[CASE] Pain in Ischial Tuberosity (Sit Bones)

Outline
 
The penitent was a 78 years old female whose main complaint was pain in the ischial tuberosity known as the sit bones when she sat down for 3 years. She had tried physical therapy and steroid injections, but the pain had not been improved. When she sat for a long time, pain was radiated to her buttocks, sacrum, inguinal area and the front side of her thighs.
 
After starting acupuncture treatment, the pain decreased every treatment. At the end of the course of treatments (Twice a week until 5th treatment, Once a week until 9th treatment and Twice for every 2 weeks treatment), she became able to sit for a long time and sit on a hard chair without any pain.
 
Treatment
 
(1st Treatment)
I diagnosed her with Liver Deficiency and strengthened left Liver-3 with Yin technique. This was the first experience of acupuncture treatment for her, so I only treated her back with light spreading needle technique and pressed down some tight spots on her buttocks with Teishin.
 
 
(2nd Treatment)
After the last treatment, there was no change in the pain in the sit bones, but she felt warmer in her lower back and buttocks. Root Treatment was right Large Intestine-6 with Yin technique (Liver Deficiency with fast pulse). From this time, I added treatment with Dispersion needle at the painful spots around the sit bone (Sacrotuberous ligament). She was complaining about the pain in both sides of the sit bones, but pressure pain was only existed on the left side, so I used Dispersion needle only on the left side.
 
(3rd Treatment)
After the second treatment, the pain in the sit bone decreased and radiating pain to the inguinal area when she sat long also decreased. Root treatment was Liver Deficiency and like the last treatment, I used Dispersion needle at the pressure pain around ischial tuberosity. The area of the pressure pain became smaller.
 
(6th Treatment)
2 days before the treatment she went to a concert, but during the concert, there was no pain in the sit bones very much. Pressure pain around the sit bone was only 1 point.
 
(9th Treatment)
The pain around the sit bone considerably decreased. There was no pressure pain around ischial tuberosity, so I told her to come back in 2 weeks.
 
(10th Treatment)
There was almost no pain for 2 weeks. There was one pressure pain point around the sit bone. Dispersion needle was used on the point. I told her to come back in 2 weeks again.
 
(11th Treatment)
There was no pain even if she sat for a long time and sat on a hard chair. Since there was no pressure pain around the sit bone and she felt much better, the course of the treatments ended.
 
Consideration
 
Root treatment was mostly Liver deficiency with Yin technique. The pain was mostly on the Bladder meridian, but it was on the ligament, so I think Liver deficiency was a good choice.
 
Special treatment was only Dispersion needle. There could be treatment using distal points, but the pain was localized and 3 years already had passed, so I think it was necessary to move Blood directly with Dispersion needle and it was very effective.
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