Pain in the Butt? Acupuncture for Sciatica

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Acupuncture has been well documented for its effectiveness in helping relieve and manage both acute and chronic pain. Over the 28-year history of SFNM, I have treated many people experiencing pain and have been impressed with the results I have seen. In particular, I have been impressed by the relief it has brought to many people suffering from sciatica.

What Is Sciatica?

Sciatica is a condition characterized by pain that radiates from the low back or buttock region down the thigh, leg and possibly your foot. It may travel down the back, outside or inside of the leg and is most often one-sided, though on rare occasions it may be in both legs. In addition to pain, sciatica may cause symptoms of weakness, numbness and tingling, and loss of sensation. The pain of sciatica can range from mild and occasional to severe and constant.

Most of the time, sciatica is caused by compression of the nerve roots that exit the spine in the low back or sacral areas. This can be due to a herniated/ruptured disc in the low back, compressed intervertebral discs, narrowing of the space where the spinal nerve exits the spine, tension in a deep buttock muscle called the piriformis, and rarely local tumors.

It has been estimated that up to 40% of people experience sciatica at some time during their lives, most commonly in people in their 40’s or 50’s, and more commonly in men than women.

It can often be diagnosed in a clinical setting with simple orthopedic tests. One of the most common tests done is the straight leg raise which stretches the sciatica nerve, causing symptom aggravation. Imaging including X Rays, MRIs or CT scans can be used to confirm the diagnosis and the causes that give rise to sciatica.

The most common treatments are pain medications and time. Most cases of sciatica resolve within six weeks or so. Pain medications and NSAIDS help manage symptoms depending on its severity and resulting disabilities. Many people prefer to avoid high doses of pain medications due to side effects and other issues, especially with long-term use. Thus many turn to acupuncture to help relieve pain and resolve the underlying condition. In severe or obstinate cases, some people get surgery to relieve their sciatica and repair the underlying problem.

What Does Science Say?

There have been many studies of acupuncture treatment of sciatica, and I will cite a few of the most reliable and recent ones below.

In The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis, the authors did a comprehensive review of 12 studies involving 1842 participants on acupuncture’s effectiveness for sciatica as measured by those who improved totally or partly. Results showed that acupuncture was more effective than conventional Western medicine.

Another 2015 study by researchers at the Rizhao Hospital of TCM and the Shanghai University of TCM investigated the effectiveness of acupuncture and herbal medicine for the treatment of sciatica. Both were found to be effective treatments, producing significant improvement in patient outcomes. As a standalone therapy, acupuncture had a total effective rate of 81.6% for pain relief and return-to-normal function. When herbal medicine was added, the effectiveness increased to 95%. Electroacupuncture, the gentle electrical stimulation of acupuncture needles, increased the effectiveness of this combined approach.

How We Treat Sciatica

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First I take a comprehensive history to determine causes and contributing factors. I then do a focused orthopedic physical exam to determine the nature of your pain and assess underlying causes. If imaging studies have been done, I review those to help guide specific treatment.

Most commonly I treat using acupuncture with electric stimulation and an individualized herb formula that addresses inflammation and supports local tissues involved. While treatment course may vary, I typically recommend treatment 2x/week for three weeks at which time I review progress and modify the treatment plan accordingly.

I have found this problem-focused approach to be very effective for most people suffering from sciatica, and it is complementary to other interventions that may be being used at the same time, including physical therapy, chiropractic, therapeutic bodywork and medications.

If you have sciatica, whether acute or chronic, and have questions about treatments, I offer 15-minute free consults to answer any questions you may have. You can contact SFNM at 415-643-6600 to schedule a consult or an appointment.

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Dr. Carl Hangee-Bauer is SFNM’s founder and Clinic Director. He has a general naturopathic medical practice and specializes in immune support for allergies, autoimmunity and cancer support, functional gastroenterology and pain management. He has over 30 years of clinical experience using individualized care and treatment plans to provide effective naturopathic based care.