Sciatica: Causes, Symptoms & Treatments with Acupuncture & Massage
- Ben Elliot
- Jun 12
- 5 min read
Updated: Jun 26
Acupuncture and massage can be very effective in managing sciatica. Sciatica typically involves irritation or compression of the sciatic nerve, often due to a herniated disc, muscle tension (e.g. piriformis syndrome), or spinal stenosis. The cause and severity of the sciatica will dictate exactly what treatment methods are used, as there are differences in how each method interacts with the body.
In this post:
What is sciatica?
How acupuncture benefits sciatica
How massage benefits sciatica
When it is not appropriate to use acupuncture or massage
Suggested treatment plans for practitioners who practice acupuncture and/or massage
Advice for helping with sciatica symptoms at home
What is sciatica?
Sciatica is a condition where pain radiates along the sciatic nerve, which runs from the lower back through the buttocks and down each leg. Sciatica more of a description of symptoms than a diagnosis. Determining the cause enables me to treat the underlying issue affecting the nerve.
Symptoms of Sciatica:
Areas affected:
Lower back pain
Glute/Buttock pain
Leg pain, often at the back of the leg
Pain in the foot
Sciatica can elicit different types of pain or altered sensation in these areas:
Shooting Pain
Burning Pain
Numbness
Pins & Needles
Causes of Sciatica
Herniated or bulging disc: The most common cause is when a disc bulges out and compresses the nerve root. In extreme cases the disc can burst or herniate causing the vertabrae to collapse on top of each other, squashing the nerve root.
Spinal stenosis: Narrowing of the spinal canal, pinching the nerve.
Piriformis syndrome: The piriformis muscle in the buttocks irritates or compresses the sciatic nerve. The sciatic nerve passes underneath the piriformis muscle and in 1/5 of people, the nerve runs through the muscles - making it more likely to be irritated.
Spondylolisthesis: A vertebra slips forward and compresses the nerve.
Trauma or injury: Can directly impact the sciatic nerve.
Red Flags
Sometimes the symptoms of sciatica can overlap with conditions that are more serious, such as Cauda Equina, Spinal Francture, Cancer and severe infection. The National Institute for Health and Care Excellence warns about the following symptoms:
Bowel/bladder dysfunction (most commonly urinary retention).
Progressive neurological weakness.
Saddle anaesthesia.
Sudden onset bilateral radiculopathy or unilateral radicular pain progressing to bilateral pain.
Incapacitating pain.
Unrelenting night pain.
If you or your patient has any of these symptoms then a trip to the GP is in order.
For more information on these red flag symptoms, visit the following link.
How can Acupuncture & Massage help?
Acupuncture for Sciatica
Pain relief: Acupuncture can reduce pain by stimulating the nervous system to release endorphins and other neurochemicals that modulate pain.
Reduce inflammation: Needling points around the lower back and along the sciatic pathway may help reduce local inflammation and improve circulation.
Muscle relaxation: It can release tight muscles (e.g. piriformis, gluteals and erector spinae) that might be compressing the sciatic nerve.
Nervous system regulation: Acupuncture may help calm the overactive pain signals in chronic sciatica.
Holistic balance: In Traditional Chinese Medicine terms, acupuncture addresses underlying imbalances like Liver Qi Stagnation or Kidney deficiency that may predispose someone to recurrent sciatica.
Massage for Sciatica
Eases muscle tension: Deep tissue or remedial massage can reduce tension in the lower back, glutes, and hamstrings—areas often contributing to sciatic compression.
Improves circulation: Helps bring oxygenated blood to the area, supporting healing and reducing inflammation.
Breaks up adhesions: Scar tissue and fascia restrictions can entrap nerves; massage helps mobilize soft tissues.
Supports alignment: Massage can complement other physical therapies by helping postural and muscular imbalances contributing to nerve impingement.
Treatment Tips
Massage & Manipulations can irritate the nerve if administered too vigorously
Combined treatments: Acupuncture and massage together often yield better, longer-lasting relief.
Individualised care: A thorough assessment helps determine whether the root cause is muscular, disc-related, or postural.
Lifestyle advice: Including stretches, exercises, and postural guidance is essential for lasting improvement.
Treatment Options
There are numerous options for the treatment of Sciatica, however I will focus on the therapies I know and practice. Please note that depending on the specific presentation of symptoms, some procedure and techniques may not be suitable.
Acupuncture Treatment Plan
Regular Acupuncture Points (1–2x per week)
Assess TCM diagnosis, but focus on local soft tissue tension should be prioritised.
Local points:
BL23-BL25, BL40, BL57, BL60 - lower back and channel support
GB30, GB34, BL36, BL40 - sciatic nerve pathway
GB30, BL54 - to release the piriformis
Huatuojiaji (L4-S3) - segmental points affecting the nerve root
Ashi points - directly over painful/tight areas
Distal points:
LI4 + LV3 (Four Gates) - move Qi
KID3 or KID6 - if chronic and related to deficiency
SP6 - harmonizes Liver and Kidney, supports Blood
Alternative methods such as Dr Tan's Balance Method can be used for pain relief with good effect
Electro-Acupuncture (1x per week or more for acute/severe cases)
Electrodes attached to needles at:
GB30 - BL40 or BL36 - BL57
Or Huato Jiaji points at L4–S1. Connect eletrodes between vertically adjacent points to pass current over nerve roots.
Frequency: 2-4 Hz for chronic pain, or alternating 2/100 Hz for both analgesia and circulation
Effects: Helps modulate nerve pain, reduce inflammation, and improve neuromuscular function
Massage Therapy (1x per week or alternating with acupuncture)
Caution when using massage and stretch as excessive compression and movement around the nerve can further irritate symptoms.
Techniques:
Deep tissue: Gluteals, piriformis, hamstrings, erector spinae group.
Trigger point release: Especially in gluteus minimus, medius, and piriformis
Myofascial release: Along the superficial backline
PNF stretching: Hamstrings, hip rotators, lumbar spine
Effleueage: Gentle massage along nthe nerve pathway can soothe the nerve
Massage Goals:
Decompress sciatic nerve
Improve mobility of fascia and muscle
Reduce pain sensitivity
Support realignment and posture
Lifestyle, Rehab & Self-Care
Daily Exercises
Neural flossing/gliding for sciatic nerve
Piriformis stretch
Hamstring and hip flexor stretches
Core strengthening: Bird-dog, dead bug, pelvic tilts
Postural correction: Especially if sedentary or driving a lot
Ergonomic Advice
Lumbar support when sitting
Avoid sitting cross-legged
Adjust workstation to reduce spinal load
Heat or Ice
Ice for acute flare-ups (nerve pain, inflammation)
Heat for muscle tension (piriformis tightness, chronic stiffness)
Expected Timeline
Timeframe | Goals |
Week 1-3 | Reduce acute pain and nerve irritation (acupuncture + electro + massage) |
Week 4-6 | Improve mobility, reduce muscular tension, start rehab exercises |
Week 6+ | Maintain symptom-free function, strengthen support muscles, taper treatment frequency |
I can't say strongly enough just how important it is to find the right combination of teratments for sciatica. The advice given here is options that many have found useful and beneficial in recovering from sciatic pain, however, the causes and presentation of someone's issue may mean some of these options are not suitable for that person.
