Sciatica is mainly
manifested as pain along the route of the sciatic nerve and
in the area where the sciatic nerve is distributed. It is
resulted from many causes, among which the following are
common: disorder of lumbar intervertebral disc, disease of
hip joint and sacro-iliac articulation, spondylitis, and
tumor of spinal cord and nerve root of lumbosacral portion.
Its main symptoms are sudden onset, persistent dull or
stabbing pain in the loins and lower limbs, and even limping
and difficulty in moving in severe cases. TCM includes this
disease in the category of "arthralgia-syndrome."
Etiology and
Pathogenesis
Suppose affection
of wind-cold-damp-heat pathogen or local trauma is A,
obstruction of channels is B, stagnation of qi and blood is
C, and malnutrition of tendons and muscles is D. TCM
believes that A leads to B; B, C, D.
Type and
Treatment
1. Type of
Cold-Dampness
Symptoms: Localized
pain below the loins and in the lower limbs which is
relieved by heat and aggravated by cold and moving, thin
white tongue coating, and taut tense pulse.
Therapeutic Method:
Warming up the channels to dispel cold, removing dampness to
clear the network-channels.
Prescription:
Modified Wutou Tang (Decoction of Sichuan Aconite Root) and
Huangqi Guizhi Wuwu Tang (Decoction of Five Drugs with
Astragalus and Cinnamon).
Ingredients:
Zhichuanwu Radix
Aconiti Preparata
Rougui Cortex
Cinnamomi
Huangqi Radix
Astragali
Danggui Radix
Angelicae Sinensis
Gancao Radix
Glycyrrhizae
Baishao Radix
Paeoniae Alba
Mahuang Herba
Ephedrae
Shengjiang Rhizoma
Zingiberis Recens
Fengmi Mel
Administration:
Decocted in water for oral use, 1 dose daily.
Modification: In
case of abundant dampness marked by pain and heaviness in
the loins and lower limbs, the drugs added are Yiyiren Semen
Coicis, Niuxi Radix Achyranthis Bidentatae, Fangji Radix
Stephaniae Tetrandrae, Bixie Rhizoma Dioscoreae Hypoglaucae.
2. Type of
Damp-Heat
Symptoms: Burning
and tic pain or heaviness and numbness or red-swelling and
hot-pain of joints in the loins and lower limbs, reddened
tongue with thin yellow coating, and slippery rapid pulse.
Therapeutic Method:
clearing away heat and dampness, promoting the circulation
of blood to activate the collaterals.
Prescription:
Modified Simiao San (Powder of Four Wonderful Herbs).
Ingredients:
Cangzhu Rhizoma
Atractylodis
Huangbai Cortex
Phellodendri
Niuxi Radix
Achyranthis Bidentatae
Mugua Fructus
Chaenomelis
Yiyiren Semen
Coicis
Jixueteng Caulis
Spatholobi
Yinchen Herba
Artemisiae Scopariae
Gancao Radix
Glycyrrhizae
Rendongteng Caulis
Lonicerae
Administration:
Decocted in water for oral use, 1 dose daily. red-swelling
and hot-pain in the joints, thirst, rigidity of the muscles
and tendons, the drugs added are Shengdi Radix Rehmanniae,
dilong Lumbricus, Qinjiao radix Gentianae Macrophyllae,
Ruxiang olibanum, Huzhang Rhizoma Polygoni Cuspidati and
Shenjincao herba Lycopodti.
In case of more
severe dampness marked by heaviness, pain and numbness in
the loins and lower limbs, nausea and greasy tongue coating,
the drugs added are Wancansha Excrementa Bombycum, Banxia
Rhizoma Pinelliae, Chenpi Pericarpium Citri Reticulatae,
Fuling Poria, Bixie Rhizoma Dioscoreae Hypoglaucae.
In case of
constipation, the drugs added is Dahuang Radix et Rhizoma
Rhei.
3. Type of
Blood-Stasis
Symptoms:
Persistent stabbing pain aggravated by moving in the loins
and lower limbs, difficulty in moving, dark red tongue with
petechiae and thin white coating, and deep uneven pulse.
Therapeutic Method:
Promoting the circulation of blood to remove blood stasis,
clearing the collaterals to arrest pain.
Prescription:
Modified Shenteng Zhuyu Tang (decoction for Relieveing
Pantalgia due to Blood Stasis).
Ingredients:
Taoren Semen
Persicae
Honghua Flos
Carthami
Danggui Radix
Angelicae Sinensis
Gancao Radix
Glycyrrhizae
Wulingzhi Faeces
Trogopterori
Xiangfu Rhizoma
Cyperi
Dilong Lumbricus
Qinjiao Radix
Gentianae Macrophyllae
Duhuo Radix
Angelicae Pubescentis
Ruxiang Olibanum
Huainiuxi Radix
Achyranthis Bidentatae
Administration:
Decocted in water for oral use, 1 dose daily.
Modification: In
case of more evident deficiency of Qi marked by
listlessness, acratia, the drugs added are Huangqi Radix
Astragali, Dangshen Radix Codonopsis, Guizhi Ramulus
Cinnamomi.
4. Type of
Deficiency of the Liver and Kidneys
Symptoms: Spasm,
pain, weakness, cold and limited movement in the loins and
lower limbs all of which are aggravated by moving, reddened
tongue with thin white coating, and thready pulse.
Therapeutic Method:
Supplementing qi and blood, invigoration the liver and
kidneys, clearing the channels and collaterals, and
expelling wind-dampness.
Prescription: Sanbi
Tang (Decoction for Treating Three Kinds for Arthralgia).
Ingredients:
Duhuo Radix
Angelicae Pubescentis
Niuxi Radix
Achyranthis Bidentatae
Qinjiao Radix
Gentianae Macrophyllae
Fangfeng Radix
Saposhinkoviae
Xixin Herba Asari
Danggui Radix
Angelicae Sinensis
Baishao Radix
paeoniae Alba
Chuanxiong Rhizoma
Chuanxiong
Shudihuang Radix
Rehmanniae preparata
Duzhong Cortex
Eucommiae
Dangshen Radix
Codonopsis
Huangqi Radix
Astragali
Fuling Poria
Chuanduan radix
Dipsaci
Rougui Corte
Cinnamomi
Gancao Radix
Glycyrrhizae
Administration:
Decocted in water for oral use, 1 dose daily.
Modification: If
there is accompanying heat-syndrome marked by pain
aggravated by heat in the loins and lower limbs, the herbs
omitted are Xixin Herba Asari Rougui Cortex Cinnamomi,
Shudihuang Radix Rehmanniae Preparata, the herbs added are
Rendongteng Caulis Lonicerae, Sangzhi Ramulus Mori, Shengdi
Radix Rehmanniae.
In case of
heaviness and soreness in the loins and lower limbs, the
herbs omitted are Shudihuang Radix Rehmanniae, Danggui Radix
Angelicae Sinensis, the herbs added are Yiyiren Semen
Coicis, Tianma Rhizoma Gastrodiae, Mugua Fructus
Chaenomelis, Sangjisheng Herba Taxilli and Gouji Rhizoma
Cibotii.
Proven Prescription
Ingredients: (with
same amount)
Qishe Agkistrodon
Quanxie Scorpio
Wugong Scolopendra
Administration: The
Above is ground into fine powder. The powder is taken with
warn boiled water, each time and 1-3times each day. 10 days
is 1 course of treatment.
Prevention
Take an active part
in physical training, pay attention to labor protection when
dong heavy physical labor, avoid long living in the wet and
cold place without sunshine, and examine and treat trauma
and pain in the loins as early as possible.
