Electroacupuncture Direct to Spinal Nerves as an Alternative to Selective Spinal Nerve Block in Patients with Radicular Sciatica – a Cohort Study

Abstract

We applied electroacupuncture to the spinal nerve root by inserting needles under x ray imaging in three cases with radicular sciatica, as a non-pharmacological substitute for lumbar spinal nerve block. In all three cases, symptoms were markedly reduced immediately after electroacupuncture to the spinal nerve root. The sustained effect was noticeably longer than that of spinal nerve blocks previously performed, in two out of the three cases. We suggest that descending inhibitory control, inhibitory control at the spinal level, inhibition of potential activity by hyperpolarisation of nerve endings, or changes in nerve blood flow may be involved in the mechanism of the effect of electroacupuncture to the spinal nerve root. These results suggest that electroacupuncture to the spinal nerve root may be superior to lumbar spinal nerve block when it is applied appropriately in certain cases of radicular sciatica, taking into consideration patient age, severity of symptoms and duration of the disorder.

A Randomized Clinical Trial Comparing the Effectiveness of Electroacupuncture versus Medium‐Frequency Electrotherapy for Discogenic Sciatica

“…Several previous studies showed that EA inhibited the primary afferent transmission of neuropathic pain [30] and that deep EA stimulation improved the pathological changes and function of the injured sciatic nerve in rats [31]. Other studies have suggested that descending inhibitory control, changes in nerve blood flow, or the inhibition of activity by nerve endings may be involved in the mechanism associated with the efficacy of EA [32]. Long-lasting alleviation of pain has been suggested to be closely related to the muscle tension improvement provided by EA [33].…”

Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis

“…Extensive research has shown that acupuncture analgesia may be initiated by stimulation of high-threshold, small-diameter nerves in the muscles [37]. A cohort study found that after electroacupuncture (EA) to the spinal nerve root, the symptoms of patients with radicular sciatica were immediately and markedly reduced [38]. Animal experiments have revealed that acupuncture is a better treatment for regeneration of crushed sciatic nerves than diclofenac sodium [39].…”

Comparison of the Effectiveness of Acupuncture Treatment and Local Anaesthetic Injection for Low Back Pain: A Randomised Controlled Clinical Trial

“…In addition, Byrn et al 27 compared injections of saline solution and distilled water and reported that distilled water was more effective. Furthermore, in patients with radicular sciatica for which nerve root block was ineffective, Inoue et al 28 found that electroacupuncture stimulation in the nerve root region gave more favourable results than anaesthesia. All these reports indicate that stimulation therapy is more effective, supporting the results of our trial.…”