If you’ve been laid low by sciatica pain for months, acupuncture might bring some lasting relief, according to a recent study.
Sciatica refers to symptoms that flare due to irritation of the sciatic nerve, which starts in the lower or lumbar spine and runs down the back of each leg. Often, the trouble begins when a lumbar disc “slips” (i.e., bulges, herniates, protrudes) out of place and puts pressure on a nerve root that is part of the sciatic nerve. The unpleasant consequences commonly include shooting, aching pain in the low back or buttocks that radiates down the back or side of the leg (typically only one leg). Some people feel a burning sensation, tingling, or weakness in the leg, even all the way into the foot.
Sciatica usually goes away on its own within four to six weeks. However, some people develop chronic sciatica, where symptoms linger for three months or longer. The study, published in JAMA Internal Medicine, looked at whether acupuncture might help in those stubborn cases.
Researchers randomly assigned 216 people with chronic sciatica due to a herniated disc to have either 10 acupuncture sessions or 10 “sham” sessions over four weeks. Those in the acupuncture group had thin needles applied to specific “acupoints” on the low back, and some additionally had needles placed on their affected leg. Those in the sham group also saw an acupuncturist, but the needles were blunt-tipped and placed on areas that are not considered to be acupoints; only one “real” needle was applied in that group—but also to a non-acupoint.
After four weeks, the participants who received real acupuncture reported a greater improvement in their leg pain—with twice the decrease in their pain ratings as the sham group, on average. They also reported more relief from their back pain and decreased difficulties with daily activities. And the improvements lasted: After one year, those who had received acupuncture were still reporting less pain than those who had received the sham sessions. Although the study looked only at cases of chronic sciatica, acupuncture may also be of some value for acute sciatica.
Acupuncture does have potential downsides. You have to find a qualified acupuncturist, go for multiple sessions, and possibly pay out of pocket. (Medicare covers a limited number of sessions for chronic low back pain, as long as they are provided by a doctor or other healthcare professional, such as a nurse practitioner or physician assistant, who is licensed to practice acupuncture.)
On the other hand, acupuncture is a low-risk therapy. While the needle part can make some people balk, the needles are very thin and not inserted deeply. In the JAMA study, some participants had minor bleeding, but no one reported serious side effects. And some people may find acupuncture more appealing than conventional treatments for chronic sciatica, which include over-the-counter medications, physical therapy, and corticosteroid injections to reduce inflammation and pain. For severe cases of sciatica causing intractable pain or weakness, surgery can take pressure off of the affected nerve.
If you’re wondering why sticking needles in the skin could help with chronic pain, the answer isn’t clear. Acupuncture originated in traditional Chinese medicine at least 2,500 years ago, but its underlying mechanisms are still under study. Some ideas proposed but not proven are that acupuncture may affect nervous system function in ways that change pain perception. Needling of the acupoints may, for example, stimulate nearby nerve fibers and trigger the release of pain-dulling chemicals like endorphins. While the “how” isn’t fully understood, a number of studies (many of low quality, however) have found that acupuncture can be helpful for various kinds of chronic pain.
To find a qualified acupuncturist, you could ask your primary care doctor for a recommendation. Another resource is the American Academy of Medical Acupuncture, a professional society of physicians who practice acupuncture. Their website has a directory where you can search for providers by state.
