Patients want to know whether acupuncture will work for their pain and if it will be more effective than pain medication. This is one aspect that was examined in the following review paper on the efficacy of acupuncture treatment for sciatica.
Ji, M., Wang, X., Chen, M., Shen, Y., Zhang, X., & Yang, J. (2015). The efficacy of acupuncture for the treatment of sciatica: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, p. 1-12. doi:10.1155/2015/192808
Retrieved from http://www.hindawi.com/journals/ecam/2015/192808/
This review searched for articles in eight English and Chinese databases.
Inclusion Criteria:
- Randomized or quasi-randomized clinical trials
- Diagnosis of sciatica, pain along the sciatic nerve distribution or tenderness at the nerve roots
- Comparison with Conventional Western Medicine (CWM)
- Oral drugs
- Topical drugs
- Injections
- Outcome measures of pain intensity or pain threshold
Exclusion Criteria:
- Studies of back pain without sciatica
- Studies that compared different acupuncture approaches rather than acupuncture versus CWM
- Studies that compared mixtures strategies and treatments
Out of 446 records, 12 papers met the inclusion criteria and represented 901 participants in the treatment groups and 941 in the control groups. All the papers were from the Chinese language databases.
Result Highlights:
Criteria for Improvement:
- All signs and symptoms gone with no relapse for six months, full resumption of work.
- Markedly improved. Signs and symptoms mostly cleared, some relapse, but able to do light work.
- Symptoms relieved pain always recurred.
The pooled data from nine of these studies indicated that there was a highly significant reduction in pain levels in the treatment groups (780 patients) versus the medication groups (771 patients). This did not vary with the type of medication being compared (steroid, non-steroidal anti-inflammatory, topical, etc.)
The review paper concludes that acupuncture is an effective method for treating sciatica, although more rigorous clinical trials should be performed.
Point Selection:
The treatment approach used to select points in all of the studies is based on Traditional Chinese Medicine Theory (TCM). TCM views sciatica as a “channel disorder” (dysfunction in the meridian) of the Gall Bladder (foot-Shaoyang) and Bladder (foot-Taiyang) meridians. Acupuncture points “removing channel obstruction and promoting qi and blood circulation” are indicated to treat the pain.
Points that were used in at least five of the studies are listed below along with their frequency of use in the studies. In addition, the common Anatomical Acupuncture indication for each point is included.
| Acupuncture Point | Number of Studies | Anatomical Acupuncture Indication for Points Used in Sciatica |
| BL 23* | 5 | Sympathetic Switch |
| BL 25* | 6 | L4 nerve root |
| BL 54 | 7 | Inferior Gluteal nerve, close to sciatic nerve |
| GB 30* | 12 | Sciatic nerve local point |
| BL 40* | 8 | Parasympathetic switch, along nerve distribution |
| GB 34* | 5 | Special sympathetic switch, along nerve distribution |
| BL 57* | 5 | Distal point in area of pain/along nerve distribution |
| BL 60* | 8 | Distal point in area of pain/along nerve distribution |
| GB 39 | 6 | Distal point in area of pain/along nerve distribution |
*Acupuncture points taught in Foundations of Anatomical Acupuncture (AA1) Course
Note that all nine points are taught by Acupuncture Canada in our Core Program. Acupuncture Canada teaches the anatomical indications for the points and the guidelines for treating pain according to autonomic nervous system theory and the relevant anatomy and neurophysiology of the condition being treated. Our students would be able to successfully treat sciatic pain using the majority of the points listed in the chart above after completing the first course in the Core Program.
Irene Biemann, BSc.PT, PT, RAc, CAFCI
