This article gives shows a standard TCM treatment for sciatica as evidenced by one research trial carried out in China titled – ‘The Warming Acupuncture for Treatment of Sciatica in 30 Cases‘, by Chen et al, and published in the Journal of Chinese Medicine, 2009.
I will begin with the summary of the treatment protocol. Followed by a look at the details of the research study.
What is sciatica?
Sciatica is a type of pain which occurs in the bottom, back of legs, feet and toes. It can be a stabbing, burning or shooting pain. Or a tingling like pins and needles, numbness or weakness. It occurs when the sciatic nerve is irritated.
The sciatic nerve is a large nerve which branches off from the spinal column at L5/S1-S3, travels down the back of the leg, down the side of the calf and to the feet. The sciatic nerve can be caused by problems with the spinal column, or disc protrusions.
The NHS states that most people with sciatica usually recover within 6 weeks. However, this can be longer in reality.
Acupuncture for Sciatica – Treatment Protocol
Acupuncture can be helpful in treating sciatica.
Before I provide the treatment protocol according to this study. It is important to state that one of the selection criteria for this trial was that the patients needed to have a TCM diagnosis of Cold-Damp and/or Kidney Deficiency.
Disclaimer – What this means is that this specific treatment (warming needle) protocol is suitable for patients with the Cold-Damp/Kidney Deficiency TCM diagnosis. It may not be suitable for all cases of sciatica.
It is up to the individual practitioner to assess according to their system of acupuncture. If in doubt, the points are as standard for a sciatica type treatment, but it may be prudent to omit the moxa.
Here is a standard TCM treatment for sciatica as carried out in one trial at the Hunan TCM Training College in Zhuzhou, China:
Bladder 23 (bilateral)
Bladder 25 (bilateral)
Bladder 40 (on the affected side)
Bladder 60 (on the affected side)
Needle size: – 0.30mm in diameter, 60-75mm in length
Moxa: – 3-5 moxa cones each on the needle handles.
Treatment Course: – One Course = acupuncture treatment once a day for 10 days. Then Three day rest before next course commences.
(My comment – this research was carried out in a Chinese TCM hospital where daily acupuncture treatments are commonplace. In this West, this frequency is unlikely. Usually treatment is once or twice a week at best).
The Warming Acupuncture for Treatment of Sciatica in 30 Cases
Next, I will give some basic details of this Chinese trial, which tested TCM warm-needle acupuncture for sciatica:
90 participants were selected from the inpatients and outpatients attending the First of Affiliated Hospital of the Hunan TCM Professional Training College . They were randomly assigned to three groups. One group (22 male, 8 females) to receive a warming-acupuncture treatment. One group (12 male, 9 females) to receive a drug – Nimesulide (non-steroid, antipyretic, analgesic and anti-inflammatory) tablets, and one group (20 males, 10 females) to receive a “point-injection” with Anisodamine (an anticholinergic). Age range seemed to be around 30-40 years. The disease duration seemed to be 5 years (nb. I am unclear from this study on the actual disease duration).
Symptom Diagnosis criteria was:
- Radiating pain the distributing area of the sciatic nerve
- Tenderness at the nerve stem, the middle clunial nerve, popliteal fossa, peroneal nerve and ankle.
- Tested positive according Lasegue’s sign, Kernig sign and Bonnet sign.
- Abnormal movement, sensation and reflection shown in area innervated by sciatic nerve, and achilles jerks were reduced or vanished.
- Narrowing of intervertebral space L4-5
- Pain threshold of 0.40-1.80MA
- TCM diagnosis of Cold-Damp and/or Kidney Deficiency
Excluded: – Patients with lumber disc prolapse, tumour or bone tuberculosis
Curiously one of the control groups was to have a drug – anisodamine (2mg) to be injected into the same points as the warm needle acupuncture group on the same treatment schedule.
Warming Acupuncture for Sciatica Treatment
Acupuncture was performed with filiform needles (0.30mm in diameter and 60-75mm in length) at the routinely sterilised points of Shenshu (Bladder 23), Dachanshu (Bladder 25), Huantiao (Gallbladder 30), Weizhong (Bladder 40) and Kunlun (Bladder 60) on the affected side.
The uniform reinforcing-reducing manipulation was given to induce the needling sensation. 5 minutes later, 3-5 moxa cones were successively ignited on the needle handles.
The treatment was given once a day for 10 days as one therapeutic course with a 3 day interval between courses.
Results were judged according to pain scores and a final result classified as either:
- “Cured” – All symptoms disappeared, with no relapse in a one year follow-up period, and with a specific pain threshold score.
- “Improved” – Symptoms “obviously” improved, specific pain threshold scores.
- “Failed” – no improvement, and no improvement in pain scores.
Results – TCM Warming Acupuncture for Sciatica
In the needle-warming acupuncture group (30 people) – 17 cases were classed as “cured”. 10 cases “improved” and 3 cases “failed”. Effective rate of “90%”.
In the Western drug group (30 people) – 8 cases were “cured”. 14 cases “improved” 8 cases “Failed”. Effective rate of “73.33%
In the Point Injection group (30 patients) – 6 cases were “Cured”, 13 cases were “improved” and 11 cases “failed” An effective rate of 63.33%
A clear win for natural acupuncture.
Scrutiny of Chinese research studies
There have been some criticism of Chinese research papers in the past by Western scientists, as they tend to show overly positive outcome measures for the therapeutic measure that are testing.
Arguably, I would say the same accusation, could be applied to Western scientists carrying out their testing for pharmaceutical drugs and other substances representing large business interests – but that is an argument for another day.
I am also unclear as to why Anisodamine (an anticholinergic), was injected into the “point-injection” control group. This is a drug that is typical used for acute circulatory shock or septic shock in China. It is not usually indicated for muscular or sciatica pain. Which suggests this control group was more closer to be another acupuncture alternative more so than a pharmaceutical control group.
Regardless, in this study, one of things that come to mind for me is non-existant drop-out rate of any of the participants. That is quite unusual. In any trial, there will usually be at least one or two patients who drop out for various reasons – adverse reactions, accidents, even death. Here there is none of that.
Some will say that this is because the Chinese are diligent, disciplined and committed. Perhaps… but they are also human.
Additionally, the significantly high ratio of people “cured” in the acupuncture group should probably raise some eyebrows. It’s actually quite difficult to achieve a clearcut result like this in research studies.
Also, this score seems quite high considering there is the additional criteria of needing to be symptom free after a 1 year follow up in order to be classed as “Cured”.
It is not clear whether this requirement applied to the “Improved” or “Failed” groups. And if this particular criteria was not met, did it mean patients would be downgraded?
Perhaps you think these points I raise are just signs of me being sceptical, disbelieving or even arrogant? I’ll leave it for you to judge.
Regardless, the most important and valuable thing about this research study, is that it simply shows us a useful protocol for treating sciatica with acupuncture using warm needle technique – which is what the Chinese do best.
- The Warming Acupuncture for Treatment of Sciatica in 30 Cases, by Chen et al. The Journal of Chinese Medicine, March 2009. Vol 29. No 1.
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