A middle-aged female patient was admitted to the hospital with right hip pain with lower extremity radiating pain for 1 week. A week ago, she developed right hip pain when standing up from a prolonged squat, which gradually worsened and was accompanied by posterior lateral radiating pain of the right lower limb, and the pain worsened when walking or coughing. After examination, it was found that the patient had right pear muscle pressure pain (+), right pear muscle tension test (+), right straight leg raise test (+), tendon reflex, muscle strength and sensation of both lower limbs were normal. CT of the lumbar intervertebral disc showed: degenerative changes of the lumbar spine and lumbar 4-5 disc herniation. Combined with the medical history and physical features, the patient was considered to have “pear-shaped muscle syndrome”, and was treated with fine silver needle release of pear-shaped muscle and ten shock waves, and the pain was relieved with the aid of anti-inflammatory and pain-relieving cream. Analysis of this case: right hip pain with lower limb radiating pain for 1 week, generally known as sciatica, lumbar disc CT shows: lumbar 45 disc herniation, easily misdiagnosed as “disc herniation”. The patient was considered to have “pear-shaped muscle syndrome” with the medical history and detailed physical examination. The pear-shaped muscle is a small muscle of the hip, long walking, squatting and excessive external rotation of the hip joint can easily cause injury to the pear-shaped muscle, causing amidships, bleeding or contracture of the pear-shaped muscle, thus compressing the sciatic nerve between or below the muscle, causing radiating pain in the ipsilateral lower limb. Find the right cause less detours, treatment is fast. Pain treatment sometimes can not be completely superstitious imaging results, specific analysis of the specific situation, often muscle soft tissue injury can not be ignored.