Piriformis, medial end, near the greater sciatic foramen
- TrP2 (Travell & Simons, vol. 2, ch. 10 — piriforme)
Record status
Documentary views
The muscle and the place
Piriformis, medial end, near the greater sciatic foramen
What the finger seeks
Deep pressure, through the gluteus maximus, on the uppermost buttock, medially, toward the region of the greater sciatic foramen — avoiding any pressure that produces tingling in the lower limb.
From the outside, palpation of the uppermost buttock constantly reveals exquisite tenderness on and just lateral to the greater sciatic foramen; the medial region of the spot is markedly tender when pressure is applied medially over the region of the greater sciatic foramen. The authors also describe an examination from inside the pelvis, outside the acupuncturist’s scope of practice, not reproduced here.
Sources
- travell-tpm-2 · vol. 2, ch. 10 — p. 205 et 217 (points médiaux, sensibilité à la pression médiale sur la région du grand foramen sciatique), p. 215 (palpation de la fesse la plus haute), p. 224 (éviter la pression qui provoque des picotements)
- baldry-tp-acupuncture · p. 301 — points actifs près de l’attache médiale du muscle
What pressure brings out
The sacroiliac region, the whole buttock and the back of the hip most consistently carry the pain.
Some authors have also reported it in the groin, at the greater trochanter or as far as the coccyx; according to others it sometimes extends to the proximal two-thirds of the back of the thigh and down the leg, in the territory of the sciatic nerve.
Sources
- travell-tpm-2 · p. 204-205 — patron principal, extension proximale de la cuisse, notes sur l’aine, le trochanter et le coccyx
- baldry-tp-acupuncture · p. 299 — fesse, hanche, arrière de la jambe dans la distribution du nerf sciatique
The technique
Invasive technique not publishable: the structured contract is incomplete.
Caution
No distance to a structure is published for this medial end. For the approach by the lateral border of the sacrum described by Pace, the authors note that a 75 or 90 mm spinal needle is needed in most patients — a needle length, not a depth. The sciatic nerve, which the authors place in close proximity, appears as the critical structure in the manoeuvre's safety record, not as a measured distance.
Convergence
This section requires a distance explicitly referencing this geometrically placed locus. A distance to its carrying muscle is never assigned to it.
no convergence calculated for this place