Sciatic Nerve Inflammation and Acupuncture: Effective?

You have pain, numbness to tingling in the buttock or behind the leg that occur repeatedly? It is very likely that a irritation or an inflammation of your sciatic nerve hides behind your symptoms. This is called a "sciatica neuralgia", or "sciatica" short!

Rest assured, the sciatica is a generally benign condition and most often due to a herniated disc lumbar which compresses one or more nerve roots du sciatic nerve. Her symptoms usually regress spontaneous in a few weeks.

Treatment of sciatica is essentially based on the management of symptoms, particularly pain which are sometimes very intense.

In this article, we will talk about acupuncture, one of the many methods used to relieve pain linked to inflammation of the sciatic nerve.

Sciatic nerve: anatomical reminder

Our spine, or "spine", is made up of 33 vertebrae stacked on top of each other and separated by intervertebral discs. The level of Lumbar spine, there are 5 voluminous vertebrae (from top to bottom) : L1, L2, L3, L4 and L5.

On each side of these 5 vertebrae emerge from the roots nerve from the spinal cord (part of our central nervous system which [among other things] transmits nerve messages from the brain to all parts of the body).

All of this nerve roots then form several nerves destined for give sensitivity and/or motor skills to different territories.

Among these nerves, the sciatic nerve, the largest and longest nerve in the human body! This goes below the piriformis muscle (see the article: piriformis syndrome) and above the superior twin muscle, crosses the muscles of the gluteal region (including gluteus maximus, upper and lower twins, quadratus femoris and obturator internus), then descends along the thigh, Calf and pied to reach the toes.

Its role is to ensure, through its various branches, motor and sensory innervation of the entire lower limb. In other words, it is thanks to sciatic nerve that we can move our leg and have sensations at the level of it (perceive heat, cold, pain, etc.).

To know in detail the anatomy of the nerve sciatica and its functions, see the following article.

Sciatic nerve: Anatomy and route (Associated pathologies)

Focus on sciatica

La sciatic neuralgia is pain in the lower limb that follows the course of the sciatic nerve. This pain is due to inflammation or an irritation one or more nerve roots of this nerve, generally by a compression of this one by a protrusion or an herniated disc lumbar.

In addition to the herniated disc, other pathologies can cause inflammation of the sciatic nerve:

• THEzygapophyseal osteoarthritis ;
• Sacroiliitis (inflammation of the sacroiliac joint);
• Le piriformis syndrome.

To know everything about sciatica (its causes, symptoms, treatments, etc.), see the following article.

AZ's Sciatica: Understanding and Relieving Its Symptoms

Sciatica treatments

Support for the sciatica is mainly based on the pain treatments, in particular thanks to:

• The application of cold or heat (see the following article to know how to choose between hot and cold in case of pain related to sciatica).

• Medication: analgesics and non-steroidal anti-inflammatories to relieve pain, muscle relaxants to fight against muscle tension...

• The corticosteroid injections (steroidal anti-inflammatories): injection of cortisone directly into the vicinity of the irritated nerve root to reduce inflammation and pain.

• La physiotherapy et the osteopathy: lumbar traction, exercises, McKenzie method, massages, manipulation techniques…

• Surgery: it consists in lifting the compression of the sciatic nerve or its nerve roots (the cure of a herniated disc for example).

• Grandma's remedies: herbal teas made from medicinal plants with anti-inflammatory and analgesic properties, certain soothing essential oils…

• Anti-stress therapies: especially meditation mindfulness and sophrology.

• Acupuncture: A complementary practice from traditional Chinese medicine that many sciatica sufferers recommend for its benefits against pain, muscle tension and stress.

Acupuncture, effective for inflammation of the sciatic nerve?

Among the many treatment options available to treat sciatica, acupuncture. Zoom on this ancestral practice sold by many patients suffering from sciatica!

What is acupuncture ?

Acupuncture is a branch of traditional Chinese medicine which would have been introduced in Europe in the 16^nd century without gaining international recognition until the 20th century.

This ancestral practice is based on the restoration in the body of a harmonious flow of Qi, the vital energy of the body. This good energy circulation would be, according to acupuncture specialists, essential to body balance and healthy.

In practice, the acupuncturist implant fine stainless needles in specific parts of the body called "acupuncture points" to influence the “Yin” and “yang” (symbolizing the two opposite parts of the same phenomenon) for therapeutic purposes.

The acupuncture points, which are numbered 361 (distributed over 14 meridians), can be located on blood paths, lymphatic, dermal or even nervous (particularly on the route from sciatic nerve).

Acupuncture to relieve sciatica

In the specific case of a irritation ou inflammation of the sciatic nerve, many 15 to 20 minute acupuncture sessions can be prescribed.

Many patients report a significant reduction in their pain from the first session, but each patient responds differently to the treatment. Moreover, the latter must be custom, that is to say adapted to the pathology of the patient and his individual specificities.

According to practitioners, this traditional Chinese therapy helps relieve the symptoms of sciatica through the following effects:

• Release of endorphins: the different acupuncture techniques can release chemical molecules involved in the fight against pain in the body called "endorphins" ( "endogenous morphine"). These endorphins are also involved in the sensations of happiness and fun, hence the state of fullness and well-being reported by patients after an acupuncture session.

• Release of painful muscle tension: especially in case of piriformis syndrome where sciatic pain is due to a contracture of the piriformis muscle (through which the sciatic nerve passes).

• Increased range of motion (which is restricted because of pain).

• Reduction of stress and anxiety: remember that stress management plays an important role in the management of sciatica (stress increases the perception of pain).

Conclusion

Acupuncture is a branch of traditional Chinese medicine that can be considered for sciatica, particularly if the latter is secondary to a piriformis syndrome.

Although many people with sciatica experience pain relief from acupuncture, no scientific evidence has been provided to confirm the effectiveness of this practice in the management of this pathology.

Acupuncture therefore remains a complementary method, that is to say that it should only be considered as a complement to a medical care in due form with a qualified healthcare professional.

Resources

References

[1] BM Berman, HM Langevin, CM Witt, and R. Dubner, “Acupuncture for chronic low back pain”, New England Journal of Medicine, flight. 363, n^o 5, p. 454-461, 2010.

[2] MW Tulder, DC Cherkin, B. Berman, L. Lao, and BW Koes, “Acupuncture for low back pain. », The Cochrane Database of Systematic Reviews, N^o 2, p. CD001351‑CD001351, 2000.

[3] “Acupuncture for Sciatic Nerve Pain | Clinique Lajeunesse”, September 28, 2020. https://cliniquedacupuncturelajeunesse.com/acupuncture-pourquoi-consulter/nerf-sciatique/ (accessed November 18, 2022).

[4] E. Manheimer, A. White, B. Berman, K. Forys, and E. Ernst, “Meta-analysis: acupuncture for low back pain,” Annals of internal medicine, flight. 142, n^o 8, p. 651-663, 2005.

[5] J.-C. Goussard, “Piriform Syndrome”, in Pond Reflections, Springer, 2011, p. 47-61.

[6] G. Edelist, AE Gross, and F. Langer, “Treatment of low back pain with acupuncture”, Canadian Anaesthetists' Society Journal, flight. 23, n^o 3, p. 303-306, 1976.