A randomized clinical trial published in JAMA Internal Medicine found that acupuncture significantly reduced leg pain and disability in patients with chronic sciatica caused by lumbar disc herniation. Patients who received real acupuncture reported clinically meaningful improvements that persisted for at least one year, supporting acupuncture as a viable treatment for long-term symptom relief [1].
The study enrolled 216 adults with chronic sciatica lasting more than three months, confirmed to be due to herniated discs. Participants were randomized into two groups: one received true acupuncture and the other sham acupuncture. Each group received ten sessions over four weeks. Outcomes were measured using the Visual Analog Scale (VAS) for leg pain and the Oswestry Disability Index (ODI), both at baseline and multiple follow-up intervals, including 52 weeks. At week 4, the mean VAS score had decreased by 30.8 mm in the acupuncture group versus 14.9 mm in the sham group. The mean reduction in ODI score was 13.0 points in the acupuncture group compared to 4.9 points in the sham group. These differences remained statistically significant at the 52-week follow-up [1].
The acupuncture protocol included standardized needle insertion at Huatuojiaji (Ex-B2), Zhibian (BL54), Chengfu (BL36), Huantiao (GB30), and Yanglingquan (GB34). Sterile, single-use stainless steel needles (0.25 mm diameter, 40 mm length) were used. Needles were inserted perpendicularly to depths ranging from 25 mm to 40 mm depending on the acupoint. Manual stimulation techniques such as lifting, thrusting, and rotation were employed to elicit the deqi response. Needles were retained for 30 minutes per session, with stimulation applied every 10 minutes. Treatments were administered five times in the first two weeks and twice per week in the subsequent two weeks, totaling ten sessions [1].
The observed analgesic effects are consistent with known neurophysiological mechanisms of acupuncture, including activation of endogenous opioid pathways and modulation of pain-related brain regions such as the anterior cingulate cortex and thalamus. Previous research cited by the authors suggests acupuncture may also downregulate pro-inflammatory cytokines like interleukin-1β and tumor necrosis factor-α, contributing to pain relief and functional improvement [1].
This trial provides high-quality clinical evidence and a clearly replicable protocol for treating chronic sciatica with acupuncture. The well-defined needle specifications, acupoint selection, treatment schedule, and manipulation techniques allow licensed acupuncturists to apply the methodology in clinical practice. The sustained symptom relief observed up to one year post-treatment further supports acupuncture’s role in long-term management of sciatica symptoms [1].
Reference
[1] Tu, J., Shi, G., Yan, S., et al. “Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial.” JAMA Internal Medicine. Published online October 14, 2024.
