From Dr. Natalie Meiri’s clinical pearl stories: Chiropractor West Palm Beach: Relief From Piriformis Syndrome With Acupuncture
This is my clinical pearl story about Chiropractor West Palm Beach: Relief for Piriformis Syndrome with Acupuncture. He was a 40 year old male patient. His chief complaints were buttock and posterior (back) leg pain. And it came on insidiously (gradual, subtle but with harmful effects) without any trauma.
To be HIPAA compliant, I will call him Marty instead of his real name.
Marty worked as a truck driver. One day he presented to my office reporting pain in the gluteal region. It was characterized as shooting, burning, or aching down the back of the leg. In addition, he reported numbness in the buttocks and tingling sensations. And it was along the distribution of the sciatic nerve.
He had seen his primary care physician and had his low back x-rayed. The pain medication his primary prescribed didn’t help at all. So that’s when he decided to come see me.
Marty’s Examination at Meiri Chiropractic
Upon examination, Marty tested positive for the piriformis syndrome. His x-rays taken at the primary care doctor showed degenerative arthritis (osteoarthritis). Marty’s diagnosis was Piriformis Syndrome.
Piriformis syndrome occurs due to sciatic nerve entrapment at the level of the ischial tuberosity (“sit bone”).
What is Piriformis Syndrome?
Firstly, the piriformis is a flat, pear-shaped muscle located in the gluteal (buttock) region of the hip/proximal thigh.
Secondly, the sciatic nerve runs under the piriformis muscle where it may be compressed (pinched) by the piriformis muscle. As the biggest nerve in your body, it originates from several nerves in your lower back. These nerves branch outward from the spine and then come together at each buttock to form the sciatic nerve, which then travels down each leg. And sciatica is defined as irritation or compression of the sciatic nerve that causes pain in the buttock area with radiation to the lower leg. This is usually a neuritis (inflammation of a nerve) and generally caused by mechanical compression or irritation of the lumbar and sacral spinal nerve roots. However, piriformis syndrome is another cause of irritation of the sciatic nerve.
Thirdly, predisposition to piriformis syndrome may be due to an anatomically short leg (one leg is structurally shorter than the other due to bone length differences). Other reasons could be due to excessive pronation (inward rotation of foot) of your foot or a pelvic rotation/misalignment.
Fourthly, in approximately 15 % of the population, there are two muscle bellies (bipartite) to the piriformis muscle. In this case, the sciatic nerve courses between the 2 muscle bellies.
Causes of Piriformis Syndrome
- Trauma to the hip or buttock area
- Piriformis muscle hypertrophy (often seen in athletes during periods of increased weightlifting requirements or pre-season conditioning)
- Sitting for prolonged periods (truck drivers, office workers, bicycle riders)
- Anatomic anomalies (abnormalities) and sciatic nerve coursing:
- In >80% of the population, the sciatic nerve courses deep to and exits inferiorly (below) to the piriformis muscle belly/tendon
Marty’s Acupuncture Treatments at Meiri Chiropractic
Marty decided to try a course of acupuncture treatments (1-2 times a week for 12 weeks).
His acupuncture treatments consisted of the insertion of very thin metal needles.
Marty reported that he was starting to feel better after the initial visit. After 12 visits, he was mostly pain-free.
Chiropractor West Palm Beach: Relief for Piriformis Syndrome with Acupuncture
Firstly, Acupuncture is a treatment that has been used for over 4000 years to treat pain and other health problems. It is a painless technique used to affect what the ancient chinese practitioners called Meridians (energy channels) in your body under the skin.
Secondly, Acupuncture’s effectiveness has been well documented in musculoskeletal pain disorders and other ailments. A widely accepted contemporary medical treatment option for myofascial pain is trigger point needling. In traditional Chinese medicine, these myofascial pain areas are called ASHI points. ASHI points are identified by tender, painful reactions upon palpation (using hands to examine body).
Thirdly, the Acupuncture treatment stimulates the imbalanced pathways along the meridians to bring balance back. The goal is to activate the body’s natural healing abilities.
Chiropractor West Palm Beach: Relief for Piriformis Syndrome with Acupuncture: Research
One study compared the difference in clinical efficacy on piriformis syndrome between trigger-point acupuncture and glucocorticoid injections (steroid shots). Findings were, “The clinical effect of acupuncture is similar to that of glucocorticoid injection on piriformis syndrome in 1 month after treatment. In 2 months after treatment, TrP acupuncture is markedly effective for attenuating pain and the functional impairment of the lower limbs, improving the quality of life and reducing the use of analgesic drugs in comparison with glucocorticoid injection”.
Ultimately, Acupuncture treatments stimulate the imbalanced pathways along the meridians to bring balance back. Moreover, the goal is to activate the body’s natural healing abilities. It’s often used to manage pain and other conditions, and can be part of a broader approach to healthcare. By combining the appropriate meridians, acupoints and the ashi points corresponding to the piriformis muscle, piriformis syndrome is effectively treated.
Chiropractor West Palm Beach: Relief for Piriformis Syndrome with Acupuncture
Meiri Chiropractic offers acupuncture for piriformis syndrome and many other ailments. Dr. Natalie Meiri is a chiropractic physician, board certified in acupuncture with over 20 years of experience. Call today for your acupuncture treatment. If you have pain due to piriformis syndrome call us today at 561-253-8984! Ask to make an appointment or find out more about: Chiropractic West Palm Beach: Relief for Piriformis Syndrome with Acupuncture.
References:
- Thomas Souza, (2018) Differential Diagnosis and Management for the Chiropractor
- Clinical study of piriformis syndrome treated with trigger-point acupuncture, Li-xue LIU, Miao-miao SHEN, Qin-ge WANG, Wen SHEN, https://www.sciopen.com/article/10.13702/j.1000-0607.20230336
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