Piriformis Syndrome

The piriformis muscle is a small muscle that extends from the deep pelvis, from the anterior surface of the sacrum, to the greater trochanter of the femur. If this muscle spasms, hypertrophies, or adheres, it physically compresses the adjacent sciatic nerve, causing symptoms similar to sciatica. Major causes include: ① continuous compression due to prolonged sitting; ② sudden twisting movements or falls; ③ leg length discrepancy or pelvic asymmetry; and ④ long-distance driving or cycling. Due to various anatomical variations in the sciatic nerve—such as positioning below the piriformis muscle (80%), penetrating it (15%), or above it (5%)—compression occurs more easily in some individuals. In Korean medicine, deep pelvic piriformis muscle issues are viewed as a state of stagnation within the muscle caused by a decline in the function governing muscles and tendons, as well as blocked Qi and blood circulation. When trauma, overwork, wind, cold, or dampness invade the meridians running through the buttocks and the back of the thighs, Qi and blood become blocked, leading to muscle spasms and adhesions that constrict the sciatic nerve. Dongjedang focuses on separating adhesions in the piriformis muscle using ultrasound-guided needle acupuncture and restoring meridian Qi and blood circulation to create a state where the muscle relaxes naturally.