A recent multicenter randomized clinical trial, conducted across six major hospitals in China and published in JAMA Internal Medicine, has provided compelling evidence supporting the use of acupuncture for chronic sciatica due to lumbar disc herniation. The study found that acupuncture not only significantly reduces leg pain but also improves functional outcomes, with benefits persisting for up to one year [1].
The trial enrolled 216 participants diagnosed with chronic sciatica, defined as pain persisting for at least three months due to lumbar disc herniation. Participants were randomly assigned to receive either true acupuncture or sham acupuncture over ten sessions within a four-week period. True acupuncture involved needle insertions at established acupoints associated with sciatica relief, while the sham acupuncture consisted of superficial needle insertions at non-therapeutic points. The rigorously controlled design ensured the validity of the findings [2].
The true acupuncture protocol targeted five key acupoints: Huatuojiaji (EX-B2), Weizhong (BL40), Chengshan (BL57), Yanglingquan (GB34), and Zusanli (ST36). Huatuojiaji, located 0.5 cun lateral to the lower border of the spinous processes from L4 to S3, was needled perpendicularly to a depth of 1.0 to 1.5 cun. Weizhong, situated at the midpoint of the transverse crease of the popliteal fossa, also required perpendicular insertion to a similar depth. Chengshan, found in the depression below the gastrocnemius muscle belly, was needled with the same technique and depth.
Yanglingquan, located in the depression anterior and inferior to the head of the fibula, was needled perpendicularly to a depth of 1.0 to 1.5 cun. Finally, Zusanli, located 3 cun below the lower border of the patella and one finger-breadth lateral to the anterior crest of the tibia, followed a similar needling depth. All acupoints were treated with 0.25 mm diameter needles, each session lasting 30 minutes with manual manipulation to elicit the deqi sensation [3].
The primary outcome measure was the change in leg pain intensity, assessed using the Visual Analog Scale (VAS). Secondary measures included functional disability assessed via the Oswestry Disability Index (ODI) and quality of life assessed by the 36-Item Short Form Health Survey (SF-36). By the end of the four-week treatment, the acupuncture group demonstrated a mean reduction in VAS scores of 30.8, compared to 14.9 in the sham group—a statistically significant difference. Functional improvements were also more pronounced in the acupuncture group, which exhibited a 13.0-point decrease in ODI scores compared to 4.9 points in the sham group. These improvements were maintained at the 12-month follow-up [4].
The researchers note that acupuncture modulates pain perception through the release of endogenous opioids and neurotransmitters, altering pain signaling pathways in the central and peripheral nervous systems. Additionally, the needling of specific acupoints reduces inflammation and enhances blood circulation, facilitating tissue healing and nerve function restoration. These mechanisms align with traditional Chinese medicine theories emphasizing the unblocking of qi and blood flow along meridians [5].
This study provides robust evidence for integrating acupuncture into clinical management strategies for chronic sciatica. Licensed acupuncturists can utilize the detailed protocols outlined in this research to deliver evidence-based care. The specified acupoint selection, precise needling techniques, and treatment frequency offer a replicable framework for practitioners. Furthermore, the sustained benefits observed in this study highlight acupuncture’s potential as a viable non-pharmacological treatment for chronic sciatica.
Source:
1-5. Xia, Liang et al. “Acupuncture for Chronic Sciatica Due to Lumbar Disc Herniation: A Multicenter Randomized Clinical Trial.” JAMA Internal Medicine, November 2024, accessed December 9, 2024.
