Piriformis Syndrome is a compression syndrome of the sciatic nerve caused by the piriformis muscle becoming congested, edematous, spastic, swollen, hypertrophic, and thickened, which irritates and compresses the sciatic nerve. It is often caused by lower limb sprains, prolonged standing or squatting, or exposure to cold and damp evils, leading to excessive stretching, persistent tension, and spasm of the piriformis muscle, resulting in thickening and adhesion, forming a hard, cord-like mass that compresses the sciatic nerve. Clinically, it mainly manifests as pain in the affected buttock and radiating "knife-cut-like" pain along the path of the sciatic nerve in the lower limb, accompanied by numbness on the lateral side of the thigh, which can be exacerbated by fatigue or exposure to external cold, damp, and wind evils. In severe cases, it can lead to limping. There is significant tenderness at the body surface projection of the piriformis muscle (at the midpoint of the line from the tip of the tailbone to the posterior superior iliac spine and the top of the greater trochanter of the femur), where a cord-like structure can be palpated, with the tendon becoming hard and less resilient. This condition falls within the category of "Bi Syndrome" in traditional Chinese medicine. Cold congeals and dampness is heavy, and when the evils of cold and damp invade the body, the flow of qi and blood is hindered, blocked in the buttock area, causing pain. If the waist and leg are contused or overworked, qi and blood are damaged, and qi deficiency leads to poor blood circulation, resulting in the lack of nourishment of the muscles and tendons in the buttock and leg area, causing pain.
Cold-Dampness Obstruction Type: Patients often have a history of exposure to cold and dampness, with cold pain in the waist area, preferring warmth and pressure; the tongue is pale, the coating is white, and the pulse is floating.
Qi Stagnation and Blood Stasis Type: There is often a history of sprain or strain in the waist area, with stabbing pain in the waist, and resistance to pressure; the tongue has stasis spots, and the pulse is unsmooth.
Qi and Blood Deficiency Type: There is a dull pain in the waist area, a general feeling of fatigue and lack of energy, shortness of breath and reluctance to speak, a tendency to be tired and prefer lying down, and a pale complexion; the tongue is pale, the coating is white, and the pulse is thin and weak.
It is recommended to perform moxibustion once a day, targeting 2 to 3 acupoints each time, with each acupoint being treated for 30 to 40 minutes. Rotate the points treated, with a 10-day period constituting one course of treatment, and then rest for 2 to 3 days before continuing with the next course. (If time permits and there is a need, more acupoints can be treated with moxibustion. The specific duration should be adjusted according to one's own physical needs.)
1. In the early stages, strict bed rest is required to reduce the activity of the affected limb and buttock. 2. During the alleviation phase, appropriate functional exercises for the waist and hip muscles should be performed. 3. Other therapies: Acupoints such as Ah Shi, Huantiao, Yinmen, Zusanli, and Kunlun are used. First, massage the acupoints Ah Shi, Huantiao, Yinmen, Zusanli, and Kunlun, then apply rolling and grasping techniques, and finally, apply static pressure, plucking, and smooth out the cord-like hard lump in the piriformis area. Once a day.