Sciatica& TCM

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Sciatica, Acupuncture and

Traditional Oriental Medicine

 

By Al Stone DAOM (Candidate)

Introduction; my own experience with an Oriental

sciatica treatment

 

My very first experience with traditional Chinese

medicine came when I had some sciatica pain during a

kung fu workout.

 

I asked my kung fu teacher about it. He showed me some

acupoints on my leg to press at home that night and

the next day. They weren't too hard to get to, but it

was nice for him to press them for me this first time.

 

 

To my utter amazement, the pain was 95% gone the very

next day. The sciatica pain that began in my lower

back and radiated down to my little toe was gone after

one session of acupressure. In my experience, the pain

would peak for about three days, and then take about

two weeks to completely fade away. But in this case it

was completely gone in two days.

 

Not all sciatica patients respond to just acupressure.

Cases such as mine did because, even though it wasn't

a pleasant situation for me, it was just a minor ache.

Some patients require the stronger stimulation of

acupuncture.

 

I get many letters from people reading this article

who want to know what points to press or how to press

them. It is difficult to answer this question briefly,

but I can say that if you want to simply mash your

thumb into any location on the lower back or leg that

is sensitive along the trajectory of the sciatica

pain, you'll be helping the problem. Don't push so

hard that it causes a bruise and don't do it so hard

that it is very painful. Just a little painful is

really what you want to shoot for. Use the thumb for

points on the legs. For tender points on the buttocks,

you'll want to use your elbow to get in there deeply.

More likely you'll end up using someone else's elbow,

but I'll leave that up to you. Hold down each point

for two minutes.

 

There are some herbal medicines that can assist you in

the treatment of sciatica. We'll even provide you the

opportunity to get some of these herbs if the syndrome

sounds like what you're going through.

 

Now, let's go a little bit deeper into how acupuncture

and herbs benefit sciatica pain.

The causes of sciatica

 

From the biomedical perspective, the cause of sciatic

nerve pain is generally considered structural in

nature. Whether it is the bones in the spine, the

discs between the spines, or even the muscles in the

buttocks, each scenario includes some sort of

mechanical irritation to the sciatic nerve which exits

the spinal cord in the lower back and travels down the

leg into the foot.

 

From the perspective of traditional Chinese medicine,

we look at the pain as one of a number of problems.

Sciatica pain that is aggravated by cold or damp

weather.

 

Sometimes cold or damp energy can get into the

acupuncture meridians and cause a dull, heavy pain

that radiates along the trajectory of one of the

meridians from the lower back to the heel, or anywhere

in between. This kind of sciatica is aggravated by

cold or damp weather. In fact, many aches or pains

that are aggravated by cold or damp weather are

considered to be the same problem. Many arthritic

conditions fall into this category.

 

Along with acupuncture, moxibustion is often used for

this sort of problem. Moxibustion is the application

of heat to the meridians or acupoints. Traditionally,

the herb Ai Ye (mugwort) is used in the shape of a

cigar with the hot part focused on the part of the

body that hurts. Moxa comes in many shapes and sizes.

The " cigar " style is popular in American clinics, but

again it varies widely. Some clinics favor the use of

heat lamps or TDK lamps which are a metal plate that

radiates heat.

 

Another weapon against sciatica that is aggravated by

cold or damp weather is an herbal formula that is said

to be warm and dry in nature. That will help with any

pain in the muscles, nerves or joints that is

aggravated by cold and/or damp weather. Du Huo Ji

Sheng Tang is its name. It tastes something like a

cross between hot coffee and Vicks' mentholatum. We

sell it in capsules at Beyond Well Being if you're

interested.

Sciatica is worse in the evening, better in the

morning and aggravated by fatigue.

 

Another cause of sciatica is called a deficiency of

the Liver or Kidney. That doesn't mean that there's

anything wrong with your liver or kidney from a

biomedical perspective. I capitalize the words Liver

and Kidney to remind the reader that I'm really

talking about different concepts than the usual organs

we think of. Fortunately, it doesn't matter what we

call it. The important thing is that we can make you

feel better and in the case of a Liver and/or Kidney

deficiency we most certainly can help. The only

problem with treating deficiency syndromes is that

they can take longer than some of the other causes of

sciatica. One way to determine if your sciatica is due

to deficiency is if the pain is aggravated by fatigue.

Deficiency syndromes tend to have a slow onset and a

long duration which is to say that this sciatica is a

chronic or long-term condition, not something that

just popped up one day.

 

I have some patients who have responded very well to

herbal medicines for sciatica that is aggravated by

fatigue. Its good to know exactly what is deficient

before treating this. Generally the deficiency is

going to be one of the four key substances in Chinese

medical theory. Qi, Blood, Yin or Yang. Knowing which

is the best way to treat this. However lacking the

ability to get a diagnosis, it is the next best thing

to get the herb formula that most often applies to

this sort of sciatica pain. It is called Jin Gui Shen

Qi Wan. You'll notice that it includes the word " Qi "

in its name. Guess what its for? Qi primarily but it

can also help with the Yang as they're related. Its a

formula that is about 2,000 years old. Well, the

recipe is that old, the herbs obviously aren't.

 

If you're interested in trying out this formula feel

free to get some here. On the other hand, if you'd

like to get some feedback on exactly which of the four

substances is deficient in your case, a more detailed

interaction should take place between your herbalist

and your back. Here's more on customized formulas.

Sciatica pain that is worse in the morning and

aggravated by sitting still.

 

The final factor that can give rise to sciatica really

is structural in nature. We call it a stagnation of

blood due to local trauma which is to say that you

pulled a muscle, or you hurt yourself in a car

accident, or maybe you have poor posture and you're

sitting in a chair without enough padding on it.

Something structural is pinching or irritating the

sciatic nerve. This could also be muscle spasms are

pinching your sciatic nerve as it passes through the

butt region. This is a common cause of sciatica, but

as you can see, it is one of three possible causes for

your sciatic pain. If this is the cause of your

sciatic pain, it will probably help to move around.

The pain will be worse in the morning because you

haven't moved much in the night and since the problem

is all about a lack of movement of Qi energy or blood,

the fact that the leg hasn't moved all night will

aggravate that condition of stagnation. Movement or

activity will help with this kind of pain. This cause

of sciatica is the most responsive to acupuncture and

responds the quickest to treatment.

 

An herbal formula often applied to this issue is

called Shao Yao Gan Cao Tang. It is used specifically

for when you have tight muscles in the lower back or

hip/buttocks. Its action doesn't effect the nerve,

only the muscles around the nerve. This particular

formula has a lot of gan cao in it. That's licorice

root and it can cause a slight rise in blood pressure

because it lowers the urinary output just a bit. If

you have hypertension, only take this formula if you

have the means by which you can monitor your blood

pressure. For the rest of us, it should be fine as is.

 

When the sciatic pain is worse in the absence of

movement, we can assume that there is something stuck

causing the pain. The difference between Qi stagnation

and Blood stagnation can be thought of as the

difference between a pinched nerve due to tight

muscles and a pinched nerve due to local trauma.

There's a lot of overlap there and even in Chinese

medicine the line between Qi and Blood stagnation

isn't always that clear. Fortunately, when it comes to

treating the pain, it doesn't really matter.

Treatments

Acupuncture

 

Fine needles, some so thin as to appear more like

wires than needles, would be inserted along the

pathway of the pain to move the Qi energy locally and

dissipate the external pathogen as well as activate

the movement of the Qi energy to remove the pain.

Sometimes other points in the body would be used to

treat the damp or cold or wind that may have spread

out into the rest of the body in addition to the

Urinary Bladder meridian.

 

Electric stimulation ( " electro-stim " ) can be used on

the needles that pass through the leg to provide an

even greater amount of stimulation. Electro-stim is a

more recent invention applied to acupuncture. While

the treatment principle is not at all " traditional

Chinese medicine " , it is a commonly used tool within

the acupuncture clinic. The reasoning is that with

minute pulses of electricity, the local nerves are

over stimulated, not with pain, but with a painless

electrical shock. This over-stimulation makes the

nerves turn down their own sensitivity, and hence, all

the other pain that travels through those nerves is

also diminished. This is the basis behind acupuncture

anesthesia, and this principle applies to sciatica as

well.

Ear Acupuncture

 

Ear Acupuncture can be used for additional assistance

in treating the pain associated with sciatica. Once

the needles are removed, seeds can be taped into the

ears so as to supply on-going stimulation to these

points. These seeds or even magnets can be worn for a

few days at a time. Of course, care should be given to

the condition of the ear's skin so as to avoid any

infection caused by dirt or moisture collecting

beneath the tape used to affix the ear seeds. There

are a number of products that your acupuncturist will

have access to that make use of flesh color tape, not

unlike the flesh color Band-Aid bandages. These pieces

of tape needn't look funny in your ears.

 

In the past, subcutaneous needles have been used

instead of ear seeds. Subcutaneous needles are like

tiny thumbtacks. They are also effective, but because

the skin is broken, and often times, the needles are

not changed everyday, the risk of infection increases.

For this reason, I don't personally suggest this

treatment. However if you're in a position to change

the little subcutaneous needle everyday and clean the

ear, then they can be an effective adjunct to

acupuncture for your sciatica pain.

Qi Gong (Chi Kung)

 

These exercises direct the Qi in the body toward the

area of the body where the Qi energy is either

deficient or stagnant. Personally, I think that Qi

Gong exercises and acupuncture have something in

common. In Qi Gong training, it is said that the Shen

leads the Qi. That means that if you're doing an

exercise in which you are focusing your mind (Shen) on

your lower back, then the Qi goes there, and healing

takes place. Acupuncture performs the same function.

The funny thing about having a needle stuck into your

back is that you think about it. You're acutely aware

of it. It forces the mind to become conscious of that

area, and so the Qi is lead to that area. Qi Gong

exercises are used in between acupuncture treatments.

 

Qi Gong is about as close to yoga as the Chinese get.

Like yoga, there are hundreds of kinds. Some Qi Gongs

move, some stand still, some sit, some stand. Some

require superhuman patience and strength; others only

require a little mental focus.

External Qi Gong

 

Sometimes, your practitioner will apply Qi to your

body from his or hers by placing his or her hands onto

your body. Often times, their hands will be very warm,

signifying that they've successfully directed their

own Qi energy into their hands for " expression " into

you.

 

As with any therapy that requires touching, it is

absolutely essential that you feel comfortable with

the treatment. If you don't, your muscles will tighten

up and the therapy will produce negative effects. You

don't want that. If you don't know how you feel about

being touched with either external Qi Gong or even

massage, your body will tell you. A muscle tightening

up beneath the pressure of a therapist is called a

guarding response. Your body is guarding itself from

further injury. If your body senses the opportunity

for further injury due to the activities of your

practitioner you need to honor that body knowledge.

Your body's really smart, and regardless of how much

you like the practitioner, or believe in his or her

medicine, your body has the last word, and if it

doesn't like what's happening, then it is best to

listen to your body's wishes.

 

If you're uncomfortable with this type of therapy,

please tell your practitioner. On the other hand, if

you are comfortable with it, you'll find that with the

right practitioner, this can be among the most

significant and moving of all therapies. This

technique of external Qi Gong can certainly begin to

look much like the more Christian " laying on of hands "

and can have some truly divine manifestations in your

life.

Chinese Massage or " Tui Na "

 

Massage therapy for sciatica can't be underestimated.

At the Chinese hospital (from which I'm actually

writing this article) there is a department that does

nothing but massage chronic, bed-ridden sciatica

patients. The massage therapy is given for twenty

minutes, once per day. Along with the other therapies

listed in this article, I've seen patients undergo

life-saving changes. Where one patient was literally

carried in by family members, a couple of weeks later,

he's walking on his own, with much less pain,

obviously.

 

Massage therapy usually requires daily sessions.

Shiatsu, Anma and the other Oriental message

techniques are also valuable. There are a variety of

western massage techniques that can also assist, but

I'm unable to really assess them in this article.

Again, have a treatment and your body will tell you if

you liked it or not.

Conclusion

 

Traditional Oriental medicine has been treating

sciatica pain as far back as anybody can remember.

While TOM identifies a variety of causes and

treatments for the variety of issues that can cause

sciatica pain, it should be noted that evolutionarily

speaking, we haven't been standing upright so long as

to work out all of the kinks. In another thousand

generations this entire issue may be a long distant

concern as we'll have likely developed the necessary

structural changes to support our upright body. Until

then, we'll have to look to the distant past for

non-surgical, holistic, and safe therapies for

sciatica pain.