24. Piriformis Syndrome
Many patients present complaining of sciatica when actually they are suffering from piriformis syndrome, defined on Wikipedia as – “When the piriformis muscle shortens or spasms due to trauma or overuse, it can compress or strangle the sciatic nerve beneath the muscle.” When the gluteus maximus is in spasm and compresses the sciatic nerve, GB 30 is the appropriate point to treat. When spasms in the lumbar area or disc impingement compress the sciatic nerve, those are the areas to treat. But when the problem originates deep inside the hip – at the attachment point of the piriformis, sciatica can become a very persistent, intractable problem – unless one treats the appropriate acupuncture point – GB 29 – deep! The piriformis lies deep and acupuncture is one of the only ways to interrupt a spasm of the piriformis. Proper stretching exercises can also help. The common M.D. alternative is to perform surgery and to sever the piriformis muscle! Not recommended!
There are a couple of ways to differentiate piriformis syndrome from sciatica caused by other sources, One is to treat the sciatica unsuccessfully by focusing on the gluteus maximus and lumbar areas. The other is to palpate the GB 29 area straight away for tenderness. Usually if the piriformis is involved GB 29 will be reactive to palpation. This was the case recently with Dr. Stan, an osteopath wise enough to come to me for treatment when he developed sciatic pain. I needled GB 29 deeply – 2” to 2.5” and also needled GB 30, GB 31, GB 34 and ah si points. I stimulated these with 2 and 100Hz e-stim for half an hour.
Result? Often it takes several treatments to effect a 100% recover, but in Dr. Stan’s case, one treatment was enough for a complete recovery.