The use of Electroacupuncture for the Treatment of Discogenic Sciatica

Sciatica refers to the pain that radiates along the path of the sciatica nerve, which branches from the lumbar spine of the lower back through the hips, buttocks, and down the leg.  Nearly 90% of sciatica cases are discogenic in origin and most likely caused by a lumbar disc herniation.  It may be accompanied by neurologic deficits, such as leg pain, leg paraesthesia (numbness and tingling), and low back pain.  Current treatments for discogenic sciatica include surgical and conservative treatments.  Surgical procedures can range from spinal fusions to discectomy.  Conservative treatments can range from medication, PT, spinal injections, etc.

Electroacupuncture (EA) has been used to treat sciatica for many decades in China.  Studies have reported that EA may effectively alleviate neuropathic pain and relieve sciatica symptoms.  A randomized clinical trial in 2017 compared the effectiveness of electroacupuncture vs medium-frequency electrotherapy (MFE) for discogenic sciatica.  MFE is also known as interferential current (IFC), a modality used by physical therapists and is similar to transcutaneous electrical nerve stimulation (TENS).

In the study, they recruited 100 participants and randomized into 2 groups: EA and MFE.  The EA group received acupuncture and electrical-stimulation at BL25 dachangshu on the affected side and bilateral Huato Jia Ji points corresponding to the lumbar disc herniation using 50 Hz frequency and a comfortably tolerated maximum current intensity.  The acupoints and frequencies used in the MFE group were the same as those used in the EA group.  The treatments in both groups were performed once daily for 5 sessions/week for the first 2 weeks and followed by 3 sessions/week for the following 2 weeks, with each session lasting 20 minutes.

The decrease in leg pain score from baseline to week 4 differed significantly between the EA group and the MFE group.  The mean change from baseline to the 4th week in average leg pain intensity was 2.3 in the EA group and 1.06  in the MFE group.  While both modalities significantly reduced leg pain scores, the EA group showed a more significant decrease compared to the MFE group.  Furthermore, they found that the pain-relieving effect of the EA (but not MFE) lasted for at least 28 weeks.  The long-term effects of EA were superior to those of MFE because the effects of EA persisted after the discontinuation of the treatment.  In addition, the EA group experienced addtional benefits: low back pain and Oswestry Disability Index both improved significantly.

This randomized controlled clinical trial demonstrated that the short-term and long-term effectiveness of EA were superior to those of MFE in improving the symptoms of leg pain and disability of chronic discogenic sciatica.

Zhang, Xue, et al. “A Randomized Clinical Trial Comparing the Effectiveness of Electroacupuncture versus Medium-Frequency Electrotherapy for Discogenic Sciatica.” Evidence-Based Complementary and Alternative Medicine, vol. 2017, 12 Apr. 2017, pp. 1–9., doi:10.1155/2017/9502718.

Posted in: Physical Therapy

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