By: Trish Yerges | For WesCom News Service
Sciatica is leg pain that originates at the nerve roots on either side of the lumbar vertebrae in the lower back. These nerve roots then course through the sciatic nerves, which run the entire length of each leg from the buttock to the toes.
Nerve roots in the lower back may be compressed. In some cases, a disk may crack, bulge and pinch the sciatic nerve. The resulting leg pain is commonly referred to as radiculopathy, and the pain can make walking, sitting or laying down an excruciating experience for some patients.
That is when acupuncture can be a viable treatment for pain relief and healing.
"The role of acupuncture is to provide relief," said Glenda O'Connor, licensed acupuncturist at Mountain Valley Therapy in La Grande. "Basically what I do is relax muscles that may be tight and creating pressure on the nerve, whether it's coming right off the lumbar or whether it's coming from the muscles, which are really big muscles."
An acupuncturist will take the patient's history and perform a tactile examination of muscles and acupuncture points on the body. The muscle may feel smooth to the touch, and then there is suddenly a notable change in texture, what O'Connor calls "a blockage."
"I feel for acupuncture points and if they have pain in them," O'Connor said. "These points can feel warm, cold, soft or really hard. They just feel a little different from surrounding muscles. This is where I would place a needle."
When treating sciatica, the needles are never inserted into the nerves themselves, but into the muscle at the acupuncture site.
"Needling a nerve would be like doing dental work without numbing," O'Connor said. "We couldn't needle a nerve if we wanted to, but I do think people have a misconception about that."
Needles are placed carefully into the muscle and connective tissues to cause a micro-trauma, which, in turn, stimulates the body's own self-healing mechanisms. The body is always undergoing repair on a cellular level anyway, but the advantage of acupuncture is that it directs the healing response to precise areas of the body to clear the blockage and allow for healing.
"In order to have healing, you have to create space," O'Connor said. "Essentially, I'm creating space by moving things down so this can flow. It's just movement. Some people say chi or energy. I think of it as movement."
Reducing pain is O'Connor's first priority. To do that, she identifies areas of blockage in the muscles along meridians.
"Acupuncture establishes increased blood flow, which brings more oxygen, brings nutrition and brings all the things the body has at its amazing disposal to heal," she said. "I want to move the blockage. If you have pain, you have blockage. If you don't have pain, you don't have blockage. It's pretty much that straight-forward."
O'Connor places needles at precise points within a meridian or channel to direct pain to exit the body, to create a pathway where energy can flow and exit, along with the pain
Sciatic nerve pain is frequently located in the gallbladder meridian or in the urinary bladder meridian. Acupuncture needling may start at the lumbar area and proceed down the leg to an exit site like the toes.
Within that pathway, a major acupuncture point for sciatica is in the cheek of the buttock that is the trigger point for the piriformis muscle located deep in the buttock, behind the gluteus maximus. This muscle is often involved with sciatic nerve pain.
"For some people, the sciatic nerves passes through the fibers of that muscle, so when that muscle gets tight, it squeezes the sciatic nerve," O'Connor said.
Each acupuncture treatment builds on itself. You get relief longer and you're increasing your healing between treatments. A fair attempt at getting benefit from acupuncture is four sessions, said O'Connor.
"After a patient has had an adequate number of treatments and he is doing pretty well, if he re-irritates that area, he can usually recover on his own," she said. "Often patients don't have to come back to me if they do enough treatments in the beginning, so you have recovery because everything is flowing real good—the channel has been cleared. So it's absolutely critical that patients come for enough treatments. Quitting prematurely is the number one mistake that patients make."
To avoid re-injury of the sciatic nerve, discover what thing or activity caused it in the first place.
"It might be something like a sagging bed that needs replacing or sitting too long at a computer," she said. "Identify the cause and make the necessary corrections and lifestyle changes."