Clinical efficacy of acupuncture in the treatment of sciatica during the remission phase of lumbar disc herniation: A secondary analysis of a randomized controlled trial

Background: Sciatica caused by lumbar disc herniation (LDH) may persist during the remission phase and negatively affect patients’ quality of life. Although acupuncture is widely used for LDH, evidence regarding its efficacy specifically in remission-phase sciatica remains limited. This prespecified subgroup analysis aimed to compare the efficacy and safety of acupuncture versus traction in participants with remission-phase LDH-induced sciatica. Methods: Data were extracted from the acupuncture and traction groups of our multi-arm randomized controlled trial conducted at Wangjing Hospital between April 2022 and June 2024. We included participants with LDH-induced sciatica in the remission phase (VAS score ≥4 and <7). All participants received 3 weeks of treatment and were followed up for 16 weeks. The primary outcome was leg pain VAS (VAS-LP). Secondary outcomes included low back pain VAS (VAS-LBP), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores. Results: A total of 78 eligible participants (39 in the acupuncture group, 39 in the traction group) were included. At week 3 and week 4 follow-up, VAS-LP scores were significantly lower in the acupuncture group, with between-group differences of −0.63 cm ( P = .019) and −0.86 cm ( P = .017), respectively. At week 16, the difference was −0.51 cm ( P > .05). After 3 weeks, JOA scores and JOA improvement rates were significantly higher in the acupuncture group. The excellent rate was 67.57% in the acupuncture group versus 47.22% in the traction group ( P = .041). No significant differences were observed in VAS-LBP or ODI scores. Adverse events occurred in 8.1% of participants in the acupuncture group and were mild and transient. Conclusion: Acupuncture demonstrated superior short-term efficacy compared with traction in relieving leg pain during the remission phase of LDH and demonstrated a favorable safety profile.