{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:26:25Z","timestamp":1787318785416,"version":"build-2736575974"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the short-term clinical efficacy and safety of Linggui Tanxue acupuncture combined with extracorporeal shock wave therapy (ESWT) in patients with piriformis syndrome (PS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty patients with PS aged 35 to 45\u202fyears were prospectively allocated using a random-number table into a control group receiving ESWT alone and a combined-treatment group receiving Linggui Tanxue acupuncture followed by ESWT, with 30 patients in each group. The treatment course lasted 2\u202fweeks. Visual analogue scale (VAS) pain scores, musculoskeletal ultrasound (MSUS)-measured piriformis muscle thickness, clinical efficacy category, and adverse events were evaluated. Pain assessment and ultrasound measurement were performed by assessors blinded to treatment allocation. Because the study was not prospectively registered and no predefined statistical analysis plan or formal sample size calculation was established before initiation, the analysis should be interpreted as exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline sex distribution, age, disease duration, VAS scores, and piriformis muscle thickness were comparable between groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). After 2\u202fweeks, both groups showed significant reductions in VAS scores and piriformis muscle thickness (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The combined-treatment group showed significantly greater improvement than the ESWT-alone control group in the two continuous outcomes: post-treatment VAS score was lower in the combined-treatment group (1.44\u202f\u00b1\u202f0.10 vs. 3.57\u202f\u00b1\u202f0.17; mean difference, \u22122.12; 95% CI, \u22122.20 to \u22122.05;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and post-treatment piriformis thickness was also lower (9.04\u202f\u00b1\u202f0.16\u202fmm vs. 12.16\u202f\u00b1\u202f0.25\u202fmm; mean difference, \u22123.13\u202fmm; 95% CI, \u22123.23 to \u22123.02;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The combined-treatment group also had a significantly higher total effective rate than the control group (86.7% vs. 46.7%; Fisher exact\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002), but this categorical outcome was considered supportive and should be interpreted cautiously. No serious adverse events occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Linggui Tanxue acupuncture combined with ESWT may provide greater short-term pain relief and greater ultrasound-measured improvement in piriformis muscle thickness than ESWT alone in patients with PS. The findings are encouraging but not definitive because of the absence of prospective registration, lack of a predefined statistical analysis plan, lack of formal sample size calculation, and the short 2-week follow-up period. Larger prospectively registered multicenter studies with predefined statistical analysis plans, formal sample size calculations, and longer follow-up are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1897807","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:21:27Z","timestamp":1785514887000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy of Linggui Tanxue acupuncture combined with extracorporeal shock wave therapy for piriformis syndrome: a prospective comparative clinical study"],"prefix":"10.3389","volume":"13","author":[{"given":"Chao","family":"Xue","sequence":"first","affiliation":[{"name":"Qingdao Huangdao District Central Hospital","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Ma","sequence":"additional","affiliation":[{"name":"Qingdao Huangdao District Central Hospital","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longlong","family":"Wei","sequence":"additional","affiliation":[{"name":"Qingdao Huangdao District Central Hospital","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songgang","family":"Liu","sequence":"additional","affiliation":[{"name":"Qingdao Huangdao District Central Hospital","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/B978-0-323-90108-6.00002-8","article-title":"Piriformis syndrome","volume":"201","author":"Lo","year":"2024","journal-title":"Handb Clin Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s00590-017-2031-8","article-title":"Four symptoms define the piriformis syndrome: an updated systematic review of its clinical features","volume":"28","author":"Hopayian","year":"2018","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"165","DOI":"10.21037\/atm-22-295","article-title":"Efficacy of extracorporeal shock waves in the treatment of myofascial pain syndrome: a systematic review and meta-analysis of controlled clinical studies","volume":"10","author":"Wu","year":"2022","journal-title":"Annals of Translational Medicine"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"665","DOI":"10.5535\/arm.2012.36.5.665","article-title":"The Effect of Extracorporeal Shock Wave Therapy on Myofascial Pain Syndrome","volume":"36","author":"Jeon","year":"2012","journal-title":"Ann Rehabil Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1097\/PHM.0000000000002286","article-title":"Efficacy of extracorporeal shockwave therapy on pain and function in myofascial pain 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syndrome","volume":"42","author":"Li","year":"2020","journal-title":"Zhonghua Wu Li Yi Xue Yu Kang Fu Za Zhi"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1302\/0301-620X.86B2.14253","article-title":"Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions","volume":"86","author":"Speed","year":"2004","journal-title":"J Bone Joint Surg"},{"key":"ref10","first-page":"768","article-title":"Use of Diagnostic Musculoskeletal Ultrasound in the Evaluation of Piriformis Syndrome: A Review for Rehabilitation Providers","volume":"19","author":"Manske","year":"2024","journal-title":"Int J Sports Phys Ther"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1002\/mus.26418","article-title":"Ultrasound appears to be a reliable technique for the diagnosis of piriformis syndrome","volume":"59","author":"Zhang","year":"2019","journal-title":"Muscle Nerve"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"721966","DOI":"10.3389\/fneur.2021.721966","article-title":"Ultrasound-guided measurement of piriformis muscle thickness to diagnose piriformis syndrome","volume":"12","author":"Siahaan","year":"2021","journal-title":"Front Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e940214","DOI":"10.12659\/msm.940214","article-title":"A case-control study of 40 patients with piriformis muscle syndrome to evaluate diagnostic findings using two-dimensional ultrasound and shear wave elastography","volume":"29","author":"Xu","year":"2023","journal-title":"Med Sci Monit"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"768","DOI":"10.26603\/001c.118145","article-title":"Use of diagnostic musculoskeletal ultrasound in the evaluation of piriformis syndrome: a review for rehabilitation providers","volume":"19","author":"Manske","year":"2024","journal-title":"Int J Sports Phys Ther"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.pain.2003.08.001","article-title":"Core outcome measures for chronic pain clinical trials: IMMPACT recommendations","volume":"113","author":"Turk","year":"2005","journal-title":"Pain"},{"key":"ref16","volume-title":"Criteria for Diagnosis and Therapeutic Effect Evaluation of Traditional Chinese Medicine Syndromes","year":"1994"}],"updated-by":[{"DOI":"10.3389\/fmed.2026.1960827","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000}}],"container-title":["Frontiers in 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