Managing Sciatica Pain with Acupuncture: What You Need to Know

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.
• BL 40 – Weizhong – Location behind the knee.

Gallbladder Meridian – GB

The gallbladder meridian/GB runs along the sides from the corner of the eyes to the pinky toe. (Thomas Perreault et al., 2021) The acupoints for sciatica within this meridian include: (Zhihui Zhang et al., 2023)

• 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