[Comparative study of different clinical approaches for gluteal muscle syndrome with silver needle].

Objective: To explore the clinical efficacy of silver needle lumbar and sacral spine approach in treating gluteal muscle syndrome.

Methods: Eighty-seven patients with gluteal muscle syndrome treated with silver needles in the Department of Rehabilitation Medicine of our hospital from September 2017 to September 2019 were selected. Except for symptoms of waist and hip pain and discomfort, all selected patients were examined by CT or MRI to confirm pathological imaging changes such as inflammatory exudation of the gluteal muscle. The 87 patients with gluteal muscle syndrome were divided into 2 groups according to the digital table method, and 42 patients in the lumbosacral approach group, including 19 males and 23 females, aged (50.70±12.45) years old, and disease duration of (1.63±1.27) years;45 cases in the buttock approach group, including 20 males and 25 females, aged (52.80±12.18) years old, with a course of disease of (1.78±1.22) years. The lumbosacral approach group was treated with spinal L to S bilateral articular process joints and L transverse process acupuncture needles, and the buttock approach group was treated with the gluteus medulla wing starting point and femoral trochanter stop. The VAS scores, soft tissue tenderness thresholds, and hip abductor muscle strength of the affected group were measured before and 4 weeks after treatment in the two groups. The clinical efficacy was also evaluated 4 weeks after treatment.

Results: After 4 weeks, the VAS score of the lumbosacral approach group was 1.26±0.70, and the buttock approach group was 1.18±0.74, which were significantly lower than those before treatment, but there was no statistical difference between the groups (>0.05). The soft tissue tenderness threshold and ipsilateral hip abductor muscle strength were (5.51±0.70) kg and (10.34±2.19) kg in the lumbosacral approach group, and (4.78±1.05) kg, (9.33±1.42) kg in the buttock approach group. The results in the lumbosacral approach group was better than those in the buttock approach group(<0.05). The clinical efficacy of the lumbosacral approach group:16 cases got an excellent result, 20 good, 5 fair and 1 poor;in the buttock approach group, 13 excellent, 17 good, 12 fair and 3 poor. The clinical efficacy between the two groups had statistical difference (<0.05).

Conclusion: In the treatment of gluteus medius syndrome with silver needle, lumbosacral approach and buttock approach can effectively relieve the pain. Compared with the improvement of soft tissue tenderness threshold and hip abductor muscle strength, the upper lumbosacral approach is more prominent, and the overall clinical effect is more significant.