BACKGROUND: Acupuncture studies frequently claim high success rates of pain relief in sciatica and non steroid anti inflammatory drugs (NSAIDs) such as diclofenac, are commonly used in treatment of sciatica. However, the therapeutic effects of acupuncture and diclofenac on sciatica remain to be compared. OBJECTIVE: To compare the effect of electro acupuncture and that of diclofenac treatment on the sciatica caused by herniation of intervertebral disc. DESIGN: A randomized controlled basic research was conducted. SETTING AND PARTICIPANTS: Forty patients of Pakistani nationality with intervertebral disc herniation were selected from China Acupuncture Center, Islamabad, Pakistan, during the period from February of 2001 to October of 2002. METHODS: The 40 patients were randomly divided into 2 groups: acupuncture group with 23 cases, treated with electro acupuncture 25 minutes daily for 7 days, and medication group with 17 case, treated with 50 mg diclofenac post cibum tid for 7 days. MAIN OUTCOME MEASURES: Laseque's sign, and tenderness and numbness of the buttock, posterior side of the thigh, and the leg. RESULTS: After the treatment, the angle of Laseque's sign of the acupuncture group was significantly bigger than that of the medication group (p < 0.05, t = 2.179); The mean VSA score of buttock tenderness relief was significantly lower in the acupuncture group than in the medication group (p < 0.05, t = 2.224). However, the mean scores of tenderness relief in the posterior side of the thigh and of the leg were not significantly different between the two groups (t = 1.912 and t = 1.580, both p > 0.05). The number of the patients with an increase of the Laseque's sign angle > 20degrees was significantly higher in the acupuncture group than in the medication group (Chi2 = 4.817, p < 0.05). Similarly, the number of the patients with the buttock tenderness relief by more than 20 scores in the acupuncture group was significantly higher than that in the medication group (Chi2 = 5.028, p < 0.05). But there were not significant differences between the two groups in tenderness relief in the posterior side of the thigh and in the leg by more than 20 scores (Chi2 = 0.583 and Chi2 = 1.081, p > 0.05). There was no significant difference in alleviation of numbness at the feet between the two groups (Chi2 = 0.680, p > 0.05). CONCLUSION: Electro acupuncture is more effective than diclofenac treatment in increasing the Laseque's sign angles and relieving tenderness in the punctured area. However, there is no significant difference in the effect on tenderness relief in the areas far from the punctured area.

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