A Case Report of Chronic Perineal Pain Improved by Korean Medicine Treatment

This study reports a case of chronic perineal pain treated with combined Korean medicine therapy, including acupuncture at Huiyin (CV1).A 67-year-old woman presented with perineal and anal pain persisting for more than two years, which began after a 6-hour bus journey.Extensive gynecological, urological, colorectal, neurological, and radiological evaluations revealed no structural cause, and prior surgical interventions for suspected pelvic congestion syndrome (laparoscopy, varicose vein surgery) provided no relief.Based on the absence of postural dependence, presence of nocturnal pain, and a negative digital vestibular palpation test, pudendal neuralgia and vestibulodynia were considered unlikely, and the patient was diagnosed with chronic idiopathic perineal pain.She was treated with acupuncture, cupping, moxibustion, pharmacopuncture, thread-embedding acupuncture and herbal medicine tailored to symptom changes over the treatment course.The Numeric Rating Scale score decreased from 10 to 2∼3, while the patient reported approximately 90% subjective pain relief.The Short-Form McGill Pain Questionnaire sensory and affective subscale score decreased from 16 to 1 and 5 to 1, respectively.The patient was able to taper and discontinue a previously prescribed anxiolytic.Symptom relief was maintained at telephone follow-up more than one year after initial presentation.This case showed sustained improvement in chronic idiopathic perineal pain following combined Korean medicine treatment.