Traditional Chinese Medicine Approaches to Sciatica Treatment

Sciatica in Traditional Chinese Medicine (TCM)

In TCM, sciatica is categorized under “Bi Syndrome” and “Low Back & Leg Pain.” It is primarily caused by external invasion of wind, cold, and dampness, stagnation of qi and blood, or deficiency of the liver and kidneys. Treatment principles include dispelling wind and cold, activating blood circulation and unblocking meridians, and tonifying the liver and kidneys. Common treatments include herbal medicine, acupuncture and massage, cupping and gua sha, and moxibustion therapy.

1. Acupuncture Therapy

Acupuncture helps to unblock meridians, relieve nerve compression, and improve blood circulation. Commonly used points include:

• Huantiao (GB30) – Relaxes tendons and activates meridians, effective for sciatica

• Zhibian (BL54) – Clears the Bladder meridian, relieves pain

• Yanglingquan (GB34) – Benefits tendons and joints

• Weizhong (BL40) – Opens channels and relieves lower limb pain

• Chengshan (BL57) – Regulates sciatica and relieves spasms

• Taixi (KI3) – Tonifies kidneys and essence, relieves low back and leg pain

Method: Retain needles for 30 minutes, 2–3 times a week. Combine with heat therapy for enhanced pain relief.

2. Herbal Treatment by Syndrome Differentiation

(1) Cold-Damp Obstruction Type

Pathogenesis: Wind-cold-damp invasion obstructs meridians, impeding qi and blood flow.Symptoms: Low back and leg pain worsened by cold, relieved by warmth; numbness, heaviness in the legs; pale tongue with white greasy coating, deep tight pulse.Treatment Principle: Dispel wind and cold, warm the meridians, unblock channels.Recommended Formula: Modified Duhuo Jisheng TangKey Herbs:

• Duhuo 10g – dispel wind-damp, relieve pain

• Qin Jiao 10g – relax tendons, unblock channels

• Fangfeng 10g – dispel wind, relieve pain

• Danggui 12g – nourish blood, relieve pain

• Chuanxiong 10g – activate blood, unblock channels

• Duzhong 12g – tonify liver/kidney, strengthen bones

• Niu Xi 12g – guide herbs downward, move blood

• Fuling 15g – strengthen spleen, eliminate damp

• Rou Gui 6g – warm meridians

• Gancao 6g – harmonize herbs

Modifications:

• Severe pain → add Frankincense 10g, Myrrh 10g

• Numbness → add Xu Duan 12g, Sangjisheng 15g

• Strong aversion to cold → add Asarum 3g, Fresh Ginger 10g

(2) Qi and Blood Stagnation Type

Pathogenesis: Qi and blood stagnation leads to blocked meridians and intense pain.Symptoms: Sharp pain, numbness, burning sensation; worse with movement; dark purple tongue, sublingual veins; choppy pulse.Treatment Principle: Invigorate blood, remove stasis, move qi, unblock meridians.Recommended Formula: Modified Shentong Zhuyu TangKey Herbs:

• Danggui 12g, Chuanxiong 10g, Taoren 10g, Honghua 10g – activate blood

• Niu Xi 12g – promote downward movement

• Dilong 12g – unblock channels

• Frankincense & Myrrh 10g each – relieve pain

• Xiangfu 10g – move qi and relieve pain

Modifications:

• Severe pain → add Corydalis 12g, Sanqi powder 3g (taken with warm water)

• Burning sensation → add Phellodendron 10g, Anemarrhena 10g

(3) Liver and Kidney Deficiency Type

Pathogenesis: Liver and kidney deficiency causes weak tendons and bones, leading to chronic pain.Symptoms: Aching weakness in low back and legs, worse after prolonged standing/sitting; numbness, aversion to cold; pale tongue, thin coating; weak pulse.Treatment Principle: Tonify liver and kidney, strengthen bones and tendons.Recommended Formula: Modified Zuo Gui WanKey Herbs:

• Shu Di Huang 15g, Shan Zhu Yu 12g, Shan Yao 15g – nourish kidney yin and spleen

• Gou Qi Zi 12g – nourish liver and kidney

• Duzhong 12g, Niu Xi 12g – strengthen bones, promote circulation

• Ba Ji Tian 10g, Lu Jiao Jiao 10g (melted) – warm kidney yang

Modifications:

• Worse at night → add Wu Wei Zi 10g, Gui Ban 12g

• Leg weakness → add Xu Duan 10g, Sangjisheng 15g

  
  

3. Other TCM Therapies

(1) Moxibustion

• Points: Huantiao, Yaoyangguan, Mingmen, Shenshu

• Benefits: Warms meridians, improves blood circulation

(2) Cupping

• Areas: Lower back, Huantiao, Weizhong

• Best for: Cold-damp and qi-blood stagnation types

(3) Tui Na (Massage)

• Techniques: Press Huantiao and Weizhong, knead lower back

• Best for: Fascia tension and muscular stiffness

  
  

4. Lifestyle and Home Care

(1) Diet

✅ Recommended:

• Tonify liver/kidney: black sesame, walnuts, black beans, yam, goji berries

• Promote blood flow: black fungus, red dates, eel, salmon

❌ Avoid:

• Cold/raw foods, iced drinks

• Greasy/oily foods (worsen dampness and pain)

(2) Exercise

• Recommended: Baduanjin, Tai Chi, swimming (warm water)

• Avoid: Prolonged sitting/standing, heavy lifting

  
  

5. Summary Table

Syndrome Type	Main Symptoms	Recommended Formula	Acupuncture Points
Cold-Damp Obstruction	Cold pain, heaviness	Duhuo Jisheng Tang	Huantiao, GB34, KI3
Qi & Blood Stagnation	Sharp pain, numbness	Shentong Zhuyu Tang	BL40, BL57, BL54
Liver/Kidney Deficiency	Aching, weakness	Zuo Gui Wan	Shenshu, Yaoyangguan, Mingmen

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