Back Clinic Sciatica Chiropractic Team. Dr. Alex Jimenez organized a variety of article archives associated with sciatica, a common and frequently reported series of symptoms affecting a majority of the population. Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or burning sensation. In some cases, the pain is severe enough to make a person unable to move. The pain most often occurs on one side.
Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower back and runs down the back of each leg as it controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot. Dr. Jimenez explains how sciatica and its symptoms can be relieved through the use of chiropractic treatment. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
For individuals experiencing or managing low back pain and/or sciatica, can lumbar traction therapy help provide consistent relief?
Lumbar Traction
Lumbar traction therapy for lower back pain and sciatica could be a treatment option to help restore mobility and flexibility and safely support an individual’s return to an optimal level of activity. It is often combined with targeted therapeutic exercise. (Yu-Hsuan Cheng, et al., 2020) The technique stretches the space between the vertebrae in the lower spine, relieving lower back pain.
Lumbar or low back traction helps to separate the spaces between the vertebrae.
Separating the bones restores circulation and helps relieve the pressure on pinched nerves like the sciatic nerve, decreasing pain and improving mobility.
Research
Researchers say lumbar traction with exercise did not improve individual outcomes compared to physical therapy exercises on their own (Anne Thackeray et al., 2016). The study examined 120 participants with back pain and nerve root impingement who were randomly selected to undergo lumbar traction with exercises or simple exercises for pain. Extension-based exercises focused on bending the spine backward. This movement is considered effective for individuals with back pain and pinched nerves. The results indicated that adding lumbar traction to physical therapy exercises did not offer significant benefits over extension-based exercise alone for back pain. (Anne Thackeray et al., 2016)
A 2022 study found that lumbar traction is helpful for individuals with lower back pain. The study investigated two different lumbar traction techniques and found that variable-force lumbar traction and high-force lumbar traction helped to relieve lower back pain. High-force lumbar traction was also found to reduce functional disability. (Zahra Masood et al., 2022) Another study found lumbar traction improves the range of motion in the straight leg raise test. The study examined different forces of traction on herniated discs. All the levels improved the individuals’ range of motion, but the one-half body-weight traction setting was associated with the most significant pain relief. (Anita Kumari et al., 2021)
Treatment
For individuals with only low back pain, exercise, and postural correction may be all that is needed to provide relief. Research confirms physical therapy exercises can help decrease pain and improve mobility (Anita Slomski 2020). Another study revealed the importance of centralizing sciatic symptoms during repetitive movements. Centralization is moving the pain back to the spine, which is a positive sign that the nerves and discs are healing and occurs during therapeutic exercise. (Hanne B. Albert et al., 2012) A chiropractor and physical therapy team can educate patients on preventing back pain episodes. Chiropractors and physical therapists are body movement experts who can show which exercises are best for your condition. Starting an exercise program that centralizes symptoms can help individuals return to their normal lifestyle quickly and safely. Consult a healthcare provider before starting any exercise program for back pain.
Movement Medicine: Chiropractic
References
Cheng, Y. H., Hsu, C. Y., & Lin, Y. N. (2020). The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis. Clinical rehabilitation, 34(1), 13–22. doi.org/10.1177/0269215519872528
Thackeray, A., Fritz, J. M., Childs, J. D., & Brennan, G. P. (2016). The Effectiveness of Mechanical Traction Among Subgroups of Patients With Low Back Pain and Leg Pain: A Randomized Trial. The Journal of orthopaedic and sports physical therapy, 46(3), 144–154. doi.org/10.2519/jospt.2016.6238
Masood, Z., Khan, A. A., Ayyub, A., & Shakeel, R. (2022). Effect of lumbar traction on discogenic low back pain using variable forces. JPMA. The Journal of the Pakistan Medical Association, 72(3), 483–486. doi.org/10.47391/JPMA.453
Kumari, A., Quddus, N., Meena, P. R., Alghadir, A. H., & Khan, M. (2021). Effects of One-Fifth, One-Third, and One-Half of the Bodyweight Lumbar Traction on the Straight Leg Raise Test and Pain in Prolapsed Intervertebral Disc Patients: A Randomized Controlled Trial. BioMed research international, 2021, 2561502. doi.org/10.1155/2021/2561502
Slomski A. (2020). Early Physical Therapy Relieves Sciatica Disability and Pain. JAMA, 324(24), 2476. doi.org/10.1001/jama.2020.24673
Albert, H. B., Hauge, E., & Manniche, C. (2012). Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions?. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 21(4), 630–636. doi.org/10.1007/s00586-011-2018-9
Can non-surgical treatments like acupuncture and spinal decompression provide relief to individuals dealing with sciatica?
Introduction
When many individuals start to feel pain running down their legs after a long day of activities, it causes them to have limited mobility and difficulty finding a place to rest. Many people think that they are just dealing with leg pain, but it can be more of an issue as they realize that it’s not just the leg pain they are experiencing but it is sciatica. While this long nerve comes from the lower back and travels down to the legs, it can succumb to pain and discomfort when herniated discs or muscles compress and aggravate the nerve. When this happens, it can impact a person’s mobility and quality of life, thus causing them to seek out treatment to reduce the pain from sciatica. Fortunately, alternative therapies like acupuncture and spinal decompression have been utilized to not only minimize sciatic pain but also provide positive, beneficial results. Today’s article looks at sciatica, how spinal decompression and acupuncture can relieve sciatica, and how integrating these two non-surgical treatments can lead to beneficial results. We talk with certified medical providers who consolidate our patients’ information to assess how sciatica can significantly impact a person’s well-being and quality of life. We also inform and guide patients on how integrating acupuncture therapy and spinal decompression can positively reduce sciatica. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating non-surgical treatments into a wellness routine to relieve sciatica and its referred symptoms. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Understanding Sciatica
Do you often experience numbness or tingling sensations from your lower back to your legs? Do you feel like your gait is feeling off balance? Or have you stretched your legs after being seated for a while, which provides temporary relief? While the sciatic nerve plays a pivotal role in motor function in the legs, when various factors, such as herniated discs and even pregnancy, start to aggravate the nerve, it can cause pain. Sciatica is a deliberating pain condition often mislabeled as low back pain or radicular leg pain due to these two musculoskeletal conditions. These are comorbidities and can be exacerbated by simple twists and turns. (Davis et al., 2024)
Additionally, when many individuals are doing repetitive motions or dealing with degenerative changes in the spine, the spinal discs are more prone to herniation. They may press on the spinal nerves, causing the neuron signals to invoke pain and discomfort in the lower extremities. (Zhou et al., 2021) At the same time, sciatica can be both spinal and extra-spinal sources in the lumbar spinal region, which causes many individuals to be in constant pain and looking for relief. (Siddiq et al., 2020) When sciatica pain starts to affect a person’s lower extremities, causing mobility issues, many people seek treatments to reduce the pain-like effects of sciatica.
The Science of Motion-Video
Acupuncture For Reducing Sciatica Pain
When it comes to treating sciatica, many people can look into non-surgical treatments due to its affordability and effectiveness in reducing sciatica and its associated pain-like symptoms. Non-surgical treatments can be customized to the individual’s pain and be combined to restore a person’s quality of life. Two non-surgical treatments that can help reduce sciatica are acupuncture and spinal decompression. Acupuncture has a long history of providing significant positive effects on lowering sciatic pain and improving a person’s quality of life. (Yuan et al., 2020) Highly trained professionals from China use acupuncture and incorporate small solid needles to provide instant relief from sciatica’s associated symptoms. This is because acupuncture exerts analgesic effects by regulating microglia activation, inhibiting the body’s natural inflammatory response, and modulating receptors along the pain pathway in the nervous system. (Zhang et al., 2023) To this point, acupuncture can stimulate the body’s acupoints to restore balance.
The Effects Of Acupuncture
One of the effects of acupuncture for relieving sciatica is that it can reduce pain intensity by changing the brain’s activity patterns when the pain receptors are disrupted. (Yu et al., 2022) Additionally, when acupuncturists start to stimulate the nerves in the muscles and tissues, they release endorphins and other neurohumoral factors that help change the pain process in the nervous system. Acupuncture helps reduce inflammation while improving muscle stiffness and joint mobility through increasing microcirculation to reduce swelling while blocking sciatica pain from affecting the lower extremities.
Spinal Decompression For Relieving Sciatica Pain
Another form of non-surgical treatment is spinal decompression, and it can help reduce the effects of sciatica and its associated pain symptoms. Spinal decompression utilizes a traction table to gently stretch the spine to create a negative pressure within the spinal disc and free up the affected nerves. For sciatica individuals, this non-surgical treatment relieves the sciatic nerve as spinal decompression helps reduce the pain intensity and improve mobility function in the lower extremities. (Choi et al., 2022) The main objective of spinal decompression is to create space within the spinal canal and neural structures to release the aggravated sciatic nerve from causing more pain. (Burkhard et al., 2022)
The Effects Of Spinal Decompression
Many individuals can begin to feel relief from incorporating spinal decompression in their wellness treatment. This non-surgical treatment promotes fluids and nutrients to the spinal disc to kick-start the body’s natural healing process. When the spine is being gently stretched, there is less pressure on the sciatic nerves, which can alleviate the pain and improve mobility. Additionally, many individuals will feel their flexibility and mobility back in their lumbar region.
Integrating Acupuncture and Spinal Decompression For Relief
So, when many people start to integrate spinal decompression and acupuncture as a holistic and non-surgical approach for relieving sciatica, the results and benefits are positive. While spinal decompression targets the mechanical healing of the spinal disc and reducing nerve pressure, acupuncture focuses on relieving the pain and reducing inflammation at a systemic level. This enhances the body’s natural healing process and offers a synergistic effect to improve treatment outcomes. Non-surgical treatments like acupuncture and spinal decompression can provide a hopeful outcome for many individuals seeking relief from their sciatic pain without resorting to surgical procedures. These treatments allow the individual to regain their mobility in their lower extremities, reduce pain, and improve their quality of life by making people more mindful of their bodies and reducing the chances of sciatica from returning. By doing so, many individuals can live a healthier and pain-free lifestyle.
References
Burkhard, M. D., Farshad, M., Suter, D., Cornaz, F., Leoty, L., Furnstahl, P., & Spirig, J. M. (2022). Spinal decompression with patient-specific guides. Spine J, 22(7), 1160-1168. doi.org/10.1016/j.spinee.2022.01.002
Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P. B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 6343837. doi.org/10.1155/2022/6343837
Siddiq, M. A. B., Clegg, D., Hasan, S. A., & Rasker, J. J. (2020). Extra-spinal sciatica and sciatica mimics: a scoping review. Korean J Pain, 33(4), 305-317. doi.org/10.3344/kjp.2020.33.4.305
Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., . . . Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ Open, 12(5), e054566. doi.org/10.1136/bmjopen-2021-054566
Yuan, S., Huang, C., Xu, Y., Chen, D., & Chen, L. (2020). Acupuncture for lumbar disc herniation: Protocol for a systematic review and meta-analysis. Medicine (Baltimore), 99(9), e19117. doi.org/10.1097/MD.0000000000019117
Zhang, Z., Hu, T., Huang, P., Yang, M., Huang, Z., Xia, Y., Zhang, X., Zhang, X., & Ni, G. (2023). The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Front Neurosci, 17, 1097830. doi.org/10.3389/fnins.2023.1097830
Zhou, J., Mi, J., Peng, Y., Han, H., & Liu, Z. (2021). Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study. Front Endocrinol (Lausanne), 12, 740200. doi.org/10.3389/fendo.2021.740200
Individuals experiencing shooting, aching pain in the lower extremities, and intermittent leg pain could be suffering from neurogenic claudication. Can knowing the symptoms help healthcare providers develop an effective treatment plan?
Neurogenic Claudication
Neurogenic claudication occurs when spinal nerves become compressed in the lumbar or lower spine, causing intermittent leg pain. Compressed nerves in the lumbar spine can cause leg pain and cramps. The pain usually worsens with specific movements or activities like sitting, standing, or bending backward. It is also known as pseudo-claudication when the space within the lumbar spine narrows. A condition known as lumbar spinal stenosis. However, neurogenic claudication is a syndrome or group of symptoms caused by a pinched spinal nerve, while spinal stenosis describes the narrowing of the spinal passages.
Symptoms
Neurogenic claudication symptoms can include:
Leg cramping.
Numbness, tingling, or burning sensations.
Leg fatigue and weakness.
A sensation of heaviness in the leg/s.
Sharp, shooting, or aching pain extending into the lower extremities, often in both legs.
There may also be pain in the lower back or buttocks.
Neurogenic claudication is different from other types of leg pain, as the pain alternates – ceasing and beginning randomly and worsens with specific movements or activities. Standing, walking, descending stairs, or flexing backward can trigger pain, while sitting, climbing stairs, or leaning forward tends to relieve pain. However, every case is different. Over time, neurogenic claudication can affect mobility as individuals try to avoid activities that cause pain, including exercise, lifting objects, and prolonged walking. In severe cases, neurogenic claudication can make sleeping difficult.
Neurogenic claudication and sciatica are not the same. Neurogenic claudication involves nerve compression in the central canal of the lumbar spine, causing pain in both legs. Sciatica involves compression of nerve roots exiting from the sides of the lumbar spine, causing pain in one leg. (Carlo Ammendolia, 2014)
Causes
With neurogenic claudication, compressed spinal nerves are the underlying cause of the leg pain. In many cases, lumber spinal stenosis – LSS is the cause of pinched nerve. There are two types of lumbar spinal stenosis.
Central stenosis is the main cause of neurogenic claudication. With this type, the central canal of the lumbar spine, which houses the spinal cord, narrows, causing pain in both legs.
Lumbar spinal stenosis can be acquired and develop later in life due to spine deterioration.
Congenital means the individual is born with the condition.
Both can lead to neurogenic claudication in different ways.
Foramen stenosis is another type of lumbar spinal stenosis that causes the narrowing of spaces on either side of the lumbar spine where nerve roots branch off the spinal cord. The associated pain is different in that it is either in the right or left leg.
The pain corresponds to the side of the spinal cord where the nerves are being pinched.
Acquired Lumbar Spinal Stenosis
Lumbar spinal stenosis is usually acquired due to the degeneration of the lumbar spine and tends to affect older adults. The causes of the narrowing can include:
Spinal trauma, such as from a vehicle collision, work, or sports injury.
Disc herniation.
Spinal osteoporosis – wear-and-tear arthritis.
Ankylosing spondylitis – a type of inflammatory arthritis that affects the spine.
Osteophytes – bone spurs.
Spinal tumors – non-cancerous and cancerous tumors.
Congenital Lumbar Spinal Stenosis
Congenital lumbar spinal stenosis means an individual is born with abnormalities of the spine that may not be apparent at birth. Because the space within the spinal canal is already narrow, the spinal cord is vulnerable to any changes as the individual ages. Even individuals with mild arthritis can experience symptoms of neurogenic claudication early on and develop symptoms in their 30s and 40s instead of their 60s and 70s.
Diagnosis
Diagnosis of neurogenic claudication is largely based on the individual’s medical history, physical examination, and imaging. The physical examination and review identify where the pain is presenting and when. The healthcare provider may ask:
Is there a history of lower back pain?
Is the pain in one leg or both?
Is the pain constant?
Does the pain come and go?
Does the pain get better or worse when standing or sitting?
Do movements or activities cause pain symptoms and sensations?
Are there any usual sensations while walking?
Treatment
Treatments can consist of physical therapy, spinal steroid injections, and pain meds. Surgery is a last resort when all other therapies are unable to provide effective relief.
Physical Therapy
A treatment plan will involve physical therapy that includes:
Daily stretching
Strengthening
Aerobic exercises
This will help improve and stabilize the lower back muscles and correct posture problems.
Occupational therapy will recommend activity modifications that cause pain symptoms.
This includes proper body mechanics, energy conservation, and recognizing pain signals.
Back braces or belts may also be recommended.
Spinal Steroid Injections
Healthcare providers may recommend epidural steroid injections.
This delivers a cortisone steroid to the outermost section of the spinal column or the epidural space.
Pain medications are used to treat intermittent neurogenic claudication. These include:
Over-the-counter analgesics like acetaminophen.
Nonsteroidal anti-inflammatory drugs or NSAIDs like ibuprofen or naproxen.
Prescription NSAIDs may be prescribed if needed.
NSAIDs are used with chronic neurogenic pain and should only be used when required.
The long-term use of NSAIDs can increase the risk of stomach ulcers, and the overuse of acetaminophen can lead to liver toxicity and liver failure.
Surgery
If conservative treatments are unable to provide effective relief and mobility and/or quality of life are affected, surgery known as a laminectomy may be recommended to decompress the lumbar spine. The procedure may be performed:
Laparoscopically – with small incisions, scopes, and surgical instrumentation.
Open surgery – with a scalpel and sutures.
During the procedure, facets of the vertebra are partially or completely removed.
To provide stability, the bones are sometimes fused with screws, plates, or rods.
Success rates for both are more or less the same.
Between 85% and 90% of individuals undergoing the surgery achieve long-lasting and/or permanent pain relief. (Xin-Long Ma et al., 2017)
Movement Medicine: Chiropractic Care
References
Ammendolia C. (2014). Degenerative lumbar spinal stenosis and its imposters: three case studies. The Journal of the Canadian Chiropractic Association, 58(3), 312–319.
Munakomi S, Foris LA, Varacallo M. (2024). Spinal Stenosis and Neurogenic Claudication. [Updated 2023 Aug 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK430872/
Ma, X. L., Zhao, X. W., Ma, J. X., Li, F., Wang, Y., & Lu, B. (2017). Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials. International journal of surgery (London, England), 44, 329–338. doi.org/10.1016/j.ijsu.2017.07.032
Can physical therapy treatment protocols aimed at improving range of motion and flexibility around the hip and relieving inflammation around the sciatic nerve help individuals experiencing deep buttock pain or piriformis syndrome?
Deep Buttock Pain
Piriformis syndrome, a.k .a. deep buttock pain, is described as sciatic nerve irritation from the piriformis muscle.
The piriformis is a small muscle behind the hip joint in the buttocks.
It is about one centimeter in diameter and functions in the hip joint’s external rotation or turning outward.
The piriformis muscle and tendon are close to the sciatic nerve, which supplies the lower extremities with motor and sensory functions.
Depending on an individual’s anatomic variation of the muscle and tendon:
The two cross over, under, or through each other behind the hip joint in the deep buttock.
This relationship is thought to irritate the nerve, leading to sciatica symptoms.
Piriformis Syndrome
When diagnosed with piriformis syndrome, it is thought that the muscle and tendon bind to and/or spasm around the nerve, causing irritation and pain symptoms.
The theory supported is that when the piriformis muscle and its tendon tighten, the sciatic nerve becomes compressed or pinched. This decreases blood circulation and irritates the nerve from the pressure. (Shane P. Cass 2015)
Tenderness with pressure on the piriformis muscle.
Discomfort in the back of the thigh.
Deep buttock pain behind the hip.
Electric sensations, shocks, and pains travel down the back of the lower extremity.
Numbness in the lower extremity.
Some individuals develop symptoms abruptly, while others go through a gradual increase.
Diagnosis
Doctors will order X-rays, MRIs, and nerve conduction studies, which is normal.
Because piriformis syndrome can be challenging to diagnose, some individuals with minor hip pain may receive a piriformis syndrome diagnosis even if they don’t have the condition. (Shane P. Cass 2015)
It is sometimes referred to as deep buttock pain. Other causes of this type of pain include back and spinal problems like:
Herniated discs
Spinal stenosis
Radiculopathy – sciatica
Hip bursitis
A piriformis syndrome diagnosis is usually given when these other causes are eliminated.
When the diagnosis is uncertain, an injection is administered in the area of the piriformis muscle. (Danilo Jankovic et al., 2013)
Different medications can be used, but the injection itself is used to help determine the specific location of the discomfort.
When an injection is given into the piriformis muscle or tendon, it is often administered by ultrasound guidance to ensure the needle delivers the medication to the correct location. (Elizabeth A. Bardowski, J. W. Thomas Byrd 2019)
Avoiding activities that cause symptoms for at least a few weeks.
Physical Therapy
Emphasize stretching and strengthening the hip rotator muscles.
Non-Surgical Decompression
Gently pulls the spine to release any compression, allowing optimal rehydration and circulation and taking the pressure off the sciatic nerve.
Therapeutic Massage Techniques
To relax and release muscle tension and increase circulation.
Acupuncture
To help relax the piriformis muscle, sciatic nerve, and surrounding area.
Relieve pain.
Chiropractic Adjustments
Realignment rebalances the spine and musculoskeletal system to alleviate pain.
Anti-Inflammatory Medication
To decrease inflammation around the tendon.
Cortisone Injections
Injections are used to decrease inflammation and swelling.
Botulinum Toxin Injection
Injections of botulinum toxin paralyze the muscle to relieve pain.
Surgery
Surgery can be performed in rare cases to loosen the piriformis tendon, known as a piriformis release. (Shane P. Cass 2015)
Surgery is a last resort when conservative treatments have been tried for at least 6 months with little to no relief.
Recovery can take several months.
Sciatica Causes and Treatment
References
Cass S. P. (2015). Piriformis syndrome: a cause of nondiscogenic sciatica. Current sports medicine reports, 14(1), 41–44. doi.org/10.1249/JSR.0000000000000110
Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 60(10), 1003–1012. doi.org/10.1007/s12630-013-0009-5
Bardowski, E. A., & Byrd, J. W. T. (2019). Piriformis Injection: An Ultrasound-Guided Technique. Arthroscopy techniques, 8(12), e1457–e1461. doi.org/10.1016/j.eats.2019.07.033
For individuals considering acupuncture for sciatica relief and management, can knowing how it works and what to expect during a session help in making the decision?
Acupuncture Sciatica Treatment Session
Acupuncture for sciatica is a safe and effective medical treatment to relieve and manage pain symptoms. Studies suggest it is as effective as other treatment strategies and causes fewer side effects. (Zhihui Zhang et al., 2023) The frequency of acupuncture to relieve sciatica pain depends on the severity of the condition and injury, but many report improvement within two to three weeks. (Fang-Ting Yu et al., 2022)
Needle Placement
Circulation problems can cause the body’s energy to stagnate in one or more meridians/channels, leading to pain in and around the surrounding area. (Wei-Bo Zhang et al., 2018)
The objective of acupuncture is to restore optimal circulation by stimulating specific points in the body called acupoints.
Thin, sterile needles stimulate the acupoints to activate the body’s natural healing abilities and relieve pain. (Heming Zhu 2014)
Some practitioners use electroacupuncture – a gentle, mild electrical current is applied to the needles and passes through the tissues to activate the nervous system. (Ruixin Zhang et al., 2014)
Acupoints
Acupuncture sciatica treatment involves specific acupoints along the bladder and gallbladder meridians.
Bladder Meridian – BL
The bladder meridian/BL runs down the back along the spine, hips, and legs. The acupoints within the meridian for sciatica include: (Fang-Ting Yu et al., 2022)
BL 23 -Shenshu – Location on the lower back, near the kidney.
BL 25 – Dachangshu – Location on the lower back.
BL 36 – Chengfu – Location on the back of the thigh, just below the buttocks.
GB 30 – Huantiao – Location on the back, where the buttocks meet the hips.
GB 34 – Yanglingquan – Location on the outside of the leg, below the knee.
GB 33 – Xiyangguan – Location lateral to the knee, on the side.
Stimulating acupoints in these meridians increases blood flow to the area, reduces inflammation, and releases endorphins and other pain-relieving neurochemicals to relieve symptoms. (Ningcen Li et al., 2021) The specific acupoints vary depending on symptoms and the root cause. (Tiaw-Kee Lim et al., 2018)
Example Patient
An example of acupuncture sciatica treatment session: A patient with persistent shooting pain extending down the back and side of the leg. A standard treatment consists of the following:
The acupuncturist thoroughly goes over the patient’s medical history and symptoms and has the patient point to where the pain is located.
Then, they palpate on and around the area to find where the pain worsens and lessens, communicating with the patient as they go along.
Depending on the site and severity, they may start placing needles at the lower back, focusing on the site of the injury.
Sometimes, the sacrum is involved, so the acupuncturist will place needles on those acupoints.
They then move to the back of the leg and insert needles.
The needles are retained for 20-30 minutes.
The acupuncturist leaves the room or treatment area but regularly checks in.
The patient may feel a warmth, tingling, or mild heaviness, which is a normal response. This is where patients report a calming effect. (Shilpadevi Patil et al., 2016)
The needles are carefully removed.
The patient may feel deeply relaxed and will be advised to get up slowly to avoid dizziness.
There may be soreness, redness, or bruising at the needle insertion site, which is normal and should resolve quickly.
The patient will be given recommendations as to avoiding strenuous activity, properly hydrating, and performing gentle stretches.
Acupuncture Benefits
Acupuncture has been shown to be a complementary therapy for pain relief and management. The benefits of acupuncture:
Improves Circulation
Acupuncture stimulates blood circulation, which nourishes damaged or irritated nerves and promotes healing.
This helps relieve sciatica symptoms, like numbness, tingling, and pain. (Song-Yi Kim et al., 2016)
Releases Endorphins
Acupuncture triggers the release of endorphins and other natural pain-relieving chemicals, which help relieve pain. (Shilpadevi Patil et al., 2016)
Regulates the Nervous System
Acupuncture rebalances the sympathetic and parasympathetic responses, which reduces stress, tension, and pain. (Xin Ma et al., 2022)
Relaxes the Muscles
Nerve pain often accompanies muscle tension and spasms.
Acupuncture relaxes tight muscles, reducing pressure and providing relief. (Zhihui Zhang et al., 2023)
From Symptoms to Solutions
References
Zhang, Z., Hu, T., Huang, P., Yang, M., Huang, Z., Xia, Y., Zhang, X., Zhang, X., & Ni, G. (2023). The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Frontiers in neuroscience, 17, 1097830. doi.org/10.3389/fnins.2023.1097830
Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., Wan, W. J., … Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ open, 12(5), e054566. doi.org/10.1136/bmjopen-2021-054566
Zhang, W. B., Jia, D. X., Li, H. Y., Wei, Y. L., Yan, H., Zhao, P. N., Gu, F. F., Wang, G. J., & Wang, Y. P. (2018). Understanding Qi Running in the Meridians as Interstitial Fluid Flowing via Interstitial Space of Low Hydraulic Resistance. Chinese journal of integrative medicine, 24(4), 304–307. doi.org/10.1007/s11655-017-2791-3
Zhu H. (2014). Acupoints Initiate the Healing Process. Medical acupuncture, 26(5), 264–270. doi.org/10.1089/acu.2014.1057
Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2014). Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology, 120(2), 482–503. doi.org/10.1097/ALN.0000000000000101
Perreault, T., Fernández-de-Las-Peñas, C., Cummings, M., & Gendron, B. C. (2021). Needling Interventions for Sciatica: Choosing Methods Based on Neuropathic Pain Mechanisms-A Scoping Review. Journal of clinical medicine, 10(10), 2189. doi.org/10.3390/jcm10102189
Li, N., Guo, Y., Gong, Y., Zhang, Y., Fan, W., Yao, K., Chen, Z., Dou, B., Lin, X., Chen, B., Chen, Z., Xu, Z., & Lyu, Z. (2021). The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation. Journal of inflammation research, 14, 7191–7224. doi.org/10.2147/JIR.S341581
Lim, T. K., Ma, Y., Berger, F., & Litscher, G. (2018). Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update. Medicines (Basel, Switzerland), 5(3), 63. doi.org/10.3390/medicines5030063
Kim, S. Y., Min, S., Lee, H., Cheon, S., Zhang, X., Park, J. Y., Song, T. J., & Park, H. J. (2016). Changes of Local Blood Flow in Response to Acupuncture Stimulation: A Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2016, 9874207. doi.org/10.1155/2016/9874207
Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. doi.org/10.1007/s11916-016-0552-1
Ma, X., Chen, W., Yang, N. N., Wang, L., Hao, X. W., Tan, C. X., Li, H. P., & Liu, C. Z. (2022). Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Frontiers in neuroscience, 16, 940343. doi.org/10.3389/fnins.2022.940343
Can the effects of electroacupuncture reduce sciatica in individuals dealing with low back pain to restore their mobility?
Introduction
When many people start to overuse their muscles in the lower quadrants, it can lead to numerous issues that cause pain and discomfort. One of the most common pain issues in the lower quadrants of the musculoskeletal system is sciatica, which is associated with low back pain. This pain duo can affect a person’s daily routine and lead them to pain and discomfort. This musculoskeletal condition is common, and when it affects one of the legs and lower back, many people state that it’s a radiating shooting pain that doesn’t go away for a while. Luckily, there are treatments like electroacupuncture to reduce sciatica associated with low back pain. Today’s article looks at the sciatica-low-back connection, how electroacupuncture reduces this pain connection, and how electroacupuncture can restore mobility to the individual. We talk with certified medical providers who consolidate our patients’ information to assess how to reduce the sciatica-low-back connection with electroacupuncture. We also inform and guide patients on how electroacupuncture therapy can be combined with other therapies to restore mobility to the body. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating electroacupuncture therapy as part of their routine to reduce sciatica associated with low back pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Sciatica & Low Back Connection
Do you feel muscle aches or pain in your lower back or your legs? Do you experience radiating, throbbing pain in your legs that affects your walking ability? Or have you noticed that your legs and lower back ache more when carrying a heavy object? Many of these scenarios are associated with sciatica, which correlates with lower back pain. Now, sciatica is often characterized by aggravating pain traveling along the sciatic nerve from the lower back region, impairing a person’s quality of life. In the musculoskeletal system, the sciatic nerve plays an important role by providing motor function to the legs. (Davis et al., 2024) Now, when the sciatic nerve, the lumbar region also has a pivotal role. The lumbar region in the musculoskeletal region also has a crucial role in providing support, strength, and flexibility to the body. However, both the sciatic nerve and lumbar spinal region are more prone to stress and injuries from traumatic injuries and environmental factors that can impact the lumbar spinal discs and the sciatic nerve.
Repetitive motions, obesity, improper lifting, degenerative spinal issues, and musculoskeletal conditions are a few causes and risk factors contributing to the development of sciatica associated with the lower back. What eventually happens is that the water content and the progressive loss of the proteoglycans of the spinal discs break down between the vertebrae and protrude out to press on the sciatic nerve, which then can become irritated and cause referred radiating pain in the legs and lower back. (Zhou et al., 2021) The combination of sciatica and lower back pain can become a socio-economic issue depending on the severity of the pain that the sciatic nerve is causing and can make individuals miss out on any activities they are participating in. (Siddiq et al., 2020) While sciatica pain-like symptoms often correlate with the lumbar region, many individuals can find the relief they are looking for through various treatments.
Sciatica Causes- Video
Electroacupuncture Reducing The Sciatica-Low Back Connection
When it comes to reducing the sciatic-low-back connection, many individuals seek out treatment that is affordable and effective in decreasing pain-like issues. Non-surgical treatments like electroacupuncture can be beneficial to many individuals who are experiencing sciatica pain correlated with the lower back. Electroacupuncture is another form of traditional acupuncture therapy that originates in China. Highly trained acupuncturists follow the same acupuncture principles by placing solid thin needles at different acupoints in the body to restore qui or chi (energy flow). Electroacupuncture combines needles and electrostimulation to reduce the central pain-regulatory mechanisms causing low back pain and sciatica by blocking the pain signals and providing pain relief. (Kong, 2020) At the same time, electroacupuncture offers analgesic properties to stimulate endorphins and reduce pain medication for low back pain safely. (Sung et al., 2021)
Electroacupuncture Restoring Mobility
When the lower extremities are experiencing limited mobility due to sciatica associated with low back pain, electroacupuncture can help relax the muscles that are aggravating the sciatic nerve and even help improve blood flow to the lumbar muscles. That is because electroacupuncture can stimulate specific body regions to reduce the somato-vagal-adrenal reflexes to relieve and restore mobility to the lower extremities. (Liu et al., 2021) Additionally, electroacupuncture can be combined with other non-surgical therapies to help strengthen the core and lower back muscles, allowing people to be more mindful of what factors are causing sciatica and lower back pain. By doing this, many people struggling with sciatica associated with low back pain can incorporate electroacupuncture as part of their treatment program combined with holistic approaches to improving their quality of life and providing a pathway to improving their mobility.
Kong, J. T. (2020). Electroacupuncture for Treating Chronic Low-Back Pain: Preliminary Research Results. Med Acupunct, 32(6), 396-397. doi.org/10.1089/acu.2020.1495
Liu, S., Wang, Z., Su, Y., Qi, L., Yang, W., Fu, M., Jing, X., Wang, Y., & Ma, Q. (2021). A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis. Nature, 598(7882), 641-645. doi.org/10.1038/s41586-021-04001-4
Siddiq, M. A. B., Clegg, D., Hasan, S. A., & Rasker, J. J. (2020). Extra-spinal sciatica and sciatica mimics: a scoping review. Korean J Pain, 33(4), 305-317. doi.org/10.3344/kjp.2020.33.4.305
Sung, W. S., Park, J. R., Park, K., Youn, I., Yeum, H. W., Kim, S., Choi, J., Cho, Y., Hong, Y., Park, Y., Kim, E. J., & Nam, D. (2021). The effectiveness and safety of electroacupuncture for nonspecific chronic low back pain: A protocol for systematic review and/or meta-analysis. Medicine (Baltimore), 100(4), e24281. doi.org/10.1097/MD.0000000000024281
Zhou, J., Mi, J., Peng, Y., Han, H., & Liu, Z. (2021). Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study. Front Endocrinol (Lausanne), 12, 740200. doi.org/10.3389/fendo.2021.740200
Can individuals with piriformis syndrome incorporate acupuncture with various therapies to reduce sciatic nerve pain and other symptoms?
Introduction
As many individuals move around from one location to another thanks to the lower body extremities, the surrounding muscles, ligaments, nerve roots, and tissues help contribute to the sensory-motor function of the hips, legs, buttocks, and feet. All these muscle groups factor in to ensure they can be mobile without the effects of pain or discomfort. However, many factors and issues can cause the surrounding muscles to develop musculoskeletal problems over time, affecting a person’s mobility. One of the muscles that helps share the responsibility for mobility to hips and buttocks is the piriformis muscle, which is often overlooked when various injuries or repetitive motions start to affect a person’s ability to walk. Today’s article examines how piriformis syndrome affects mobility, how sciatic pain correlates with piriformis syndrome, and how therapies like acupuncture can help reduce piriformis syndrome. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to minimize piriformis syndrome affecting a person’s mobility. We also inform and guide patients on how treatments like acupuncture can help reduce sciatic nerve pain associated with piriformis syndrome. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from piriformis syndrome that is affecting their ability to walk. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.
Piriformis Syndrome Affecting Mobility
Have you been experiencing muscle tightness in your hips or buttock region, affecting your walking ability? Do you feel sensations of numbness, tingling, or burning pain traveling down to your knees and feet? Or, after a long day of work, do you feel pain when you are sitting down? Most of these symptoms are often correlated with piriformis syndrome. The six surrounding muscles surrounding the gluteal region of the thighs and hips all work together to provide lower body movement while stabilizing the hips and rotating the thighs. The piriformis muscle is a small, flat, pear-shaped muscle that runs on top of the sciatic nerve. Piriformis syndrome is a clinical musculoskeletal condition that causes sciatic nerve entrapment that causes many individuals to report shooting and burning pain down to their buttock region. (Hicks et al., 2024) This causes many people to think they are dealing with low back pain associated with sciatica. When a person is dealing with piriformis syndrome, they will experience limited mobility in their hips, which, over time, if not treated, will affect the thighs and legs.
How Does Sciatic Nerve Pain correlate with Piriformis Syndrome?
Additionally, since piriformis syndrome is correlated with sciatic nerve pain, some clinical findings causing overlapping risk profiles include restricted external hip rotation and muscle tightness of the lumbosacral muscles. Other clinical findings range from palpatory pain over the greater sciatic notch to aggravated pain in a seated position. (Sharma et al., 2023) Since sciatic nerve entrapment is correlated with piriformis syndrome, it is still regarded as the non-discogenic cause of sciatica. (Son & Lee, 2022) When that sciatic nerve gets trapped within the piriformis muscle, many people will experience numbness, tingling sensations, and similar pain patterns in the legs, just like sciatica; however, when individuals are looking for treatments to reduce the sciatic nerve pain and improve the piriformis muscle.
Acupuncture Therapy Reduces Piriformis Syndrome
When people are looking for treatments to reduce their sciatic nerve pain correlated with piriformis syndrome, they are seeking treatments that are affordable and can reduce the pain through consecutive sessions. Acupuncture therapy can help reduce the effects of piriformis syndrome. Acupuncture is a complementary and alternative therapy from China that uses solid, thin needles to be placed on the acupoints in the body. Additionally, highly trained professionals can incorporate various acupuncture methods to treat and reduce the effects of piriformis syndrome. (He et al., 2023) At the same time, when a person is being treated for piriformis syndrome, an acupuncturist uses ultrasound-guided techniques to allow accurate needle placement within the deep muscles to provide an effective treatment response. (Fusco et al., 2018) This allows the affected surrounding muscles to relax and reduce sciatic nerve pain.
Acupuncture Reducing Sciatic Nerve Pain
Since sciatic nerve pain and piriformis syndrome have overlapping risk profiles, they can also be associated with other musculoskeletal pain conditions that can affect a person’s mobility. Acupuncture can help mitigate the pain signals causing motor or sensory disturbances within the pelvic and hip regions. (Kvorning et al., 2004) Acupuncture is one of the oldest forms of non-surgical therapy that can be combined with other various therapies to help remobilize the hips and decompress the pain affecting the sciatic nerve while providing relief. (Vij et al., 2021) By incorporating acupuncture as part of a person’s health and wellness treatment plan, they will begin to gradually manage the associated symptoms and reduce the chances of piriformis syndrome from returning to cause sciatic nerve pain in the lower extremities. This allows people to be more mindful and help restore the body’s natural healing process over time.
Reclaim Your Mobility- Video
References
Fusco, P., Di Carlo, S., Scimia, P., Degan, G., Petrucci, E., & Marinangeli, F. (2018). Ultrasound-guided Dry Needling Treatment of Myofascial Trigger Points for Piriformis Syndrome Management: A Case Series. J Chiropr Med, 17(3), 198-200. doi.org/10.1016/j.jcm.2018.04.002
He, Y., Miao, F., Fan, Y., Zhang, F., Yang, P., Zhao, X., Wang, M., He, C., & He, J. (2023). Acupuncture Methods for Piriformis Syndrome: A Protocol for Systematic Review and Network Meta-Analysis. J Pain Res, 16, 2357-2364. doi.org/10.2147/JPR.S417211
Kvorning, N., Holmberg, C., Grennert, L., Aberg, A., & Akeson, J. (2004). Acupuncture relieves pelvic and low-back pain in late pregnancy. Acta Obstet Gynecol Scand, 83(3), 246-250. doi.org/10.1111/j.0001-6349.2004.0215.x
Sharma, S., Kaur, H., Verma, N., & Adhya, B. (2023). Looking beyond Piriformis Syndrome: Is It Really the Piriformis? Hip Pelvis, 35(1), 1-5. doi.org/10.5371/hp.2023.35.1.1
Son, B. C., & Lee, C. (2022). Piriformis Syndrome (Sciatic Nerve Entrapment) Associated With Type C Sciatic Nerve Variation: A Report of Two Cases and Literature Review. Korean J Neurotrauma, 18(2), 434-443. doi.org/10.13004/kjnt.2022.18.e29
Vij, N., Kiernan, H., Bisht, R., Singleton, I., Cornett, E. M., Kaye, A. D., Imani, F., Varrassi, G., Pourbahri, M., Viswanath, O., & Urits, I. (2021). Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review. Anesth Pain Med, 11(1), e112825. doi.org/10.5812/aapm.112825
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