Combination of Manual Acupuncture Therapy and Ear Acupuncture (Battlefield Acupuncture) in Patients with Piriformis Syndrome: A Case Report

Background: Piriformis syndrome is a neuromuscular disorder caused by compression of the sciatic nerve by the piriformis muscle, leading to buttock pain radiating to the lower extremity. Pharmacological management generally includes nonsteroidal anti-inflammatory drugs and drugs for neuropathic pain, but long-term use may result in adverse effects. Therefore, nonpharmacological management such as acupuncture may be considered. Case: A 28-year-old male presented with right buttock pain radiating to the right calf for 2 years, aggravated by prolonged sitting, standing, and walking. FAIR, Pace, Freiberg, and Beatty maneuvers were positive. The patient was treated on an outpatient basis using manual acupuncture on body points and ear acupuncture using Battlefield Acupuncture points twice weekly for six sessions. Outcome measures included the Numeric Rating Scale (NRS), the Oswestry Disability Index (ODI), and hip abduction range of motion (ROM). Results: After six sessions of therapy, NRS improved from 5 to 0, ODI from 24.4% to 0%, and hip abduction ROM from 18° to 45°. Conclusions: Manual acupuncture and auricular acupuncture may contribute to symptom improvement in piriformis syndrome. However, the observed benefit in this case cannot establish clinical efficacy because a single case report does not determine causality, and symptom improvement may also have been influenced by avoidance of aggravating activities.