The treatment of sciatica in Traditional Chinese Medicine

Sciatica belongs to the category of "arthralgia" and "low back and leg pain" in traditional Chinese medicine, which is mainly caused by invasion of wind, cold and dampness, stagnation of qi and blood, and deficiency of liver and kidney. The treatment principle is to dispel wind and cold, activate blood circulation and dredge collaterals, and nourish liver and kidney. Specific treatment methods include oral administration of Chinese medicine, acupuncture and massage, cupping and scraping, and moxibustion therapy.

1. Acupuncture treatment

Acupuncture can dredge meridians, relieve nerve compression, and improve blood circulation.

The main acupuncture points are:

Huantiao (GB30): relaxes the muscles and activates the collaterals, improves sciatica

Zhibian (BL54): dredges the foot-sun meridian and relieves pain

Yanglingquan (GB34): relaxes the muscles and benefits the joints

Weizhong (BL40): dredges the meridians and activates the collaterals, relieves lower limb pain

Chengshan (BL57): regulates sciatica and improves spasms

Taixi (KI3): tonifies the kidney and replenishes essence, relieves waist and leg pain

Methods:

Leave the needle in for 30 minutes, 2-3 times a week.

Combined with heat lamp therapy, it enhances the analgesic effect.

2. Chinese medicine syndrome differentiation and treatment plan

(1) Cold-dampness blocking the collaterals

Pathogenesis: Wind, cold and dampness invade the meridians, the circulation of qi and blood is blocked, causing pain.

Symptoms: pain in waist and legs, aggravated by cold, relieved by hot compress, numbness and heaviness in lower limbs, pale tongue with greasy white coating, deep and tight pulse

Treatment method: dispel wind and cold, warm the meridians and dredge the collaterals

Recommended prescription: Duhuo Jisheng Decoction with modifications

Chinese herbal medicine:

Duhuo 10g (dispel rheumatism, relieve arthralgia and pain)

Qinjiu/Gentiana macrophylla 10g (dispel rheumatism, relax muscles and activate collaterals)

Fangfeng/Saposhnikovia divaricata 10g (dispel rheumatism, relieve pain)

Danggui/Angelica sinensis 12g (activate blood circulation and nourish blood, relieve pain)

Chuanxiong 10g (activate blood circulation and qi, dredge the collaterals)

Duzhong/Eucommia ulmoides 12g (tonify liver and kidney, strengthen muscles and bones)

Niuxi/Achyranthes bidentata 12g (lead the medicine downward, activate blood circulation and dredge the collaterals)

Fuling/Poria 15g (strengthen the spleen and dispel dampness)

Rougui/Cinnamon 6g (warm the meridians and dispel cold)

Gancao/Licorice 6g (harmonize all medicines)

Additions and subtractions:

Severe pain → add Ruxiang/frankincense 10g, Moyao/myrrh 10g (to promote blood circulation and relieve pain)

Severe numbness in the lower limbs → add Chuanxuduan 12g, Sangjisheng/mistletoe 15g (to nourish the liver and kidney, strengthen the tendons and bones)

Obvious fear of cold → add Xixin/asarum 3g, Shengjiang/ginger 10g (to warm the meridians and dispel cold)

(2) Qi stagnation and blood stasis type

Pathogenesis: Qi and blood stasis, tendons and veins are blocked, resulting in severe pain and limited movement.

Symptoms:

Tingling, numbness, burning sensation, pain aggravated by activity, dark purple tongue, sublingual ecchymosis, sluggish pulse

Treatment: Activate blood circulation and dissipate blood stasis, promote qi and dredge collaterals

Recommended prescription: Shentong Zhuyu Decoction with modifications

Chinese herbal medicine:

Danggui/Angelica sinensis 12g (activate blood circulation and nourish blood)

Chuanxiong 10g (promote qi and activate blood circulation)

Taoren/Peach kernel 10g (activate blood circulation and dissipate blood stasis)

Honghua/Safflower 10g (activate blood circulation and dredge collaterals)

Niuxi/Achyranthes bidentata 12g (activate blood circulation downward)

Dilong/Earthworm 12g (dredge meridians and activate collaterals)

Ruxiang/Frankincense 10g (activate blood circulation and relieve pain)

Moyao/Myrrh 10g (dissipate blood stasis and relieve pain)

Xiangfu/Cyperus rotundus 10g (promote qi and relieve pain)

Additions and subtractions:

Severe pain → add Yanhusuo/Corydalis yanhusuo 12g, Shanqifen/Panax notoginseng powder (taken with water) 3g (strong analgesic)

Obvious burning sensation → add Huangbai/Phellodendron chinense 10g, Zhimu/Anemarrhena asphodeloides 10g (clearing heat and unblocking meridians)

(3) Liver and kidney deficiency type

Pathogenesis: Liver and kidney deficiency, malnutrition of tendons and bones, leading to chronic low back and leg pain and weakness.

Symptoms:

Weak waist and leg pain, aggravated after standing or sitting for a long time, numbness of lower limbs, fear of cold, pale tongue with thin coating, weak pulse

Treatment: nourish liver and kidney, strengthen tendons and bones

Recommended prescription: Zuogui Pills with modifications

Chinese herbal medicine:

Shudihuang/Rehmannia glutinosa 15g (tonifies kidney yin)

Shanzhuyu/Cornus officinalis 12g (tonifies liver and kidney)

Shanyao/Chinese yam 15g (strengthens spleen and replenishes qi)

Gouqizi/Lycium barbarum 12g (tonifies liver and kidney)

Duzhong/Eucommia ulmoides 12g (strengthens tendons and bones)

Niuxi/Achyranthes bidentata 12g (leads the medicine downward, activates blood circulation and dredges)

Bajitian/Morinda officinalis 10g (warms and nourishes kidney yang)

Lujiaojiao/Deer antler glue 10g (melts) (tonifies kidney yang, strengthens tendons and bones)

Additions and subtractions:

Worsened at night → add Wuweizi/Schisandra chinensis 10g, Guiban/Tortoise shell 12g (tonifies yin and suppresses yang)

Weak lower limbs → add 10g of Xuduan/Dipsacus asper, 15g of Sangjisheng/Viscum album (tonify liver and kidney, strengthen tendons and bones)

3. Other TCM physiotherapy

(1) Moxibustion

Moxibustion points: Huantiao, Yaoyangguan, Mingmen, Shenshu

Efficacy: warm the meridians and dispel cold, improve local qi and blood circulation

(2) Cupping

Cupping sites: lumbosacral region, Huantiao, Weizhong

Applicable population: cold and damp type, qi stagnation and blood stasis type

(3) Massage/Tui Na

Technique: press Huantiao and Weizhong, massage lumbosacral region

Applicable population: those with fascia tension

4. Lifestyle conditioning

(1) Diet conditioning

✅ Suitable for:

Warming and tonifying liver and kidney: black sesame, walnut, black bean, yam, wolfberry

Activating blood circulation and removing blood stasis: black fungus, red dates, eel, salmon

❌ Avoid eating:

Cold food (icy drinks, raw and cold food)

Greasy food (prone to produce dampness, aggravating pain)

(2) Exercise recommendations

Recommended: Ba Duan Jin, Tai Chi, swimming (warm water)

Avoid: sitting or standing for long periods of time, avoid excessive weight bearing

5. Summary

Syndrome type Main symptoms Recommended prescription Acupuncture points

Cold and dampness blocking the collaterals - cold, pain and heaviness - (Duhuo Jisheng Decoction) Huantiao, Yanglingquan, Taixi

Qi stagnation and blood stasis - tingling and numbness - (Shentong Zhuyu Decoction) Weizhong, Chengshan, Zhibian

Liver and kidney deficiency - soreness, pain and weakness - (Zuogui Pills) Shenshu, Yaoyangguan, Mingmen

Combined Chinese medicine, acupuncture, moxibustion, massage, and exercise can effectively relieve sciatica and improve the quality of life. It is recommended to find a professional Chinese medicine practitioner to diagnose and treat the diseases.