I. What are the main symptoms of pear-shaped muscle syndrome? Pain is the main manifestation of pear-shaped muscle syndrome. The pain is mainly in the buttocks and can radiate to the lower limbs. In severe cases, the pain cannot be walked or is severe after walking for a certain distance, and it is necessary to rest for a moment before continuing to walk. Patients may feel that the pain is deeper and radiates mainly to the posterior or posterior lateral side of the ipsilateral lower limb, and some may also have numbness in the lateral calf and discomfort in the perineum. If the pain is severe, you may complain of “cutting” or “burning” pain in the buttocks, difficulty in flexing the legs, kneeling on both knees, and difficulty in sleeping at night. The pain in the affected limb is aggravated by the increase in abdominal pressure due to urination and defecation, coughing and sneezing. Second, what is the main cause of pear-shaped muscle syndrome? Most of the patients have a history of trauma, such as flashing, twisting, crossing, standing, squatting with heavy objects on the shoulder, walking with weight and getting cold. Certain actions such as lower limb abduction, external rotation or squatting into a straight position when the pear-shaped muscle elongation, stretching and injury to the pear-shaped muscle. After the injury of the pear-shaped muscle, local congestion and edema or spasm, repeated injury leads to hypertrophy of the pear-shaped muscle, which can directly compress the sciatic nerve and appear pear-shaped muscle syndrome. Secondly, the anatomical relationship between the pear-shaped muscle and the sciatic nerve is mutated, which can also lead to compression or stimulation of the sciatic nerve and produce pear-shaped muscle syndrome. In addition, due to some gynecological disorders such as inflammation of the pelvic ovaries or adnexa and inflammation of the sacroiliac joint may also affect the pear muscle, affecting the sciatic nerve through the inferior foramen of the pear muscle and the corresponding symptoms occur. Therefore, female patients with this disease also need to understand the presence of gynecological inflammatory diseases. Third, diagnosis and differential diagnosis Most patients with pear syndrome have a history of carrying heavy objects, contusion flash sprain and exertion and cold, pear muscle area has obvious pressure pain, lumbar pressure pain and percussion pain, spinous process without distortion, lumbar elevation test can be (-), or within 60 ° (+), more than 60 ° but for (-), but we should pay attention to a considerable part of lumbar protrusion patients combined with pear syndrome. Typical cases in the pear muscle area can be palpable striated elevation, local blunt thick, or diffuse blunt thick, chronic pear syndrome, the pear muscle flaccid atrophy, and the following diseases to distinguish. 1, lumbar synostosis: every occurrence in young adults aged 20 to 40 years old, lower back pain with one side of the lower limb pain as the main feature, may have lumbar spinal deviation, in L4, 5 or L5S1 spine next to the obvious pressure pain, the compressed sciatic nerve from the hip down the radiating pain, rarely radiated to the lumbar region. 2.Lumbar small joint disorder: the cause is sudden without obvious history of trauma, and sciatica rarely appears. If local edema occurs due to inflammation around the small joints near the nerve root, the nerve root can be affected, and at this time, radioactive sciatica can appear during lumbar back extension movement. 3, lumbar spinal tuberculosis: the disease is slow onset, progressive aggravation, no interval, lumbar leg buckling pain in the spinous process, no radiating pain, rapid hematocrit, x-ray cone edge with defect, or cold pus shadow. 4, spinal stenosis: this syndrome is divided into intermittent claudication type spinal stenosis and sciatica spinal stenosis, the former can not stand for a long time and walk a long way, walking for a long time will appear numbness and weakness of the lower limbs, and improve after rest and squatting; the latter has a long-term history of lower back pain, clinical symptoms have leg pain with numbness, every after squatting or lying down to recover, mostly on both sides, or left and right alternately, straight leg raising test are negative. Fourth, what are the non-surgical treatments for pear-shaped muscle syndrome? Non-surgical treatment for pear-shaped muscle syndrome includes manipulation, local closure, muscle injection, physiotherapy, Chinese herbal medicine, acupuncture, etc.