Sciatica (Low Back & Leg Radicular Pain)
Overview
Sciatica is radiating, electric, or burning pain along one buttock, posterolateral thigh and lateral calf into the dorsum of the foot, sometimes with numbness or weakness. Chinese medicine groups it under obstructive pain of the low back and leg, from wind-cold-damp, injury or strain causing channel obstruction and qi–blood stasis, or liver–kidney deficiency depriving sinews of nourishment. Patterns include cold-damp or damp-heat obstruction, blood stasis blocking collaterals, and liver–kidney deficiency. Bladder/bowel dysfunction, saddle numbness, or foot drop indicates cauda equina syndrome—an emergency.
Pattern differentiation (clinical patterns)
Cold-Damp Obstruction
Cold heavy fixed pain with difficulty turning, worse in cold/damp weather and relieved by warmth, cool affected limb, white greasy coating, deep tight pulse.
Scatter cold and drain dampness; warm the channels and unblock collaterals.
Blood Stasis Blocking Collaterals
Stabbing fixed low-back/leg pain that worsens with pressure, possibly after injury, worse at night, dark tongue with stasis spots, rough pulse.
Invigorate blood and resolve stasis; unblock collaterals to stop pain.
Liver–Kidney Deficiency
Recurrent low-back/leg pain worse with exertion, weak numb legs, dizziness, tinnitus, weak low back/knees, pale tongue, fine weak pulse.
Tonify liver and kidney; strengthen sinews and bones.
Connections
Daily care & prevention
In the acute phase rest, avoid bending/lifting and prolonged sitting, and keep the low back warm; in remission do regular lumbar/core exercise (e.g., prone back extensions and glute bridges), control weight, and use a medium-firm mattress. Heat and press Weizhong (BL40), Yaoyangguan (GV3), Shenshu (BL23), Huantiao (GB30), and Yanglingquan (GB34). Worsening leg weakness, saddle numbness, or loss of bladder/bowel control requires immediate emergency care; pain lasting 4–6 weeks, or with fever/weight loss, needs further investigation.
When to seek medical care
Saddle-area numbness, urinary retention/incontinence, or bilateral leg weakness (cauda equina syndrome) requires urgent surgical assessment; severe post-traumatic pain, fever/chills, night pain with weight loss, or cancer history warrants ruling out infection, fracture, and tumor.