What is sciatica?

Written by Na Hong Wei
Orthopedics
Updated on January 02, 2025
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Sciatica refers to severe pain caused by various reasons that result in the compression and irritation of the sciatic nerve. The typical pain of sciatica radiates from the lower back to the buttock or the back of the thigh and the lateral side of the leg down to the foot. The pain can intensify during coughing or increased abdominal pressure. Additionally, this condition is often accompanied by dullness or numbness, and in a minority of cases, it can cause bilateral sciatica. Generally, there are three main causes of sciatica: The first is chemical irritation, mainly when the disc tissue comes into contact with the sciatic nerve, releasing chemical substances that stimulate and trigger an autoimmune response, resulting in neuritis. The second cause is mechanical compression, primarily from protuberance and nucleus pulposus compression or traction on the already inflamed nerve root, leading to obstructed blood flow and worsening edema. The third cause follows chemical stimulation and mechanical compression, leading to ischemic symptoms in the injured nerve, which then results in pain. Therefore, sciatica typically has primary and secondary causes. The primary cause is sciatic neuritis, while secondary causes are usually associated with lumbar spinal stenosis, lumbar disc herniation, lumbar tumors, and piriformis outlet syndrome.

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Written by Na Hong Wei
Orthopedics
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How to completely cure sciatica?

Treatment methods for sciatica include several approaches. First, resting on a hard board bed; typically, this rest period lasts three to four weeks, during which many patients experience symptom relief. Second, pharmacological treatment is recommended, usually involving non-steroidal pain relievers, as well as vitamins B1, B6, and B12. Short courses of corticosteroid hormones are also used. However, it is important to use hormones minimally and to stop their use correctly if possible. Third, traditional Chinese medicine and herbal treatments are preferred. Many cases of sciatica may be alleviated or even cured with the proper application of traditional Chinese medicine and herbs. Common remedies include Xuanluo Tongbi Decoction, Wutou Xixin Tongbi Decoction, and Duhuo Jisheng Decoction. Local injection treatments are also available, but it is crucial to ensure precise and successful injection on the first attempt. Fourth, exercise therapy is essential as inactivity can lead to muscle atrophy, so proper rehabilitation is necessary. Sixth, dietary therapy should focus on nutritious foods while avoiding junk food and spicy, stimulating dishes.

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Written by Lv Yao
Orthopedics
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Which department should I go to for sciatica?

For sciatic nerve pain, it is recommended to first consult an orthopedic or spinal surgery specialist. Initially, it is important to determine the cause of the pain, such as whether it is caused by a herniated disc pressing on the nerve root. If it is confirmed that the pain is not caused by a herniated disc pressing on the nerve root, and it is purely sciatic nerve pain, you can then visit a pain management clinic to check for potential issues like piriformis syndrome. In essence, start with an orthopedic consultation to rule out orthopedic conditions. If no orthopedic issues are found, then consult a pain management specialist.

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Written by Feng Ying Shuai
Traditional Chinese Medicine
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Is cupping useful for sciatica?

Sciatica is a syndrome characterized by radiating pain originating in the lower back and extending through the buttocks, back of the thigh, outer side of the calf, and outer side of the foot. It particularly affects those who have experienced external exposure to cold, dampness, or injury from local strains or overexertion, leading to stagnation of Qi and blood stasis type of sciatic pain. Cupping therapy has been shown to be effective, meaning it can alleviate some of the clinical symptoms of sciatica to a certain extent. For example, cupping therapy for cold-dampness type can lighten the local cold and dampness, expel wind and open the channels, and thereby relieve pain. If the condition is due to Qi stagnation and blood stasis, blood-letting cupping can be used to promote the circulation of Qi and blood, remove stasis, regenerate new blood, and alleviate joint pain.

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Written by Cheng Bin
Orthopedics
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Can sciatica be treated with acupuncture?

Regarding whether acupuncture can be used for sciatica, it should first be clarified that acupuncture is feasible for treating sciatic nerve pain. Acupuncture can promote the recovery of nerves, thereby effectively alleviating the symptoms of sciatic nerve pain. However, it is important to note that it is best to undergo acupuncture in the acupuncture and massage department of a formal hospital. Formal hospitals are more professional, have a better grasp of indications, and tend to provide more satisfactory results. Additionally, for patients with sciatic nerve pain, it is crucial to minimize local irritation. It is essential not to expose the area to cold, apply local heat, and combine treatment with some neuro-nourishing medications, such as mecobalamin, which is quite effective.

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Written by Na Hong Wei
Orthopedics
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Which department should I register for sciatica?

Sciatica is divided into primary and secondary types. Primary sciatica is caused by inflammation of the sciatic nerve itself, thus one should visit the Department of Neurology. Secondary sciatica is more common and usually stems from spinal conditions, so initially one should visit the Department of Spinal Surgery. Alternatively, one can visit the Department of Orthopedics, which deals with broader orthopedic issues. If experiencing severe acute pain, a visit to the Pain Management Department can provide rapid and effective pain relief. For frequent episodes of sciatica and interest in rehabilitation, the Rehabilitation Department can be considered. Additionally, traditional Chinese medicine has unique approaches to treating sciatica, so visiting the Department of Traditional Chinese Medicine to try treatments with Chinese herbs and methods is also an option.