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Chinese Herbal Therapy For Sciatica And Lumbago

Sciatica And Lumbago
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Sciatica And Lumbago

Sciatica refers to pain radiating along the sciatic nerve, which originates in the lower spine as a combination of several nerves from the lumbosacral region (1, 2). The nerve branches from the spine to the left and right buttocks and then travels down the back of the legs, at about the middle of the thighs, to the feet.

Sciatic pain usually radiates from the buttock and is felt primarily in the back of the thigh, though it may extend to the foot. Usually, only one side is affected. Although the pain is felt in the fleshy part of the body, the origin of the pain is a pinching of one or more of the nerves departing the spinal cord in the area of the intervertebral disks. Initially, there may be a temporary prolapse or extrusion of the disk (or disks) that causes the spinal column to squeeze down on the nerves. In cases of destruction of the disk, the pain will become chronic. Pressure can also be applied on the nerve from damage to the vertebra themselves. If the pressure is sufficiently severe, the nerve transmissions are interrupted and there can be weakness, loss of feeling, and a resultant wasting of the leg. Sciatic pain may worsen whenever a pressure is applied to the affected area, such as results from coughing, sneezing, or straining during defecation, as well as common physical activities.

Therefore, sciatic pain is actually a spinal problem related to some cases of lower back pain, known as lumbosacral pain, and commonly called lumbago. Lumbago may arise from similar types of disk problems that don¡¯t happen to affect the sciatic nerve, but, instead, remain localized. Lumbosacral pain may also result from muscle and tendon strains in the lower back, whether or not they lead to disk compression or protrusion. Another pain syndrome, Achilles tendonitis, has a relatively high rate of association with sciatica and lumbago. It is caused by injuries that may occur more often when the lower back is painful, leading to abnormal gait.

The current medical treatments for damaged disks and vertebrae involve administration of pain relievers and avoidance of stress on the spine by resting and limiting activities. However, while bed rest may reduce the immediate pain, it has been shown to have minimal effect on the long-term course of sciatica (3), which involves spontaneous healing within about 3 months for 87% of patients. Emotional distress, especially job dissatisfaction, has been found to be highly correlated with both the occurrence and persistence of back pain and sciatica (4, 5).

From the Chinese viewpoint, patients who present lumbago or sciatic pain are usually diagnosed as suffering from a type of bi syndrome (6). Bi syndromes involve blockage and pain and are especially prevalent in the lower half of the body. Bi syndromes are often caused by unknown factors; that is, there may be little apparent reason for the occurrence, though a significant injury to the back would be an obvious cause. From the period of the Neijing (ca. 100 B.C.) to the present, bi syndrome has been said to be induced mainly by the influences of cold, damp, and wind. Because of the location in the lower body, and the tendency of the pain to radiate downwards, the disorder is frequently attributed to a combination of cold and dampness: these are yin factors that have a natural downward course. Wind, an external pathogenic factor of mysterious nature (see: Drawing a concept: Feng), is thought to carry the pathogenic influences into the body and contribute to the variable nature of the pain.

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