Sciatica – Lumbosacral Pain

I often treat patients who attend clinic with pain in the lumber, buttock and leg, commonly described as sciatica.

Sciatica is usually described by the patient as a stabbing or burning pain that radiates from the buttock down the back or side of the leg occasionally reaching the foot (generally following the path of the sciatic nerve). Typically it affects only one side and is aggravated by driving, walking, bending and coughing. The pain can vary in intensity and affect more or less areas of the leg at different times of the day. The pain can be severe, debilitating and very draining.

Western medicine breaks sciatica down into primary and secondary types. Primary sciatica is due to an infection affecting the sciatic nerve directly. Secondary sciatica is caused by adjacent structures causing pressure or displacement of the sciatic nerve, such as a prolapsed lumber disk, infection in the tissues about the sacrum, coccyx or pelvis, or muscular dysfunction. In clinic I find that a condition called piriformis syndrome, where the piriformis muscle in the buttock excerpts pressure on the sciatic nerve, is often the cause of sciatic pain.

It appears to me that the Western medicine treatment of sciatica  is often vague and comes down to taking pain killers and waiting for it to spontaneously resolve; unfortunately by the time I see a patient the pain has often been present for a long time and or the problem resolves briefly but returns frequently. Fortunately though traditional Chinese medicine (TCM) takes a more practical approach and is often an extremely effective treatment.

TCM classifies the signs and symptoms associated with sciatic pain as Bi Syndrome (pronounced ‘bee syndrome’), a particular diagnosis referring to a painful condition. The cause of this bi syndrome is most often considered to be due to stagnation of qi and blood in the Gall Bladder and or Bladder meridians that closely follow the pain route, see images below.

Bladder Channel

Gall Bladder Channel

This stagnation of qi and blood may be caused by various aetiologies but some common examples are:

  • Prolonged trauma or strain generally characterised by stabbing or piercing pain and a history of trauma. I have noticed that a poor driving position or excessive driving over many years can be a cause and trigger of sciatica
  • Invasion of Wind-Cold-Damp generally characterised by a radiating heaviness with the pain worse in cold damp weather or a cold damp environment, and better for a warm dry environment
  • Kidney Deficiency generally characterised by frequent recurrence of the sciatica. It is often aggravated by exertion, alleviated by rest and accompanied by a weak sore back and knees, tiredness and a feeling of cold in the affected area

Experience shows that TCM treatments are frequently effective in treating the underlying patterns causing qi and blood stasis and relieving the pain of sciatica. Treatment may consist of acupuncture, cupping, moxibustion, massage, or often a combination of these therapies. Usually the patient responds quickly with relatively few treatments, although further treatments may be recommended to treat the underling disorders to help prevent recurrence.

To prevent sudden relapse the patient should not let the affected area get cold and should slowly build up exercise and stretching. Where there is an underlying pattern involving Damp then it may also be advisable for the patient to modify their diet to avoid foods cold and dampening in nature.

By Austin ©2014 Austin Austin

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