Piriformis Syndrome

The indications for surgery for piriformis syndrome are actually very limited. Piriformisectomy is considered only in the following cases: ① when the nerve is anatomically entrapped due to piriformis muscle proliferation, or ② when nerve function decline (muscle weakness or loss of sensation) persists despite 6 to 12 months of intensive conservative treatment. Most cases of piriformis syndrome involving only pain and numbness are resolved with non-surgical treatment. If an orthopedic surgeon has recommended surgery, the priority is to reconfirm whether the two conditions mentioned above apply and to re-evaluate whether conservative treatment is sufficient. In Korean medicine, surgery is a method of surgically removing blood stasis and adhesions, but it cannot restore organ function or meridian circulation. Dochim (needle acupuncture) has the advantage of simultaneously restoring meridian and Qi-blood circulation while dissecting adhesive tissues similarly to surgery. At Dongjedang, we first attempt an intensive course of Dochim and thread lifting before surgery, and track changes in piriformis muscle thickness using ultrasound to objectively determine whether the issue can be resolved without surgery. Many patients who visited us before surgery have successfully switched to conservative treatment.