Piriformis Syndrome

How Chinese medicine differentiates piriformis syndrome as a Painful Obstruction (Bi Syndrome), the four patterns you'll actually meet in practice, and the points for each. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Progressive weakness, loss of bladder/bowel control, or numbness in the saddle area needs urgent medical evaluation before assuming it is piriformis syndrome.

General Acupuncture Points

Acupuncture points traditionally used for piriformis syndrome — 6 key points, used across the patterns below rather than tied to just one.

Point	Key action
G.B.-30	Removes obstructions from the channel, resolves Dampness and expels Wind.
BL-54	Benefits the lower back, removes obstructions from the channel.
BL-40	Removes obstructions from the channel — He-Sea point for the lower back and knee.
G.B.-34	Promotes the smooth flow of Liver-Qi, benefits the sinews.
BL-23	Tonifies the Kidneys and nourishes Kidney-Essence.
BL-18	Nourishes and invigorates Liver-Blood.
SP-9	Regulates the Spleen, resolves Dampness.

The Four Patterns

↑ reinforcing ↓ reducing ⊥ even method.

1. Qi and Blood Stagnation View full pattern →

Clinical manifestations: Fixed, stabbing pain in the buttock; pain worse with pressure and prolonged sitting.

Tongue: Dark purple body with stasis spots, distended sublingual veins. Pulse: Wiry and choppy.

Treatment principle: Invigorate Blood and dispel stasis to relieve fixed pain and unblock the channels.

G.B.-30 ↓ BL-54 ↓ BL-40 ↓ G.B.-34 ↓

Note: no moxa. Matches Liver-Blood stasis — a dark purple tongue with stasis spots is the same discoloration marker named there.

2. Painful Obstruction with Wind-Cold-Damp

Clinical manifestations: Deep, heavy aching pain; a cold sensation in the buttock; worse in cold, damp weather; stiffness and heaviness in the hip.

Tongue: Pale, slightly swollen body with teeth marks, white greasy coating. Pulse: Wiry and tight, slow, or soggy.

Treatment principle: Expel Wind, Cold, and Dampness from the channels and relieve pain.

G.B.-30 ↓ G.B.-34 ↓ BL-40 ↓

Note: moxa applicable. No deck on this site has a Wind-Cold-Damp Bi-syndrome category, so no pattern link is given here.

3. Painful Obstruction with Liver and Kidney Deficiency

Clinical manifestations: Dull, persistent buttock pain, not sharp or stabbing; pain worse at night; lower back and knee soreness and weakness; fatigue and lack of stamina; numbness or tingling down the leg.

Tongue: Pale, thin body with thin white coating. Pulse: Fine, weak, slow, especially weak at the Chi position.

Treatment principle: Dispel Wind-Cold-Damp while nourishing the Liver and Kidneys.

BL-23 ↑ BL-18 ↑ G.B.-30 ⊥ G.B.-34 ⊥ BL-40 ⊥

Note: moxa applicable on the tonifying points. No deck on this site combines Liver and Kidney deficiency into a single Bi-syndrome slide, so no pattern link is given here.

4. Painful Obstruction due to Damp-Heat in the Channels

Clinical manifestations: A heavy, distending ache in the buttock; local warmth or redness over the piriformis; pain relieved by cold applications; pain worsened by humid or hot weather; thirst, irritability, dark urine.

Tongue: Red body, possibly slightly swollen, yellow greasy coating. Pulse: Slippery and rapid.

Treatment principle: Clear Heat and dry Dampness from the lower body, unblocking the channels.

G.B.-30 ↓ G.B.-34 ↓ SP-9 ↓ BL-40 ↓

Note: no moxa. No deck on this site has a Damp-Heat Bi-syndrome category, so no pattern link is given here.

Related conditions

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