Acupuncture Reduces Leg Pain from a Herniated Disk

Recent clinical research has demonstrated that acupuncture significantly alleviates leg pain and improves function in patients suffering from chronic sciatica due to herniated discs. A multicenter randomized clinical trial conducted across six tertiary-level hospitals in China assessed the efficacy and safety of acupuncture compared to sham acupuncture in this patient population. The study involved 216 participants who were randomly assigned to receive either 10 sessions of acupuncture or sham acupuncture over a four-week period.

The primary outcomes measured were changes in leg pain intensity, assessed using the Visual Analog Scale (VAS), and functional disability, evaluated with the Oswestry Disability Index (ODI). Results indicated that the acupuncture group experienced a mean decrease of 30.8 mm in VAS scores, compared to a 14.9 mm reduction in the sham group. Similarly, ODI scores decreased by 13.0 points in the acupuncture group, versus a 4.9-point reduction in the sham group. These benefits persisted through a 52-week follow-up period, underscoring the long-term efficacy of acupuncture in managing chronic sciatica from herniated discs.

The acupuncture protocol employed in this study was designed to target specific acupoints associated with sciatic nerve pathways. Practitioners utilized fine, sterile, single-use needles, typically 0.25 mm in diameter and 40 mm in length, to ensure precise stimulation. The primary acupoints selected included:

• BL40 (Weizhong): Located at the midpoint of the transverse crease of the popliteal fossa.

• BL23 (Shenshu): Situated 1.5 cun lateral to the lower border of the spinous process of the second lumbar vertebra.

• GB30 (Huantiao): Found at the junction of the lateral one-third and medial two-thirds of the distance between the prominence of the greater trochanter and the sacral hiatus.

• BL54 (Zhibian): Positioned 3 cun lateral to the median sacral crest, at the level of the fourth sacral foramen.

In addition to the primary acupoints used in the study for treating chronic sciatica, other secondary acupoints were selected to support symptom relief and enhance the overall therapeutic effect. These auxiliary acupoints were chosen based on their traditional associations with pain relief, sciatic nerve pathways, and the lumbar spine. Here are some additional points used for sciatica and lumbar pain treatment based on individual patient presentation:

• BL36 (Chengfu): Located on the posterior thigh, midway between the gluteal fold and the knee, this point is used for alleviating pain along the sciatic pathway, especially for issues radiating down the posterior leg.

• BL57 (Chengshan): Positioned on the posterior leg, about 8 cun below BL40, this point is commonly used to treat lower back pain, stiffness, and sciatic pain extending down the calf area.

• BL60 (Kunlun): Found in the depression between the lateral malleolus and the Achilles tendon, this point is known for its effectiveness in relieving lower back and leg pain, particularly when the pain reaches the ankle area.

• GB34 (Yanglingquan): Located on the lateral side of the lower leg, just below the knee, GB34 is often used to relieve muscle and joint pain, particularly around the hips and legs. It is the influential point of tendons and sinew.

• ST36 (Zusanli): Situated on the anterior aspect of the lower leg, 3 cun below the knee joint, ST36 is traditionally used to strengthen the body’s energy and relieve pain in the lower extremities, supporting overall pain management.

• DU3 (Yaoyangguan): This point, located below the spinous process of the fourth lumbar vertebra, is used in treatments for lower back pain, especially for pain originating from the lumbar region.

These additional acupoints were stimulated according to traditional needle insertion techniques, with needle depths and manipulations adjusted based on the patient’s sensitivity and response to elicit the deqi sensation. In this study, practitioners used both manual and electrical stimulation on selected points, where electrical stimulation was applied at low frequencies (2 Hz) to enhance analgesic effects for deeper and longer-lasting pain relief.

Each session involved the insertion of needles to a depth sufficient to elicit the deqi sensation—a composite of sensations including soreness, numbness, and distension, indicative of effective needle placement. Manual manipulation techniques, such as lifting, thrusting, and rotating the needles, were applied to enhance therapeutic outcomes. Sessions lasted approximately 30 minutes, with treatments administered twice weekly over the four-week intervention period.

The study also monitored serum biomarkers to elucidate the underlying mechanisms of acupuncture’s analgesic effects. Notably, there was a significant reduction in pro-inflammatory cytokines, including interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), in the acupuncture group compared to baseline levels. These findings suggest that acupuncture modulates inflammatory pathways, contributing to pain relief and functional improvement in patients with chronic sciatica.

This rigorously conducted trial provides compelling evidence supporting the use of acupuncture as an effective and safe intervention for chronic sciatica resulting from herniated discs. The detailed acupuncture protocol, including specific acupoint selection, needle specifications, and manual manipulation techniques, offers a valuable framework for practitioners aiming to implement this therapy in clinical settings. The observed reductions in pro-inflammatory cytokines further substantiate the biological plausibility of acupuncture’s therapeutic effects, highlighting its potential role in modulating inflammatory processes associated with chronic pain conditions.