Ultrasound-guided Dry Needling Treatment of Myofascial Trigger Points for Piriformis Syndrome Management: A Case Series.

Objective: The purpose of this case series was to describe the outcomes of diagnostic ultrasound-assisted dry needling in the management of piriformis syndrome.

Clinical Features: Case 1: a 45-year-old woman reported gluteal pain occasionally radiating in the sciatic region. Her magnetic resonance imaging showing sciatic nerve edema in the underlying portion of the piriformis muscle. Case 2: a 55-year-old man had gluteal pain after deep palpation or being in a prolonged sitting position. A previous magnetic resonance imaging showed a disk herniation at L2-L3. Case 3: a 65-year-old woman reported pain in the sciatic area when she was walking and at nighttime rest. All patients had been treated with oral drugs, with poor results.

Interventions and Outcome: Patients had the same quality and duration of symptoms. The treatments of piriformis muscle and gluteus minimus, medius, and maximus muscles were performed using a convex probe and a 0.30 × 60 mm needle, which was inserted out of plane, maintaining a constant view of its tip. All patients were treated over 10 days and followed up for 6 months. Their symptoms resolved during this time and no adverse reactions were reported.

Conclusion: For these 3 patients with piriformis syndrome who were treated with ultrasound-guided dry-needling treatment, their symptoms resolved and their quality of life improved.