Chronic sciatica can be debilitating, particularly when it is caused by a herniated disc and has failed to respond to conventional treatments. New high-quality research now adds strong evidence that acupuncture is not only a viable option, but an effective and safe treatment for people living with long-term sciatic pain.
A Chinese research team recently published a large randomised clinical trial in JAMA Internal Medicine examining the effects of acupuncture in patients with chronic sciatica lasting longer than six months. All participants had persistent symptoms despite standard medical care, making this a particularly relevant study for those who feel they have “tried everything”.
The study included 220 patients who were randomly assigned to receive either verum (true) acupuncture or sham acupuncture over a four-week treatment period. Patients in the acupuncture group received 10 sessions, with treatments delivered three times per week for the first two weeks and twice per week thereafter.
The acupuncture protocol was based on commonly used points for lumbar and sciatic pain. Bilateral back points included Dachangshu (BL-25) and Guanyuanshu (BL-26). Unilateral leg points were selected according to the location of the patient’s pain. For pain along the side of the leg, points such as Huantiao (GB-30), Fengshi (GB-31), Yanglingquan (GB-34) and Xuanzhong (GB-39) were used. For pain along the back of the leg, points including Zhibian (BL-54), Chengfu (BL-36), Weizhong (BL-40), Chenshan (BL-57) and Kunlun (BL-60) were selected. Each treatment involved a total of nine acupuncture points.
The sham acupuncture group received needling at non-acupuncture points adjacent to the true points, using short, blunt needles designed to minimise therapeutic effect.
The primary outcome measured was pain intensity using a 100 mm visual analogue scale (VAS), assessed from baseline through to 12 weeks. Secondary outcomes included functional ability, quality of life, use of pain medication and longer-term pain relief, with follow-up extending to 52 weeks.
The results were compelling. Patients receiving true acupuncture experienced significantly greater pain reduction than those in the sham group. By week four, leg pain had decreased by an average of 30.8 mm on the VAS in the acupuncture group, compared with a 14.9 mm reduction in the sham group. These differences emerged as early as week two and were maintained throughout long-term follow-up, persisting up to one year.
Functional outcomes also improved. Disability, measured using the Oswestry Disability Index (ODI), decreased by 13 points in the acupuncture group compared with just under 5 points in the sham group at week four. Improvements in function and quality of life were sustained, although they were less pronounced than the reductions in pain.
Importantly, no serious adverse events were reported in either group, reinforcing the safety of acupuncture as a treatment option for chronic sciatica.
The authors conclude that acupuncture should be considered a valuable complementary therapy for patients with chronic sciatica due to herniated discs, particularly for those who have not achieved adequate relief with conventional treatments. This study adds robust clinical evidence to support what many practitioners and patients have observed in practice: acupuncture can offer meaningful, lasting relief from chronic sciatic pain.
Reference: Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial. JAMA Intern Med. 2024;184(12):1417–1424.
