Treating Pain with TCM - Part 6: Sciatica
One of the more common forms of back pain I see in clinic is sciatica. Sciatica is pain the radiates into the thigh or foot caused by the constriction of the sciatica nerve from age (wear and tear), herniation of the disc pinching the nerve, tight muscles pinching the nerve, or injury. The pain usually feels like an electric shock that runs down the leg.
In TCM, whenever someone comes for back pain treatment, we always ask if the pain radiates down the leg. Depending on the location of pain, the type of pain, and where it radiates to help to pinpoint the cause. Most sciatica patients have pain that runs down the back of the leg, but there are some instances where pain runs down the side as well.
The meridian channel that runs down the back of the leg is the Urinary Bladder channel. It's also the location the sciatic nerve follows. In the rare instance, the pain runs down the side of the leg, that's the Gallbladder channel. The GB channel also runs across the sciatica nerve at the point GB30 (HuanTiao) and the pain is usually caused by the piriformis muscle.
Treatment
We usually see patients with sciatica after they've had one or more cortisone shots for pain. Either they don't want to have more or they've reached the allotted amount. If the cause of sciatica is a bulging disc, we'll also recommend they see a chiropractor to reposition it. If the pain is caused by injury or tight muscles, use acupuncture around that area, but be careful not to needle the nerve. Acupuncture, Cupping, Tui Na, and herbs can all help with the pain.
Pain on the Urinary Bladder channel:
Acupuncture points: UB 32, 36, 37, and 38. Ashi on the areas of pain. Two other useful points to use are UB 40 and 57. Electrostimulation can be used, but you need to be careful not to use stimulation on the nerve itself.
Cupping: Moving up and down the UB channel on the thigh
Tui Na: Massage on the butt, thigh, and calf area.
Pain on the Gallbladder Channel:
Acupuncture points: GB 30, 34, 40, 41, 44. Ashi on the area of pain. GB 32 is also a useful point.
Cupping: Moving up and down the GB channel on the side of the thigh.
Tui Na: Massage on the butt and the side of the thigh.
Herbal Formulas:
Lu Jiao Jiao Tang
Du Huo Ji Sheng Tang
In the next article, I'll start to cover the lower back pain. Just about everyone has had this pain at some point in their life and if they haven't, they will. I hope you enjoyed the article and it's given you a little more information about how TCM looks at sciatica.
References:
http://orthoinfo.aaos.org/topic.cfm?topic=A00351
http://www.itmonline.org/arts/sciatica.htm