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"Acupuncture treatment as an effective therapy for lower back pain with sciatica" By BJ DiMartini

By BJ DiMartini


Abstract
OBJECTIVE:  To report clinical efficacy of acupuncture treatments with 7 patients suffering from acute and chronic lower back pain (LBP) with sciatica.  Activity patterns, pain intensity ratings using the Visual Analogue Scale (VAS), palpation and orthopaedic assessments were recorded every treatment.  It should be noted that regardless of whether the condition was acute or chronic, the sciatic pain may be reduced to the absence of pain with acupuncture and electro-acupuncture (EA) treatments.  RESULTS:  All 7 patients noted either a decrease in pain or complete absence of pain within 6 treatments of either acupuncture or EA.  Sciatic pain was reduced to 0/10 VAS on 6 out of 7 patients.  The 7th patient presented a decrease with the sciatic pain VAS score following treatment.
Introduction
This is a case report to show clinical efficacy of acupuncture treatments upon 7 patients suffering from lower back pain with accompanied sciatic pain.  According to the National Institute of Health, “Nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Americans spend at least $50 billion each year on low back pain, the most common cause of job-related disability and a leading contributor to missed work.”  Further complicating matters is the addition of sciatic pain that occasionally accompanies lower back pain yet further debilitates people from normal daily activities and normal sleeping habits.
Case Presentation
Patient 1 (IB) is a 79 year-old female with chronic lower back pain, back muscular spasms and sciatic pain referring down the right gluteus muscles to the iliotibial band, including the lateral calf muscles.  Pain was 8/10 VAS upon the first treatment.  Acupuncture and EA was conducted 6 times in 6 weeks.  Each treatment decreased the level of pain in both the lower back and sciatica.  The muscular spasms stopped after the 5th treatment.  The pain will return between 3-5 days post treatment, but has not exceeded 5/10 VAS since the 3rd treatment.  Her sleeping patterns are now balanced because of the decrease in pain.  She is currently continuing acupuncture and EA treatments for relief.
Patient 2 (VD) is a 58 year-old male with chronic lower back pain and acute sciatic pain referring down the left gluteus muscles to the posterior thigh ending at the left popliteal crease.  Pain was 8/10 VAS upon first treatment with remarkable discomfort and loss of sleep.  Following the 3rd treatment in 2 weeks the pain was generalized in the lower back at 3/10 and the referring sciatic pain was absent.  A 5-month follow-up was obtained with the paitent reporting occasional lower back pain no higher than 2/10 VAS.  Sciatic pain remains absent.
Patient 3 (DK) is a 43 year-old male with chronic lower back pain and occasional referring sciatic pain to the lateral calf.  Pain was 6/10 VAS upon first treatment.  Acupuncture was performed with the use of an infrared mineral heat lamp over the lower back.  Immediate relief was noted post-treatment.  Only one treatment was performed to this date.  A follow-up noted a return of intermittent pain from 0/10 to 3/10 VAS with a desire to continue recommended treatments.  Sciatic pain remains absent.
Patient 4 (RM) is a 36 year-old male and professional lacrosse player with acute lower back pain and referring sciatic pain down the left gluteus muscles, posterior thigh, and the left popliteal crease.  Pain was 4/10 VAS with loss of sleep and decreased energy relating to the pain upon first treatment.  A series of 3 EA treatments were conducted within 2 weeks.  Stretching exercises were prescribed.  Currently, the patient reports minimal discomfort at a 1/10 VAS with an unrelated mild gastrocnemius strain on the left calf.
Patient 5 (BN) is a 66 year-old male with acute lower back pain and muscular spasms referring through the right gluteus muscles down to the right popliteal crease.  Pain was 9/10 VAS with loss of sleep and remarkable loss of range of motion.  Patient had 3 EA treatments in 2 weeks resulting in a decrease in pain with increase in range of motion and return of normal sleeping patterns.  Upon the 4th treatment the lower back pain was a secondary chief complaint and sciatic pain was absent.  Following the 5th treatment in 4 weeks the lower back pain and referring sciatic pain were completely gone.
Patient 6 (RU) is a 40 year-old male with acute lower back pain and referring sciatic pain down the left gluteus muscles, posterior thigh, posterior calf and ending at the insertion of the Achilles tendon.  Pain was recorded at 8/10 VAS upon the first treatment with lack of sleep caused by the pain.  EA was conducted and immediate decrease in pain was noted.  The patient surprisingly admitted 1/10 VAS pain upon leaving the office.  Follow-up was conducted over the phone of which the patient reported 0/10 pain in the lower back and 0/10 sciatic pain.
Patient 7 (SW) is a 64 year-old male with chronic lower back pain and acute sciatic pain referring into the left gluteus muscles down to the supra-posterior thigh region.  Pain was recorded at 6/10 VAS upon the 1st treatment.  2 EA treatments were performed in 2 consecutive days.  Upon the 2nd treatment, the sciatic pain was absent and the lower back pain was 1/10 VAS only at certain times of the day with movement.
Discussion
Acupuncture and EA has shown promising results in past studies with LBP, but more investigation is needed for the purpose of studying sciatic pain with LBP.  One study suggests, “One mechanism of action of acupuncture and electrical acupuncture stimulation could be that, in addition to its influence on the pain inhibitory system, it participates in causing a transient change in sciatic nerve blood blow, including circulation to the cauda equine and nerve root.”   More investigation is needed to understand the effects of acupuncture and EA with sciatic pain.
Conclusion
Findings show that acupuncture and EA were effective in decreasing lower back and sciatic pain, increasing energy, and regulating sleeping patterns in all 7 patients presented in this report.  In addition, acupuncture and EA also promoted well being, thus giving value to the clinical efficacy of treatments for the 5 out of 7 patients who were obese. 

References
1. Office of Communications and Public Liaison, National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda, MD 20892
2.  Evidence-based Complementary and Alternative Med. 2008 Jun;5(2):133-43.