Acupuncture and herbs relieve sciatica, a condition characterized by lower back pain radiating through the hips, buttocks, and legs. Researchers from the Rizhao Hospital of TCM (Traditional Chinese Medicine) and the Shanghai University of TCM investigated the efficacy of acupuncture for the relief of sciatic pain. Sciatics induces lower back and hip pain. Both acupuncture and acupuncture plus herbal medicine were effective and produced significant positive patient outcomes. In addition, the researchers document that acupuncture and herbs stimulate important biochemical changes causing pain reduction.

Acupuncture as a standalone therapy had a total effective rate of 81.6% for the relief of pain due to sciatica and restoration of normal function. Acupuncture combined with herbal medicine achieved a 95% total effective rate. As a result, the researchers conclude that the combined therapy approach is more effective than using only acupuncture as a standalone therapy for the treatment of sciatica.

Han et al. note that acupuncture increases serum β-EP, which reduces transmission of nerve pain signals. Sciatica is also characterized by increased levels of IL-1,IL-6, and TNF-α. Hand et al. note that acupuncture successfully downregulates these biochemicals thereby contributing to reductions of pain and inflammation. The research of Li et al. from the Rizhao Hospital of TCM and the Shanghai University of TCM confirms the findings of acupuncture’s ability to regulate β-EP, IL-1, IL-6, and TNF-α. Li et al. note that both acupuncture and acupuncture plus herbs regulate the sciatica related biochemical expression but the combination therapy of acupuncture plus herbs outperforms standalone acupuncture therapy.

The Oswestry Disability Index (ODI), the Japanese Orthopaedic Association (JOA) score, and the Visual Analogue Scale (VAS) were used to measure changes in pain levels, functions of daily activity, lifting, walking, sitting, standing, sleeping, socialization, travelling, and other aspects of life affected by sciatica. Measurements were taken prior to therapy and 3, 10, and 22 days after completion of acupuncture and herbal therapy protocols.

The primary acupuncture points used in the semi-protocolized acupuncture point prescription were:
Zhibian, BL54
Chengfu, BL36
Huantiao, GB30
Fengshi, GB31
Weizhong, BL40
Dachangshu, BL25
Chengshan, BL57
Yaoyangguan, DU3
Ashi

Additional acupuncture points were added for specific differential diagnoses. For qi stagnation and blood stasis, Xuehai (SP10) and Taichong (LV3) were added. For liver and kidney deficiency, Shenshu (BL23) and Taixi (KD3) were added. For cold and damp stasis, Yanglingquan (GB34) was added.

Mild reinforcing and reducing manual acupuncture techniques were applied with 0.30 x 40 mm acupuncture needles. Stimulation was applied until deqi was evoked at each acupoint. Total needle retention time for each acupuncture session was 15 to 30 minutes.

The herbal formula Tong Bi Zhi Tong Tang was ingested orally. The primary ingredients are:
Du Zhong, Eucommia ulmoides 15 g
Sang Ji Sheng, Chinese taxillus 15 g
Gou Ji, Rhizoma cibotii 15 g
Gui Zhi, Cassia 10 g
Hong Hua, Safflower 6 g
Dang Gui, Angelica 10 g
Chuan Xiong 15 g
Niu Xi, Cyathula officinalis 15 g
Wei Ling Xian, Clematis 15 g
Sheng Ma, Bugbane 10 g
Bai Zhi, Angelica dahurica 10 g
Tian Nan Xing, Rhizoma arisaematis 10 g
Zhi Gan Cao, Honey-fried licorice root 6 g

Additional herbs were added based on differential diagnostics. For cold and damp stasis, Chuan Wu (Radix aconiti preparata) 15 g and Xi Xin (Asarum sieboldii) 3 g were added. For qi and blood stasis, Ru Xiang (Boswellia carterii) 10 g and Mo Yao (Myrrh) 10 g were added. For qi deficiency, Huang Qi (Astragalus) 30 g was added. For liver and kidney deficiency, Shu Di Huang (Rehmannia glutinosa) 20 g and Shan Zhu Yu (Cornel) 10 g were added.

The clinical and objective tests results indicate significant reductions in pain, increases in functionality, and reductions in inflammatory responses for sciatica patients. Manual acupuncture, on its own, achieved an 81.6% total effective rate and, when combined with herbs, achieved a 95% total effective rate.

In a related study, Hoang et al. find electroacupuncture effective for sciatic nerve regeneration. In a laboratory experiment, electroacupuncture restored motor functions and enhanced recovery rates for injured sciatic nerves. The results demonstrate that electroacupuncture stimulates recuperation from "neuropathic pain that develops following a nerve injury."

Hoang et al. note that electroacupuncture promotes sensory and motor nerve fiber regeneration while shortening the duration of recovery times following nerve injuries. The researchers concluded that "electro-acupuncture appears to be a valuable method to accelerate motor recovery and alleviate neuropathic pain symptoms that occur after nerve crush." These findings are consistent with the Li et al. manual acupuncture results.

References:
Li, L., Li, N. J., Xin, D. M. & Zhao, L. (2014). Tongbi Zhitong Decotion Combined with Acupuncture Treatment on 60 Patients with Sciatica of Nerve Roots. Chinese Journal of Experimental Traditional Medical Formulae. 20(20).

Han, C., Sun, Z. R. & Yue, J. H. (2014). Efficacy of Acupuncture Treatment on Nerve Root Sciatica. Liaoning Journal of Traditional Chinese Medicine. 41(2): 324.

Hoang et al. BMC Complementary and Alternative Medicine 2012, 12:14. Electro-acupuncture on functional peripheral nerve regeneration in mice: a behavioural study. Ngoc Son Hoang, Chamroeun Sar1 Jean Valmier, Victor Sieso, and Frédérique Scamps.