Piriformis Syndrome

Both Piriformis Syndrome and lumbar disc herniation cause radiating pain from the buttocks to the legs along the sciatic nerve pathway, making it difficult to distinguish them based on symptoms alone. Methods to differentiate the two include: ① FABER test (Piriformis) vs. Straight Leg Raise test (SLR, disc) ② MRI (presence of disc herniation) ③ Ultrasound (Piriformis hypertrophy/adhesion) ④ Confirmation of piriformis origin if pain decreases by more than 50% during sciatic nerve block. When both conditions coexist, treatment priorities are determined after evaluating which is the primary cause of the symptoms. Korean medicine clinics offer integrated treatment that addresses both areas simultaneously. In Korean medicine, the co-occurrence of piriformis syndrome and lumbar disc herniation is understood as a state of stagnation of Qi and blood throughout the entire pathway extending from the lower back through the buttocks to the lower extremities. Restoring the flow of the entire meridian, starting from the lower back, passing through the piriformis area, and reaching the lower extremities, allows for a simultaneous approach to both issues. Dongjedang utilizes an integrated protocol that treats the lumbar spine and piriformis muscle within the same treatment session. We determine the priority of needle acupuncture by identifying areas where blood stasis is primarily concentrated using ultrasound. By reinforcing kidney function—which governs bones and joints—through internal treatment, a favorable environment for the recovery of both the intervertebral disc and the piriformis muscle is created.