Acupuncture treatment for low back pain and lower limb symptoms - therelationship between acupuncture or electroacupuncture stimulation andsciatic nerve blood flow
1)Motohiro Inoue, 1)Hiroshi Kitakoji, 2)Tadashi Yano, 3)Yasukazu Katsumi

1) Department of clinical acupuncture and moxibustion II, Meiji university of oriental medicine

2) Department of health promoting acupuncture and moxibustion, Meiji university of oriental medicine
3) Department of orthopaedic surgery, Meiji university oriental medicine

Objective: To investigate the clinical efficacy of acupuncture treatment for lumbar spinal
canal stenosis and herniated lumbar discs using acupuncture stimulation to the Ex-B2 pointat the lumbar level, electroacupuncture stimulation of the pudendal nerve, andelectroacupuncture stimulation of the nerve root. In addition, changes in sciatic nerve bloodflow were measured in rats undergoing acupuncture, lumbar acupuncture stimulation,
electrical acupuncture stimulation of the pudendal nerve and electrical acupuncture
stimulation of the sciatic nerve.
Methods: (Clinical trial) After determining the lumbar level of the disorder based on
symptoms and X-ray and MRI findings, acupuncture of the Ex-B2 point was performed for
10 min. Electroacupuncture stimulation of the pudendal nerve was achieved using twoacupuncture needles inserted to the pudendal nerve stimulation point in the gluteal region.
For electroacupuncture stimulation of the nerve root, two acupuncture needles wereinserted in the portion of the nerve root that appears peripherally from the intervertebral
foramen under X-ray fluoroscopy. A 10-point scale or Visual Analogue Scale (VAS) was usedfor evaluation of pain and dysesthesia. Continuous walking distance was confirmed withreports from the patients.
(Animal study) Acupuncture or electroacupuncture stimulation was performed to thelumbar muscle region, the pudendal nerve and the sciatic nerve of rats. Sciatic nerve bloodflow was measured using laser-Doppler flowmetry.
Results: In the clinical trial, some effects were observed with each of the acupuncture
treatments, but compared to acupuncture of the lumbar muscles (Ex-B2), electricalacupuncture stimulation of the pudendal nerve and electrical acupuncture stimulation of
the nerve root tended to provide a more favorable effect. In the animal study, changes in
sciatic nerve blood flow were observed with each of the methods of acupuncture stimulation.
Discussion: From this report it can be seen that clinically, the first choice in treating lumbar
spinal canal stenosis or a herniated disc would be acupuncture stimulation at the disorderlevel Ex-B2, which is safe, easy, and effective to a certain degree. If acupuncture of thelumbar muscles proves to be ineffective, electroacupuncture stimulation of the pudendal
nerve should be attempted. In cases where electroacupuncture stimulation of the pudendal
nerve is also ineffective, treatment should be changed to electroacupuncture stimulation of
the nerve root. The results suggest that in addition to the effects on the pain inhibitory
system, acupuncture and electrical acupuncture stimulation may cause a transient change
in blood flow at the sciatic nerve, the cauda equina, or the nerve root.
Keywords: spinal nerve root, sciatic nerve, pudendal nerve, spinal canal stenosis, discherniation