Is acupuncture effective for sciatica?
New research from the UK shows that acupuncture should be considered as a treatment option for patients suffering from sciatica. The study was a systematic review and network meta-analysis comparing the clinical effectiveness of different treatment strategies for sciatica.
A network meta-analysis can provide estimates of relative efficacy between many interventions, even though some have never been compared head-to-head. UK authors identified 122 relevant studies covering 21 treatment strategies for sciatica.
Effective treatments for sciatica:
For the first time, many different treatment strategies for sciatica have been compared in the same systematic review and meta-analysis. This approach has provided new data to assist shared decision-making. The findings support the effectiveness of nonopioid medication, epidural injections, and disc surgery. They also suggest that spinal manipulation, acupuncture, and experimental treatments, such as anti-inflammatory biological agents, may be considered.
Treatments not effective for sciatica:
The findings do not provide support for the effectiveness of opioid analgesia, bed rest, exercise therapy, education/advice (when used alone), percutaneous discectomy, or traction. The issue of how best to estimate the effectiveness of treatment approaches according to their order within a sequential treatment pathway remains an important challenge.