to patient, in part due to the distribution of the sciatic nerve and its various pathways. Common symptoms, however include lower back pain, hip pain, burning or tingling down the leg, a constant pain on one side of the buttock, shooting pain in the buttock or leg which makes it difficult to stand up and is worst for sitting and pain and /or difficulty moving the leg or foot. Sciatic pain typically radiates from the lower back and buttock into the thigh, and depending on the location of nerve irritation, down the posterior, lateral or medial aspect of the lower leg. Commonly the condition affects one leg however it can be both. Pain can be sharp, dull, shooting and coincide with weakness, and numbness. https://www.webmd.com/back-pain/guide/sciatica-symptoms. Patient feedback is often that it affects their quality of sleep, their ability to do everyday tasks like vacuuming and picking up their kids or grandkids. Driving in particular, is often a key factor in exacerbating the condition, thus for many Australians who drive to and from work every day, heavily impacting an individual’s quality of life.
Sciatica is primarily diagnosed through physical examination and history taking. Signs and symptoms make up a large part of history taking as the dermatomal region of pain is a good indicator of sciatic distribution. Assessing the patients level of activity can help to distinguish if the pain is from piriformis syndrome which is more likely the case in athletes or true sciatica. from According to an article by B W Koes, MW van Turlder and W C Peul, physical examination of sciatica weigh heavily on neurological testing, with the Straight leg raise or Lasegues sign being the most common physical assessment of nerve impingement. In chronic cases, imaging may be used to identify whether the presence of a herniated disk with nerve compression is present. Such findings must correlate with typical symptoms of sciatica as there is a high prevalence of people (20- 36%) who have disk herniation without sciatica.
Modern Medicine and Sciatica
Modern medicine for sciatica usually involves a combination of medication alongside activity modification. Medications usually involve nonsteroidal anti-inflammatory drugs, muscle relaxants, analgesic for pain relief and in severe cases nerve blocks. The GP will often recommend avoiding activities which aggravate the condition such as long stints in the car or over activity which puts too much strain on the lower back.
When other treatments have been ineffective, surgery may be recommended as a last resort due to potential side effects from scar tissue post-surgery. Surgery to assist sciatic symptoms is typically due to a ruptured or slipped disk and is called a partial discectomy. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sciatica
Chinese Medicine for Sciatica
Chinese medicine views pain conditions like sciatica as blood stagnation in the local area as well as looking at the dermatomal distribution from a traditional Chinese medicine perspective. It aims to relax the deepest muscles of the lower back, spine and buttocks in order to release pressure on the sciatic nerve, accessing deepest muscles surrounding the nerves and vertebra which makes it a unique modality.
Acupuncture for Sciatica Research
There have been many studies and reviews on the effectiveness of Acupuncture in treating sciatica. Below is a couple of these.
In one clinical trial patients were divided into three treatment groups. The outcome was an increase in sciatic nerve blood flow of 56.9 % in with lumbar muscle acupuncture, 100 % in both pudendal nerve stimulation and sciatic nerve stimulation with sciatic nerve stimulation sustaining the increase in blood flow for a longer duration. In addition to influencing the pain inhibitory system, electrical acupuncture participates in a transient change in sciatic nerve blood flow.
Acupuncture treatment for low back pain and lower limb symptoms- The relationship between acupuncture or electroacupuncture stimulation and sciatic nerve blood flow.
Motohiro Inoue, Hiroshi Kitakoji, Tadashi Yano, Naoto Ishizaki, Megumi Itoi and Yasukazu Katsumi.
In 2015 A Systematic Review and meta-Analysis on the Effectiveness of Acupuncture for Treating Sciatica was conducted by Zongshi Qin, Xiaoxu Liu, […], and Zhishun Liu. The aim was to access current evidence on the effects of acupuncture for treating sciatica. A total of 11 randomized controlled trials were included which fit credible criteria. The results concluded that “acupuncture may be more effective than drugs and may enhance the effect of drugs for patients with sciatica.”
Zongshi Qin, Xiaoxu Liu, […], and Zhishun Liu.
What’s involved in an Acupuncture Session for Sciatica?
During an initial acupuncture session, your practitioner will go through a thorough medical history, as well as checking the tongue and pulse to ascertain a Chinese medical diagnosis. Once this has been established your practitioner will use fine, disposable and sterilised needles to access specific points throughout the body. With pain conditions like Sciatica and lower back pain, local points at and around the area may be used as well as distal points found on the upper and lower limbs depending on the diagnosis. For such muscular skeletal conditions, additional modalities within the umbrella of Chinese medicine may be included to add enhance the treatment. These may include, cupping, moxa and gua sha.
Typically used on the back, cupping uses glass cups to create a vacuum over the skin, designed to release muscle tightness, toxins and congestion to assist aches and pains associated with muscular imbalance, viruses and the flu.
Acupuncture can be very relaxing and calming on the nervous system, many patients finding they fall asleep or deep relaxation during a treatment.
Claiming Acupuncture for Sciatica on Health Funds
Acupuncture treatments with all our practitioners are claimable with all major health funds. Check with your health fund to make sure your level of cover also covers acupuncture treatments. The refund you can claim is dependant on the type and level of cover you have. A quick call to your health insurance provider will give you the answer.