Background Sciatica is one of the most severe neuralgic diseases. Until today, there have been no ideal treatments for this affection. Current pharmacologic therapies are inadequate for many patients. Besides, some adverse effects may occur. To remain pain free, acupuncture is used as an interesting alternative for sciatica treatment.
Objectives This study aims to compare the efficacy of acupuncture used as monotherapy to its efficacy when combined with bloodletting in the treatment of sciatica.
Methods A prospective clinical trial was performed with patients suffering from sciatica who were randomly assigned to one of two groups: patients (20 cases) who were treated by acupuncture plus bloodletting (group 1) (G1) and patients (20 cases) who were treated by simple acupuncture (group 2) (G2). All patients received the treatment 3 times a week for 20 minutes for a total of 10 sessions. The visual analogical scale (VAS) pain score and the Lasègue's sign (LS) were assessed at baseline, at the third, sixth, ninth and last visit.
Results Forty cases of sciatica ranging in age from 31-70 years were treated in this study. 15 (37%) among them were females while 25 (63%) were males. The average time between the start of clinical symptoms and the first acupuncture session was 38.6 [2, 120] months. 90% of patients had sciatica pain lasting 6 months or more. 37 patients (92.5%) finished the protocol: 19 (95%) in G1 and 18 (90%) in G2. The mean VAS pain score in G1 was 7.15 at baseline. It was reduced to 0.75 after the tenth session. A significant decrease of mean VAS pain was also observed in G2 (from 6.8 at baseline to 1.15 after the tenth session). LS was negative in 4 cases (2%) in G1 versus 2 cases (1%) in G2 at baseline. After the tenth session, it became negative in 18 cases (90%) in G1 versus 17 cases in G2. A statistically significant difference (p<0.05) between different sessions was noted. Comparing the two groups, the decrease of mean VAS was more pronounced in G1. However, this difference was not statistically significant (p>0.05). Moreover, there was no significant difference between the two groups concerning the improvement of the LS. 94.7% of patients in G1 were satisfied at the end of the cure versus 88.8% of patients in G2.
Conclusions These results suggest that acupuncture therapy is beneficial, effective and safe in the treatment of sciatica, especially when associated to bloodletting. Since this therapy avoids drug's side effects, it should be more considered. A large scale rigorously designed study is warranted to confirm the current results. Another challenge lies in how to clinically combine acupuncture, bloodletting and Western medicine.
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Disclosure of Interest None declared