Treatment of Sciatic pain by Traditional Chinese Medicine (TCM)
Sciatic pain is not a diagnostic term. It is only a symptom,
similar to shoulder pain, that is also a symptom, not a
diagnosis yet. Sciatic nerve goes from spine, through lower
back, hip, to the back of the though, outside of the small leg
and outside of the feet. Any reasons that press the nerve, such
as by enlarged bone structure, spasm or swelling of the soft
tissue around the nerve, or the damage or inflammation of the
nerve per se, or tumor inside the spine, all can cause the pain
on the zones that the nerve distributes to.
Therefore, if your doctor tells you that you suffer from
sciatic pain, it is not an exact diagnosis yet. He needs to
further more find the reason(s) for the hurt of the nerve.
In clinic, most time, the sciatic pain is due to the spasm of
the muscles in the hip and due to the suppress of the nerve by a
protruded intervertebral disk.
It is very common in clinic to see a patient with sciatic pain.
To subgroup the patients as stem type, root type, or
shrub type is not so useful for TCM clinic practice. TCM pays
more attention to see if the pain is due to Cold, Fire, Wetness,
blood-stagnation, Qi-stagnation, or Phlegm accumulation in the
area where the nerves goes.
Chinese medicine uses herbal therapy, acupuncture, moxibustion,
or Chinese Tuina massage (you can also call it Chinese
chiropractor) therapy for the treatment of sciatic pain. For
most cases, it works very well. Generally speaking, no matter to
use the herbal therapy or acupuncture, after the first session
of treatment, the pain can be reduced to some level. To make the
pain complete disappear, it needs one to two months of
Chinese herbal therapy
For the use of Chinese herbal therapy, we need to know if the
sciatic pain is due to a trauma or not. For example, we need to
know if the pain happens after lifting heavy stuff, or cough, or
sneeze, or pushing hard during bowel movement, etc. If it comes
due to a trauma, we choose the herbal formula established by
doctor Shaodong Chen.
If the patient feels mostly pain and there is no clear skin
swelling or bruise, the pain is not affected by the weather
change, we use herbal formula Zheng Yao Tang, Huo Luo Xiao Ling
Dan, or Tao Hong Tong Dou Tang.
If the tongue is red in color, the tongue covering is yellow and
thick, the pulse feels string-fast, it indicates that there is
Fire-Wetness inside the body. Use herbal formula Zhi Bo Xie Re
Hua Yu Tang.
If the pain is worse during raining weather, and there is purple
color on the tongue, it indicates a Wetness and Blood stagnation
inside the body, use Bu Shen Huo Xue Tang or use Shen Zhao Tang
plus Du Huo Ji Sheng Tang.
If the patient has no clear history of a trauma, use the
If the pain is very severe, the muscle on the leg feels spasm,
use Shao Yao Gan Cao Tang, or Shao Yao Gan Cao Tang plus Ma
Huang Fu Zi Xi Xing Tang.
If the patient feels hot in the body, and likes to drink cold or
ice water, use Ma Xing Shi Gan Tang, plus herb Sheng Jing Cao,
Mu Gua, etc. or use Ma Xing Shi Gan Tang plus Shao Yao Gan Cao
If the patient is strong in body constitution, has hard the
tightness feeling on the upper stomach, use Da Chai Hu Tang. For
such patient, if the lower abdomen feels tight or discomfort or
pain too, or constipation, use Tao He Cheng Qi Tang.
If the body condition is Yang deficiency and Cold accumulation
into a cold mass, the patient feels pain on the side of abdomen
too, feels hot in the body but cold in the hands and feet, use
Da Huang Fu Zi Tang, or Da Huang Fu Zi Tang plus Shao Yao Gan
If the patient usually feels cold hands and feet, use Dang Gui
Si Ni Tang plus Shao Yao Gan Cao Tang.
If the whole body also feels sour, and the sciatic pain is worse
at night, use Shu Jing Huo Xue Tang.
If the patient feels cold in the body, and in the feet, but hot
on the face, and if the person has spasm in the calf from time
to time, use Wu Ji San plus Shao Yao Gan Cao Tang.
If the patient is with some ganecologic disorders, disorder of
menstruation, some mass that can be touched on the lower abdomen
(due to tumor from uterus or ovary, or inflammation from
intestine, such as chronic appendicitis, or due to
endometriosis), use Gui Zhi Fu Ling Wan plus Shao Yao Gan Cao
If patient, especially for old person, has pain in the lower
back, especially the pain might be due to diabetes, use Ba Wei
If it is really hard to tell which herbal formula should be
used, use Quan Xie Hong Hua Tang.
For the herbal decoction, it needs to be drunk every day, three
times a day. The pain can be reduced from the second day.
Acupuncture is another commonly used therapy for sciatic pain.
There are many different remedies for the acupuncture, depending
on the acupuncturists. It works for slight to medium level of
the sciatic pain. The commonly used acupuncture points are those
located on the lower back, and back of the legs, such as Shen
Shu, Da Chang Shu, Xiao Chang Shu, Zhi Bian, Huang Tiao, Yao
Yang Guan, Cheng Fu, Wei Zhong, Yang Ling Quan, Qiu Xu, and Zu
Ling Ti, etc. Cupping and Moxibustion is usually used during the
acupuncture session too. After acupuncture, we also apply a
herbal patch on to the painful place.
Acupuncture needs to be performed every day. The pain can start
to become less after the fist treatment. Acupuncture should be
done at least two to three times a week until the pain is much
less and much tolerable. After that, it is needed once a week
for two to three weeks for a maintenance.
For very severe sciatic pain, especially if it is caused by
intervertebral disk protrution, it is better to ask a Chinese
style of chiropractor to return the disk back to its normal
position. However unfortunately it is difficult to find such
chiropractor in the western world. After the treatment of such
Chinese style of chiropractor, we still need to use Chinese
herbal therapy or acupuncture to reduce swelling or spasm of
surrounding tissues that pressed the sciatic nerve.
During the treatment of sciatic pain, especially after the first
treatment, there is about 5% of patients who may feel more pain.
It is called healing crisis. It usually lasts for half day to
one day. After that, the pain would subside much faster than
most other patients. Therefore, it is bad for the patient on one
side, but it is also a good sign on another. Very rarely, such
worse pain is due to a malpractice of the acupuncturist.
Everyone should understand this possibility and tell your
acupuncturist if you do feel more pain after the treatment, so
as to allow the acupuncturist to change his treatment remedies.
It is the mutual hope from both patient and the acupuncturist to
reduce the sciatic pain as soon as possible.
Patient with sciatic pain must have a break from heavy physical
activities. We should know that the pain is the signal from our
body asking us to slow down, rather than to move more
vigorously. Do not mis-regard the meaning of any signals from
our body. We must wait until the pain completely goes away. The
treatment for sciatic pain does not need special care for diet.
The attention in the diet, if any, is to prevent constipation
since it may make the sciatic pain worse during bowel movement.
After disappear of the sciatic pain, the person should still be
careful not to have heavy physical action, such as lifting heavy
stuff, or vigorous exercise. Otherwise, the pain may come back
again. You see, before you had the sciatic pain this time, you
have no any problem for your lower back and your sciatic nerve.
Now your sciatic nerve has been damaged one time, and there
would be higher chance that your sciatic nerve is hurt again if
you do not care it in future. You cannot expect that your
sciatic nerve becomes much stronger than ever so as no future
hurt upon similar vigorous physical activities. We must be very