Ask an expert - muscles and bones - sciatica

14 questions

This sounds rather like the effects of a prolapsed or bulging disc pressing on the nerves and causing these distal effects, and we have to say that acupuncture treatment has been used to good effect in treating both chronic lower back pain and in sciatica, as both of our factsheets show:

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/back-pain.htmlhttps://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/sciatica.html

Although osteopaths focus mainly on the structure of the body, and might be able to adjust misalignments of the lower back, it can sometimes take a more functional treatment like acupuncture to achieve greater change by encouraging the musculature of the lower back to function more efficiently and hold the back in place after it has been adjusted. This is how we tend to explain the fact that back pain and its treatment remains one of the commonest reasons for referral to an acupuncture practitioner. Of course, this is to take a very conventional view of the symptoms which you have. From a Chinese medicine point of view it is a failure in the flow of energy which generates symptoms such as you are experiencing, and it is not unusual to find that patients with considerable arthritic degeneration of the lower spine can be relieved of their symptoms even where the lower back cannot possibly have changed, i.e. the 'obvious' cause of the problem isn't really the cause of the problem.What we always recommend is that you visit a local BAcC member so that they can take a look at exactly how your problem presents and see what might be possible for you. In Chinese medicine each person is unique and different, and treatment is geared not just to the symptom but to the overall balance of the person. It is not uncommon to find that some patterns of discomfort are manifestations of more complex underlying imbalances, and from our perspective the real strength of this system of medicine is that by addressing the whole person we believe that symptoms are more likely to stay gone and not to return.

We are sorry to hear that in spite of all the treatment you are receiving matters don't seem to be improving. It's a little difficult to answer this question, because as you can easily understand, our expertise lies in using traditional acupuncture so we wouldn't hold ourselves out to be experts in any other fields. However, we invariably suggest osteopaths and chiropractors as alternatives, and indeed, often work with them to achieve change. Our work on the functional aspects of the body together with their work on the structural aspects is often what is called synergistic, the two treatments having more effect than the sum of their parts.

We would want to know a great deal more before offering any other suggestions, though. As our factsheet shows

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/sciatica.html

the evidence of the use of acupuncture in treating sciatica is pretty good, so the fact that you are seeing no change is unusual. It would also be helpful to know exactly how much of a problem it is/was, and how it came about, i.e. suddenly through accident or slowly through wear and tear. All of these have a bearing on what we might recommend to a patient we took on.

The one thought that we can't help have, though, is that this is quite a great deal of treatment to be having all at once. We tend to reserve more than once weekly treatment for really acute problems where the patient cannot function at all. For more chronic problems two or more treatments a week might just be a little disruptive to the healing process. Not everyone would agree, and in China, for example, acupuncture might well be routinely delivered every day for a ten day course of treatment. Many Chinese practitioners do the same in the UK, but the majority of us tend to leave a little more space between sessions to give the body time to adjust. It might just be that less is more in your case, and that letting the treatment bed in for a little longer might encourage more progress.

There are a variety of associated bodywork treatments in oriental medicine - tui na, shiatsu, etc - many of which are used within traditional practice by acupuncturists but also by people who specialise in these techniques. You might usefully see if this could be added to the mix.

More than this we really cannot say without access to more comprehensive background information, but we would encourage you to ask your practitioner about what else you might usefully do. They, after all, have access to all the information which we would need, and have undoubtedly come across similar cases in the past and know what is likely to be a good adjunct and who locally is best qualified to offer it.

We have been asked about the treatment of sciatica many times, and a recent answer was:

As you can read from our factsheet

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/sciatica.html

there has been a significant amount of research into the treatment of sciatica with acupuncture, and the results have been increasingly positive. The threshold for being able to make a definite claim is based on a research process for which very little acupuncture treatment except non-traditional formula work will work, but there have been dozens of Chinese studies aimed at finding what works better which seem to show that sciatica responds well to treatment. Certainly this 'expert's' experience is that sciatica seems to respond well to treatment in most cases.

There is no doubt that formula treatment will work to an extent, and there are many medical acupuncturists and 'cookbook' practitioners who will use the same 'sciatica' patients on every patient. The real strength of traditional acupuncture, though, is that it addresses the problem of why sciatica occurs in this particular patient, or more properly why the system does not put right and recover from the injuries which normally cause it. Twenty different people may have the same named condition but be treated in twenty entirely different ways. What this does is not just put the problem right but try to make sure that it does not recur.

There are no special treatments for sciatica, and no specialists, so any well-trained traditional acupuncturist should be able to help you. The best advice, though, since there are one or two cases which would not make us feel so optimistic, is to pop in to see a BAcC member local to you for a chat and to get a short face to face assessment of what is going on. This will not only give you more precise information but also give you a chance to meet a practitioner and see where they work before committing to treatment.

We are surprised that seeing an osteopath has made no difference, but the one strength of acupuncture is that it mainly deals with function, not structure. If an osteopath puts a lower spine back into shape but the surrounding musculature still retains levels of poor function, then it will revert quite quickly. Encouraging better function in the local tissue can of its own accord spring the spine back into shape, as well as balancing up the whole system which in and of itself can achieve good results. Many people come to acupuncture treatment for back and hip problems.

Of course, if the problem is pseudo-sciatica, the most likely cause of which is piriformis syndrome, then this is all the more likely to be the case. The effect of the spasm in this muscle can put pressure on the sciatic nerve which generates exactly the same symptoms as one would get from compression of the nerve root. Acupuncture treatment can be effective in helping to address this as well.

In summary you may well find that acupuncture can help your wife. The real question is how much help and how sustainable the outcomes are. We have great faith in treatment always doing something, but there are times when the effects are short lived and non-incremental, so it is very important to try to establish good measurable outcomes and also to review progress every five sessions or so to ensure that you don't build up an unintentional treatment habit where the weeks can slip by unnoticed.

Q:  I have bad sciatica had 3 visits to a chiropractor and started to feel a bit better  yesterday.  I was given acupuncture in the bottom of my spine.  The needles caused me a lot of pain when inserted and since then I am in so much pain feeling  like raw nerves -  is this normal ?

A:  We would hesitate to use the word 'normal' in circumstances like this but it can happen.

 There are two possibilities. First is that the treatment has caused an exacerbation of the original problem. This can happen with treatments for back, neck and sciatica types of pain, and if this is the case then the feeling will subside within 48 hours, or by the time you read this reply. Many health professionals like us, osteopaths and chiropractors do warn people that this can happen, and take it as a good sign that the treatment has 'engaged'. 

 The reaction is not usually that severe, however, normally the existing problem plus a bit more, so we suspect that the problem may well have been caused by the treatment. Chiropractors are not within the mainstream of acupuncture practice within the UK, and many learn small amounts of acupuncture for treating specific problems within their scope of practice. This can mean that there use of needles is slightly more hard-hitting than, say, a traditional acupuncturist who is trying to move energy. Trying to get a neuro-physiological effect can sometimes mean using thicker needles and deeper insertions, and with that the risk of a bruise or a slight nerve impingement increases considerably. This does not usually mean permanent damage; even when people do suffer treatment injuries very few indeed cause more than a short lived problem. It does mean, though, that there can be a very different kind of post treatment pain, often sharp and severe.

 The best thing to do is to discuss the problem with the person who gave you the treatment to see if they can provide any illumination about where they were needling, how deeply and with how much manipulation, to get a sense of what damage might have been caused and how quickly it will resolve. If it carries on for a week then it would be advisable to arrange a GP appointment for the doctor to have a look at what is going on, and possibly prescribe some pain relief.

 The chances are that the reaction is the former. We certainly hope so, and this will mean that it has resolved by the time you read this. If it hasn't, then it would warrant further investigation

A:  As you can read from our factsheet

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1138-sciatica.html

there has been a significant amount of research into the treatment of sciatica with acupuncture, and the results have been increasingly positive. The threshold for being able to make a definite claim is based on a research process for which very little acupuncture treatment except non-traditional formula work will work, but there have been dozens of Chinese studies aimed at finding what works better which seem to show that sciatica responds well to treatment. Certainly this 'expert's' experience is that sciatica seems to respond well to treatment in most cases.

There is no doubt that formula treatment will work to an extent, and there are many medical acupuncturists and 'cookbook' practitioners who will use the same 'sciatica' patients on every patient. The real strength of traditional acupuncture, though, is that it addresses the problem of why sciatica occurs in this particular patient, or more properly why the system does not put right and recover from the injuries which normally cause it. Twenty different people may have the same named condition but be treated in twenty entirely different ways. What this does is not just put the problem right but try to make sure that it does not recur.

There are no special treatments for sciatica, and no specialists, so any well-trained traditional acupuncturist should be able to help you. The best advice, though, since there are one or two cases which would not make us feel so optimistic, is to pop in to see a BAcC member local to you for a chat and to get a short face to face assessment of what is going on. This will not only give you more precise information but also give you a chance to meet a practitioner and see where they work before committing to treatment.



Page 1 of 3

Post a question

If you have any questions about acupuncture, browse our archive or ask an expert.

Ask an expert

BAcC Factsheets

Research based factsheets have been prepared for over 60 conditions especially for this website

Browse the facts