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Sciatica

How Chinese medicine differentiates sciatica, the five patterns you'll actually meet in practice, and the points for each. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Loss of bladder or bowel control, saddle numbness, or progressive leg weakness are red flags for cauda equina syndrome and need emergency medical care. None of this site's 11 pattern decks contain a dedicated "Painful Obstruction" (Bi Syndrome) category for musculoskeletal channel pain — they are organized around internal-medicine organ patterns instead — so none of the 5 patterns below link to a deck slide; every point below still links to its own points-deck entry.
General Acupuncture Points

Acupuncture points traditionally used for sciatica — 10 key points, used across most of the patterns below rather than tied to just one.

PointKey action
G.B.-30Removes obstructions from the channel, resolves Dampness, expels Wind, tonifies Qi and Blood.
BL-40Removes obstructions from the channel, resolves Dampness, benefits the lower back and legs.
BL-23Tonifies the Kidneys, nourishes Kidney-Essence, strengthens the lower back.
G.B.-34Removes obstructions from the channel, relaxes the sinews, resolves Dampness, subdues Liver-Yang.
SP-10Cools Blood, invigorates Blood and eliminates stasis.
LIV-3Subdues Liver-Yang, promotes the smooth flow of Liver-Qi, invigorates Blood.
BL-18Moves Liver-Qi and eliminates stagnation, resolves Damp-Heat, nourishes and invigorates Liver-Blood.
KI-3Tonifies the Kidneys (Yin and Yang), strengthens the lower back and knees.
ST-36Benefits Stomach and Spleen, tonifies Qi and Blood.
SP-6Strengthens the Spleen, nourishes Blood and Yin, invigorates Blood.
The Five Patterns

reinforcing   reducing   even method — technique below follows standard Excess/Deficiency treatment principle for each pattern, not tied to a specific point-by-point source.

1. Painful Obstruction with Wind-Cold-Damp

Clinical manifestations: Sharp, fixed pain running along the sciatic nerve path from the buttock down the leg; pain and stiffness distinctly worse with cold and damp weather; heaviness and numbness in the leg; stiffness that limits movement in the lower back and hip; brought on by exposure to cold and damp, sitting on cold surfaces, sudden weather changes, or overexertion; eased by warmth and heat packs, gentle movement once warmed up, dry conditions, or moxibustion.
Tongue: Pale, slightly swollen body with tooth marks, white greasy coating. Pulse: Wiry and Tight, or Soggy and Slow.
Treatment principle: Dispel Wind-Cold-Damp, relieve painful obstruction, warm the channels, support Liver and Kidneys.
Expel Wind-Cold-Damp, local
Support Liver-Kidney
Note: moxa applicable throughout.

2. Blood Stagnation

Clinical manifestations: Fixed, stabbing pain along the buttock and leg that doesn't shift location; pain distinctly worse at night and with pressure on the area; a history of trauma, injury, or prolonged sitting; dark circles under the eyes or dusky lips; brought on by an old injury, prolonged sitting or poor posture, cold exposure constricting circulation, or overexertion; eased by gentle movement, warmth, avoiding prolonged sitting, or gentle massage once the acute pain settles.
Tongue: Purple or dusky body with stasis spots, distended dark sublingual veins. Pulse: Choppy or Wiry.
Treatment principle: Invigorate Blood, dispel stasis, unblock the channels, alleviate pain.
Note: no moxa.

3. Liver and Gallbladder Damp-Heat

Clinical manifestations: Burning, heavy pain along the outer hip and thigh; pain distinctly worse in humid or hot weather; a bitter taste in the mouth; irritability and restlessness; redness and warmth along the path of the pain; brought on by hot humid weather, spicy or greasy food, alcohol, or stress and frustration; eased by cool dry conditions, cooling food and drinks, rest, or avoiding alcohol and spicy food.
Tongue: Red body, especially at the sides, thick yellow greasy coating. Pulse: Wiry, Slippery, Rapid.
Treatment principle: Drain excess Fire from the Liver and Gall Bladder, clear Damp-Heat from the Lower Burner.
Note: no moxa.

4. Painful Obstruction with Liver and Kidney Deficiency

Clinical manifestations: Dull, chronic aching pain rather than sharp or burning; soreness and weakness in the lower back and knees; numbness or tingling in the leg; fatigue with weak, heavy legs; pain distinctly worse in cold, damp weather; brought on by ageing, chronic overwork, a long-standing untreated injury, or cold damp exposure; eased by warmth, rest, gentle strengthening exercise, or moxibustion on the lower back.
Tongue: Pale, thin body, thin white coating. Pulse: Fine and Weak, often Slow, especially faint at the rear (Kidney) position.
Treatment principle: Dispel lingering Wind-Cold-Damp while tonifying Liver and Kidneys to strengthen the lower back and legs.
Tonify Liver-Kidney, Qi
Local channel, dispel lingering Cold-Damp
Note: moxa applicable throughout.

5. Painful Obstruction with Qi and Blood Deficiency

Clinical manifestations: Dull, aching pain along the leg; numbness or tingling in the limb; fatigue and a general lack of strength; a pale face and lips; pain that worsens with activity and improves with rest; brought on by chronic illness, overwork, poor diet, or a long recovery from injury; eased by rest, warm nourishing food, gentle graded exercise, or moxibustion.
Tongue: Pale body, possibly thin, with tooth marks, thin white coating. Pulse: Fine and Weak, may be Slow.
Treatment principle: Tonify Qi and Blood, strengthen the Spleen, nourish tissue to relieve dull pain and numbness.
Tonify Qi-Blood
Local channel
Note: moxa applicable on the tonifying points.
Related conditions

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