Piriformis syndrome & acupuncture - Acupuncture and Moxibustion

Townsend Letter for Doctors and Patients, July, 2003 by Honora Lee Wolfe

Treatment outcomes

After four courses of therapy, 63 members of the multidirectional acupuncture group were judged cured, 16 cases got a marked effect, and only one case got no effect. In the conventional or unidirectional acupuncture group, 50 cases were judged cured, 25 got a marked effect, and five got no effect. Therefore, the cure rates were 78.8% and 62.5% respectively. However, in terms of total effectiveness rates, there was no significant difference. Where there was a significant difference was in the number of acupuncture treatments necessary to achieve a cure. Of the 63 patients cured in the multidirectional needling group, six cases were cured with one course of treatment, 31 were cured in two courses, 21 were cured in three courses, and five required four courses. Among the 50 cases cured in the unidirectional needling group, only one case was cured in one course, 18 were cured in two courses, 25 were cured in three courses, and six were cured in four courses. Therefore, 58.7% of those who were cured in the multidi rectional acupuncture group were cured in 1-2 courses of treatment, while only 38% of those cured in the conventional acupuncture group were cured in two courses. Thus the course of treatment necessary to affect a cure was statistically shorter using the multidirectional needling method.

Discussion

According to Dr. Wu, needling a single acupoint in multiple directions is a technique which is found as early as in the Nei Jing (Inner Classic). Dr. Wu quotes the Ling Shu (Spiritual Axis) chapter titled "Needling the Officials" as saying, "Waggling needling means first needling perpendicularly, [then] lifting [and needling) front and back, [then] waggling [side to side] sinew tension in order to treat sinew impediment." This type of needle technique soothes the sinews and relaxes spasm, frees the flow of the network vessels and stops pain. It very pronouncedly transports and moves the qi and blood in the diseased area. In this case, this technique is used to relax spasm and contracture of the piriformis muscle, reduce relative hyperemia and edema, and to loosen and resolve adhesions. This is based on the idea that piriformis syndrome is a species of sinew vessel impediment obstruction due to qi stagnation and blood congelation. Because there is no free flow, there is pain.

Since professional and other serious athletes are often injured in this way, clinicians who work with athletes need as many treatment options as possible. I hope this treatment protocol may help more athletes, professional or weekend warriors to be relieved of the pain of piriformis syndrome.

For more information on the treatment of piriformis syndrome with Chinese medicine, see Bob Flaws & Philippe Sionneau's The Treatment of Modern Western Medical Diseases with Chinese Medicine available from Blue Poppy Press.