By Christina Morris, L.Ac.
Sciatica is a condition characterized by pain that radiates from the low back, down through the buttock and along the back of the leg. Pains from sciatica may be as mild as a slight discomfort or cramp to completely debilitating. From a Western Medicine perspective sciatica is usually due to a structural deformity of the bones that make up the spine, the discs between the vertebrae, or muscular tension. The irregularity of the bone, disc, or pressure from muscle irritates the sciatic nerve that exits the spine. This irritation can create discomfort and pain in the low back, buttock and leg. It is estimated that 40% of the population will experience sciatica at some time during their lives.
According to the theories of Traditional Chinese Medicine, sciatica is due to a disharmony in the energetic pathways that circulate throughout the body. Sciatica may be due to a deficiency or an excess condition. Traditional Chinese Medicine derives a treatment plan based on the individual’s specific pattern of imbalance.
Pain and discomfort associated with sciatica differs from person to person. There are some people who have an increase in pain in the evenings and feel better in the mornings. Others may experience more pain when fatigued or after activity. These examples are often associated with deficiency patterns. Energetic deficiencies of organs can create imbalances in the body that may lead to pain and disease over time. Deficiency syndromes usually have a slower onset and a longer duration which can create a chronic condition. These conditions generally take more time to treat.
Sciatica that occurs suddenly is usually due to an excess condition. Traditional Chinese Medicine views this as a form of stagnation in the energetic pathways. Pain associated with stagnation usually occurs more in the mornings, increases with sitting and decreases with activity. This kind of blockage prohibits full circulation to the local area and surrounding areas and can create sharp, stabbing or achy sensations. Other sensations often felt with sciatica may be burning or tingling down the leg, a constant ache in the buttock, weakness or numbness in the leg or foot, or shooting pains when trying to stand. Conditions that can aggravate sciatica may be cold or damp weather. During these weather changes the person may feel a dull or heavy pain anywhere from the low back down to the heel.
Traditional Chinese Medicine utilizes therapies such as acupuncture, herbs and massage in the treatment of sciatica. Heat therapy (such as moxabustion and TDP lamps), and electrical stimulation are often integrated with acupuncture treatments. Qi Gong is a form of exercise commonly used in Traditional Chinese Medicine to treat a variety of ailments including sciatica. During these exercises the mind focuses on balancing the energetics of the body to bring about a healing response.
Other treatments for sciatica may include heat or ice, physical therapy, osteopathic or chiropractic treatments. Injections of non-steroidal anti-inflammatory drugs (NSAID’S), oral steroids or epidural steroid injections may be given to decrease inflammation. Surgery should be the last resort.
The prognosis for sciatica is very good in most cases. There are many options to choose from in the treatment of sciatica. During acute attacks it is best to have some bed rest and avoid heavy lifting or vigorous activity. Gentle stretching is generally good for the low back, buttocks and legs. With proper rest and relaxation some sciatic pains may resolve themselves.