New Research: Acupuncture for Chronic Sciatica

Sciatica, pain that travels from the lower back through the buttock and down the leg, is one of the most common reasons patients visit our clinic. A major clinical trial now adds strong evidence that acupuncture can help.

Sciatica is most often caused by a herniated disk pressing on a nerve root in the lower spine. Many people improve with time and conservative care, but for a meaningful number of patients the pain lingers for a year or longer, limiting work, sleep, and everyday movement.

What the study found

In 2024, JAMA Internal Medicine published one of the largest rigorous trials to date on acupuncture for sciatica. Researchers at six hospitals in China enrolled about 220 adults with chronic sciatica caused by a herniated disk. Half received 10 acupuncture sessions over four weeks. The other half received sham acupuncture, a placebo treatment designed to look and feel like the real thing.

• After four weeks, leg pain in the acupuncture group dropped by about 31 points on a 100-point scale, compared with about 15 points in the sham group.
• Patients who received real acupuncture also reported greater improvement in daily function, measured with a standard back-disability questionnaire.
• The benefits were still present at the one-year follow-up.

Why it matters

Comparing real acupuncture against a convincing sham helps separate the effect of the treatment itself from the simple expectation of being treated. That design is what makes this trial stand out.

It also builds on earlier evidence for back pain. The American College of Physicians' clinical guideline for low back pain lists acupuncture among the non-drug therapies physicians should consider first, and since 2020 Medicare has covered acupuncture for chronic low back pain under specific conditions.

Keeping it in perspective

No single study settles a question. This trial was conducted in China and focused specifically on sciatica from a herniated disk, and some researchers have raised questions about how fully sham acupuncture can be blinded. Sciatica also has other causes, so an accurate diagnosis comes first.

Some symptoms need urgent medical care rather than acupuncture: new or worsening leg weakness, numbness in the groin or inner thighs, or loss of bladder or bowel control. Acupuncture works best as part of a complete plan that can include your physician, physical therapy, and gentle movement.