What is Sciatica?
In its simplest definition Sciatica refers to pain along the course of the sciatic nerve. The sciatic nerve is the longest nerve in the body and arises from the lower spine. If part of the nerve becomes irritated then symptoms of pain, numbness, tingling and even muscle weakness can occur along its pathway. As this nerve travels from the low back, through the buttock and hip and down the leg, pain can be felt across this whole area. Sometimes though there can be little or no back pain and just pain in the leg.
The most common cause of sciatica is a disc problem, usually at the lower two levels of the lumbar spine. These spinal segments are commonly called L4 and L5 and take the largest load in the spine. These segments are very mobile making them vulnerable to degenerative changes and injury. L4 and L5 are prone to injury from high impact sports as well as repetitive activities and poor lifting technique. Being overweight also increases the risk of sciatica, as does prolonged sitting as sitting puts the most load on this area compared to either standing or lying down .
Treatment for Sciatica
Mild cases may resolve without treatment over a couple of days. Often sciatica can last for 6 to 12 weeks and sometimes longer. In the past bed rest was advised, but today it is understood that in most cases keeping mobile leads to better results (1). Persistent or severe pain can be treated with a range of measures which may include painkillers, anti-inflammatory herbs or medications, manual therapy, exercises and acupuncture. Steroid injections and even surgery are options in more difficult cases (1-3).
Acupuncture Twice as Effective as Standard Treatment
A recent study a found that acupuncture was twice as effective as standard care for sciatica, and more effective than pain killers, manual therapy or exercise therapy on their own (4). This means that acupuncture should be considered as a core component of the management of sciatica for most people. Even with the best care it takes time for sciatica to resolve. During this time attention should be paid to risk factors such as repetitive activities, poor posture and prolonged sitting. Core stability exercises provide better support for the vulnerable lumbar spine and should also be incorporated.
Sciatica can really interrupt work and play, but there are many effective strategies to assist recovery, and acupuncture is one of them (4, 5). There is much more to effective acupuncture than putting a needle in a sore spot, so it is important that acupuncture treatment is performed by a Registered Acupuncturist. Our Registered Acupuncturists draw on a range of acupuncture techniques and related therapies depending on the individual needs of the client and their progress. You can check if your Acupuncturist is registered by searching the register at http://www.chinesemedicineboard.gov.au
(1) SA Health. Managing Sciatica. http://www.sahealth.sa.gov.au/wps/wcm/connect/07edec8049e4dbbfb409fe3a89b74631/ManagingSciatica-RAH-AlliedHealth-120123.pdf?MOD=AJPERES&CACHEID=07edec8049e4dbbfb409fe3a89b74631
(2) Gugliotta, M., da Costa, B. R., Dabis, E., Theiler, R., Jüni, P., Reichenbach, S., … Hasler, P. (2016). Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open, 6(12), e012938. http://doi.org/10.1136/bmjopen-2016-012938
(3) Lewis R WN, Matar HE, et al. The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model. Health Technology Assessment, No 1539. Southampton (UK): NIHR Journals Library; 2011
(4) Lewis RA, Williams NH, Sutton AJ, Burton K, Din NU, Matar HE, et al. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. The spine journal : official journal of the North American Spine Society. 2015 Jun 1;15(6):1461-77.
(5) Huang Z, Liu S, Zhou J, Yao Q, Liu Z. Efficacy and Safety of Acupuncture for Chronic Discogenic Sciatica, a Randomized Controlled Sham Acupuncture Trial. Pain Med. 2019 Nov 1;20(11):2303-2310. doi: 10.1093/pm/pnz167. PMID: 31369674.