By Dr. Zhisong Chen, O.M.D., Ph.D., L.Ac.
Sciatica refers to a set of pain symptoms along the path of the sciatic nerve, including the lower back, hip, and various parts of the posterior aspect of the thigh, the posterolateral leg, and the lateral foot. The primary cause is the compression of the sciatic nerve by spinal disc herniation. In addition, cauda equine tumor, spinal stenosis, lumbosacral nerve root inflammation, and pregnancy can also induce sciatica. Sciatica is more common in young adult laborers. Typically, symptoms only manifest on one side of the body. Sciatica can be divided into two types: root sciatica and trunk sciatica. The former is always with acute onset induced by putting forth strength, bending down, or vigorous activity. Pain always radiates from the lower back to one hip, posterior thigh, popliteal fossa, lateral leg, and foot. Pain is like burning and cutting and becomes worse when coughing, putting forth strength, and during the night. To avoid nerve tension and compression, patient always uses special position, for example, lying to the healthy side and curving the hip and knee joints when in sleep, standing on the healthy side. Gradually it causes scoliosis, which is mostly inclined to the healthy side. To avoid the nerve root being compressed, patient tends to be inclined to the healthy side when sitting. Trunk sciatica is always induced by cold or injury. Pain radiates from the buttock to the posterior thigh, posterolateral leg, and lateral foot. Pain becomes worse when walking, exercising, and sciatic nerve is dragged. To reduce the traction of the sciatic nerve trunk, scoliosis is to the affected side.
Sciatica belongs to the category of “arthralgia syndrome” in traditional Chinese medicine. Clinically along the history physicians treat it from the points of “wind, cold, and damp”, “obstinate arthralgia”, and “tendon arthralgia”. People living in cold and damp area can be invaded by inclement weather. The cold and damp pathogens can block channels and cause qi and blood stagnation, which brings about pain. Cold and damp both are yin pathogen. Cold tends to contract and damp is viscous, so patient feels the waist, thigh, and leg cramping and painful, difficult in extension and flexion, and numbness. Pain recurs repeatedly and is hard to cure. Cold and damp pathogens can further affect tendon and bone, leading to tendon spasm and joint pain. Blockage of qi and blood circulation can cause blood stasis, which manifests piercing pain in a fixed location. Clinically, the main principle in treating sciatica is to dispel wind and cold and remove damp. For patients with tendon and channel malnutrition and stagnation, it is necessary to nourish the kidney and liver, stimulate the circulation of the blood and cause the muscles and joints to relax. The main herbs include Aconite Root, Kusnezoff Monkshood Root, angelica dahurica, Rhizoma Atractylodis, Clematis chinensis, Eucommia ulmoides, Cyathula officinalis, Asarum sieboldii, Angelica sinensis, Caulis Spatholobi, Ligusticum chuanxiong, etc. Acupuncture points include Huantiao (GB30), Yibian (BL54), Yinmen (BL37), Weizhong (BL40), Weiyang (BL39), Yanglingquan (GB34), Zusanli (ST36), Shensu (BL23). These methods must be guided by professional practitioners.
Research shows that acupuncture is effective on sciatica. As early as in the 1980’s , it was reported that among 1471 cases of sciatica treated by acupuncture, including body acupuncture, electric acupuncture, moxibustion, catgut implantation at acupoint, high frequency impulse electrotherapy, and acupoint injection, 97.5% were effective and 57.1% were cured.
陈智松博士受到资深中医教育，传承中医精华，应用针灸、中药相互结合辩证治疗坐骨神经痛。欢迎咨询和就诊陈智松博士全科中医针灸诊所。地址：8818 Tuckerman Ln, Potomac, MD, 20854。电话：301-979-9040。Email: firstname.lastname@example.org。网站：www.chennmac.com。