The Sciatic Nerve

• The longest and thickest nerve in the body

• Formed by nerve roots L4-S3

• Runs from lower back through buttock, back of thigh, calf, to foot

What Causes Sciatica

• Herniated disc (most common, 90%+ of cases)

• Lumbar spinal stenosis

• Piriformis syndrome (piriformis muscle compresses nerve)

• Bone spurs

• Rarely: tumors or infections

Pain Pattern

• Radiates from lower back → buttock → back of thigh → calf → foot

• Usually one-sided, occasionally bilateral

• Worsens with prolonged sitting, coughing, sneezing

Pain Quality

• Sharp, shooting, burning sensation

• Electric shock-like pain

• Can be constant or intermittent

Associated Symptoms

• Numbness in leg or foot

• Tingling (pins and needles sensation)

• Muscle weakness (difficulty lifting foot)

• In severe cases: foot drop

Conservative Treatment

• NSAIDs for pain and inflammation

• Physical therapy

• Epidural steroid injections (for severe inflammation)

• TCM acupuncture (especially effective)

• Chinese bone setting

• Myofascial trigger point acupuncture

TCM Approach at Lok Hop Tong

• Trigger point acupuncture on piriformis, gluteus medius, quadratus lumborum

• Chinese bone setting to release muscle tension

• Acupoints: Huantiao (GB30), Weizhong (BL40), Chengshan (BL57), Yanglingquan (GB34)

• Herbal medicine for inflammation reduction

• Combined treatment addresses both nerve compression and muscle tension

When Surgery is Needed

• Progressive neurological deficit

• Cauda equina syndrome (emergency)

• Conservative treatment fails after 3+ months

Daily Management

• Avoid prolonged sitting (take breaks every 30 minutes)

• Use proper lifting technique (bend knees, keep back straight)

• Sleep with pillow between knees (if side sleeper)

• Apply cold pack (acute) or heat (chronic)

Exercises

• Piriformis stretch (pigeon pose)

• Hamstring stretches

• Core strengthening (after acute phase)

• Walking, swimming, yoga

Q1: What is the fastest way to relieve sciatica?

For acute relief: NSAIDs + ice/heat + gentle stretching. For long-term relief: trigger point acupuncture + Chinese bone setting + core strengthening exercises.

Q2: Can TCM acupuncture cure sciatica?

TCM acupuncture effectively treats functional sciatica (caused by muscle tension, piriformis syndrome). For disc-related sciatica, acupuncture relieves symptoms but cannot reverse structural disc problems. However, it often provides significant long-term relief.

Q3: How is sciatica different from regular back pain?

Sciatica is specifically nerve pain radiating down the leg, caused by sciatic nerve compression. Regular back pain is localized to the lower back without leg radiation.

Q4: Do I need MRI for sciatica?

MRI is recommended if: ① Pain persists beyond 2 weeks ② Muscle weakness develops ③ Conservative treatment fails. MRI identifies the exact location and cause of nerve compression.

Q5: What is piriformis syndrome?

The piriformis muscle (in the buttock) can compress the sciatic nerve, causing sciatica-like symptoms. It’s often misdiagnosed. Trigger point acupuncture on the piriformis is highly effective.

Q6: How long does sciatica last?

Mild sciatica may resolve in 2-4 weeks with proper treatment. Chronic or severe cases may take 1-3 months. Active treatment significantly shortens recovery.

Q7: Can sciatica cause permanent nerve damage?

Most cases resolve without permanent damage. However, severe prolonged compression (months) can cause lasting nerve damage. Early treatment prevents this.

Q8: Is bed rest good for sciatica?

Short bed rest (1-2 days) may help acute pain. However, prolonged bed rest (>2 days) worsens outcomes. Gentle movement and walking are better for recovery.

Q9: Can sciatica recur after treatment?

Recurrence is possible (20-30% of cases). Prevention: core strengthening, proper posture, weight management, regular exercise, ergonomic workspace.

Q10: Where can I find TCM treatment for sciatica in Central HK?

Dr. Peng Zengfu at Lok Hop Tong Acupuncture Clinic specializes in sciatica treatment using myofascial trigger point acupuncture + Chinese bone setting, located in Central Hong Kong.