Buttock Pain for 5 Years… It Was Not Just Piriformis Syndrome

Acupuncture Treatment for Chronic Buttock Pain & Sacroiliac Dysfunction in Auckland

A man in his thirties came in mainly complaining of deep buttock pain.

For nearly five years, he had experienced lower back pain, buttock pain, leg numbness, and aching down the leg.
The symptoms gradually became worse, especially over the last two years.

He worked in a job that required prolonged standing.
At first, the pain was mostly in the lower back, but later a deep pain developed inside the buttock — a very specific point that became unbearable after standing too long.

MRI showed no significant disc herniation or major lumbar abnormality.

But despite the “mild” imaging findings, the pain kept getting worse.

Eventually he relied on anti-inflammatory medication almost every day just to continue working.
If he stopped the medication, the deep buttock pain and leg numbness would return quickly.

Over the years, he had tried physiotherapy, chiropractic treatment, acupuncture, and muscle release work.
Each treatment helped “a little,” but never enough to stop the medication.

Like many chronic patients, he slowly lost confidence in treatment itself.

When he first came in, he repeatedly described himself as having “piriformis syndrome.”
And clinically, it did resemble that pattern at first.

There was clear tenderness in the gluteal muscles and piriformis region.

But after the first few treatments, the improvement was smaller than expected.

That was the turning point.

👉 The muscles were involved — but they were probably not the main source.

Further examination revealed marked tenderness around the sacroiliac joint.
Treatment direction was then adjusted toward the sacroiliac region, including local release, cupping, and targeted bleeding techniques.

The response became more obvious.

Pain reduced significantly.
Medication use dropped from daily dependence to only occasional use.

But one deep buttock pain point still remained.

This led to another reassessment.

Treatment was later directed toward the sacrotuberous ligament attachment near the ischial tuberosity — a deeper stabilizing structure often missed in chronic buttock pain cases.

The next day, his wife sent a message saying:

“His buttock pain is about 80% better.”

And for the first time in a long time, he was no longer relying on painkillers.

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Clinical Insight

This case was important because the diagnosis was not clear from the beginning.

The real progress came from repeatedly reassessing the pain pattern and being willing to change direction.

Many chronic buttock pain cases are not caused by one isolated muscle alone.
Sometimes the deeper stabilizing structures around the pelvis become the true driver of persistent pain.

In chronic pain work, treatment itself often becomes part of the diagnostic process.