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.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua city, Hunan province
China