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Why Your Sciatica Might Actually Be Dead Butt Syndrome

Why Your Sciatica Might Actually Be Dead Butt Syndrome

Why Your Sciatica Might Actually Be Dead Butt Syndrome

You’ve been told you have sciatica. Maybe you’ve even been told it’s piriformis syndrome. But according to Chad Johnson, Licensed Acupuncturist and founder of Asheville Orthopedic Acupuncture, there’s a good chance both of those diagnoses are wrong. The real culprit is something with a very different name: dead butt syndrome.

Chad joined host Travis Richardson on the Be Well Asheville Podcast for Episode 28 of the Wellness in Asheville series. The conversation is packed with practical, body-centered insight that makes you rethink how you’ve been treating your pain.


Episode 28: Chad Johnson on Orthopedic Acupuncture + Recovery Optimization
Listen on: Buzzsprout | Apple Podcasts | Spotify | Amazon Music

What Is Dead Butt Syndrome and Why Are You Probably Calling It Sciatica?

The gluteus medius is a muscle that attaches at the iliac crest, the upper outer edge of your hip. When you sit for extended periods, whether in a car, on a plane, or reclined on the couch watching Netflix, you compress that muscle for hours at a time and push the blood out of it.

The result is a necrotic, painful gluteus medius. Chad calls it what it is: dead butt syndrome. It is a real, recognized condition.

Here is what makes it tricky. The referred pain pattern from that muscle lands right at the sacrum and L5, which is your lower back. So people walk into Chad’s clinic pointing at their back, convinced they have sciatica. But the hip is the source of the problem.

“Everybody comes in and says, ‘I have sciatica’ or ‘piriformis syndrome,’ but it’s wrong in both cases. It’s this gluteus medius muscle. And the referred pain pattern is right here at the sacrum and L5.” — Chad Johnson, L.Ac.

If you sit for long stretches regularly, this is worth paying attention to.

Microscopic Needles for Acupuncture for Alpha-Gal
Hot towels and organic massage lotion on a cart in a massage therapy room in Asheville, NC

What Makes Chad's Approach Different

Chad studied at a school in New York that trained him in three distinct styles of acupuncture over three full years with no herbs, just acupuncture. That gave him an unusually broad technical foundation to draw from.

But what really sets his practice apart is palpation. Where many acupuncturists diagnose through pulse and tongue analysis, Chad reads the body through touch. He feels the whole muscle system, traces the channel blockages, and finds exactly where the dysfunction is hiding.

He uses the Kiiko Matsumoto Japanese style, which allows him to test a point before committing a needle to it. Using fingernail pressure at a candidate point, he checks whether tension in a target area reduces by at least 30 percent. If it does, the needle goes in and the expected result is 60 to 80 percent relief from whatever is being treated.

Patients feel the change in real time. That kind of immediate feedback is not something most acupuncture approaches offer.

Massage therapy room room interior detail with natural objects and lighting.

The Two Pain Patterns Chad Sees Every Single Day

Modern life is predictable in certain ways, and so is the body’s response to it.

Right shoulder pain is extremely common, largely because of how people use a mouse. Hovering the hand over a mouse for hours creates chronic tension in the right shoulder girdle.

Right hip pain almost always accompanies it. The right shoulder and right hip are closely linked through the body’s channel system. Between them lie the liver and kidney, so when one area goes, the other tends to follow.

These patterns feed directly into the gluteus medius problems described above. The lifestyle of modern sedentary work creates a cascade that most people try to treat locally, when the whole chain needs to be addressed.

Three Recovery Habits Chad Recommends to Everyone

Chad gives every patient the same foundational advice, regardless of what brought them in. These are not complicated, but most people are not actually doing them.

1. Hydration Done Right

Drinking water while sitting at a desk sends most of that water straight to the bladder. To get water into the muscles, you need to pair hydration with movement. Even light stretching immediately after drinking a half cup of water will drive that fluid into the muscle tissue rather than through to the kidneys.

This is why athletes can run for an hour without needing a bathroom stop. The movement is routing the water to where it is needed.

2. Conscious Breathing

Chad uses this term intentionally. From a Chinese medicine perspective, breathing is a two-part process. The inhale sends oxygen to the kidneys and the exhale releases it through the lungs. A deep belly breath that fully expands the lower lobes is what creates the lung-kidney connection, and that connection is central to the body’s ability to heal itself.

Most people breathe in choppy, shallow rhythms all day. A smooth, wave-like breath pattern directly affects heart rate variability because the lungs act as pressure pillows on either side of the heart, compressing and releasing it with each breath cycle.

Chad’s in-clinic reset technique: take one big breath in while raising the shoulders, then drop them hard. Follow with two more breaths at 60 percent in, 100 percent out, slowly. Just three breaths can bring a stress level from an eight down to a five.

3. Balancing Movement and Rest

Chad sees a lot of high-performers who push hard to recover and then re-injure themselves. During recovery from surgery, illness, or injury, the body needs more rest than usual, more hydration than usual, and movement that is smooth rather than strenuous.

Qigong-style movement, meaning smooth, full range of motion with no load, is what he recommends first. Strength training comes back only after the tissue has learned to open and close without resistance.

Why Acupuncture Before and After Surgery Matters

One of Chad’s strongest convictions is that acupuncture should be part of every surgical protocol. He has seen the difference consistently: patients who receive acupuncture both before and after a procedure recover significantly faster and more completely than those who do not.

This is not fringe thinking. The circulatory, neurological, and tissue-level effects of acupuncture directly support the body’s healing process, and timing treatments around surgery maximizes that support.

Crystal Ear seeds for Auricular Acupuncture in Asheville for Alpha-Gal Syndrome

Maintenance Acupuncture for Longevity

Crystal Ear seeds for Auricular Acupuncture in Asheville for Alpha-Gal Syndrome

A growing number of Chad’s patients come in not because they are in pain, but because they cannot afford to be. Business owners, caregivers, professionals with high-stakes responsibilities come in every two to four weeks to stay sharp, resilient, and functional.

As Chad put it: “I’ve got too much responsibility. I can’t die.” That is the mentality, and acupuncture as a longevity practice supports it. Better sleep, better recovery, better stress management, and better ability to sustain physical performance over time

Key Takeaways from the Episode

  • Most sciatica pain is actually dead butt syndrome, which is gluteus medius compression from prolonged sitting
  • The Kiiko Matsumoto style allows point-testing before needling for measurable, real-time results
  • Right shoulder and right hip pain are the most common patterns in modern life and they are closely linked
  • Pair hydration with movement so water actually reaches your muscles
  • Deep belly breathing connects the lungs and kidneys, which is the foundation of the body’s healing cycle
  • Acupuncture before and after surgery significantly accelerates recovery
  • Regular maintenance acupuncture supports longevity, performance, and resilience

Listen to the Full Episode

You can find Episode 28 of the Wellness in Asheville Podcast on the Be Well Asheville website, or wherever you listen to podcasts.

Work with Chad

Chad Johnson, L.Ac. practices at Asheville Orthopedic Acupuncture on Haywood Road. To book an appointment or learn more, visit ashevilleorthopedicacupuncture.janeapp.com or call the clinic directly at 828-333-5087.

You can also find more info about CEU classes at tinyurl.com/moxahouse.

This post is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making changes to your health routine.

If You Are Seeking Orthopedic Acupuncture in Asheville NC

If musculoskeletal pain or movement restriction is limiting daily activity or athletic performance, we are available to evaluate whether orthopedic acupuncture is appropriate for your condition.

Orthopedic Acupuncture in Asheville

Orthopedic Acupuncture in Asheville

Orthopedic Acupuncture in Asheville, NC

Voted Best Acupuncturist in Asheville | MOUNTAIN XPRESS BEST OF WNC 2026

Root-cause, Patient-centered, Results-driven

Orthopedic Acupuncture is the foundation of how we evaluate and treat musculoskeletal pain and structural dysfunction at Asheville Orthopedic Acupuncture  at Moxa House. This approach also includes care for autoimmune conditions, chronic health patterns, and complex or unclear diagnoses that have not responded fully to previous treatment.

Our work integrates traditional East Asian medicine with modern structural assessment and anatomical understanding.

Chad Johnson, L.Ac., providing Orthopedic Acupuncture treatment in Asheville, NC

What Is Orthopedic Acupuncture?

Orthopedic acupuncture integrates traditional East Asian medical systems with structural and biomechanical evaluation.

In our clinic, this includes:

  • Japanese Acupuncture
  • Kiiko Matsumoto Style (KMS) with palpation-based diagnosis and treatment
  • Acupuncture Zone Treatment (AZT)
  • Traditional Chinese Medicine (TCM)
  • Classical Acupuncture
  • Five-Element Acupuncture Theory
  • Zheng Gu Tui Na orthopedic bodywork
  • Muscle and Joint Reintegration Therapy
  • Trigger Point and Dry Needling strategies
  • Myofascial assessment
  • Joint and movement evaluation
  • Massage Therapy
  • Moxibustion, a traditional heat-based therapy from Chinese and Japanese medicine used to increase circulation and support tissue recovery
Chad Johnson, L.Ac., providing Orthopedic Acupuncture treatment in Asheville, NC
Moxibustion treatment on a patient's back at Asheville Orthopedic Acupuncture

Moxibustion

In Japan, Moxibustion is practiced as a medical modality in its own right. We incorporate it when tissue warming, circulation support, or recovery assistance is clinically appropriate.

Treatment is guided by palpation-based diagnosis and structural findings. We evaluate joint mechanics, fascial tension, muscular balance, and movement quality, and we adjust based on how the body responds.

We move from pain reduction into identifying and correcting the mechanical stress contributing to dysfunction. We are committed to doing this in as few treatments as possible.

How We Help

Our approach brings together specialized acupuncture and hands-on therapies to address pain, injury, movement dysfunction and complex conditions. Treatment is individualized based on what we find during your assessment.

Orthopedic & Japanese Acupuncture
Specialized acupuncture combining orthopedic assessment and treatment with gentle Japanese styles.

Explore Acupuncture →

Dry Needling
Precise treatment of muscular pain, trigger points and areas of restricted movement.

Explore Dry Needling →

Clinical Massage Therapy
Individualized therapeutic massage focused on pain relief, mobility, recovery and function.

Explore Clinical Massage Therapy →

Chad Johnson, L.Ac., providing Orthopedic Acupuncture treatment in Asheville, NC

Who We Help

Patients come to us with everything from recent injuries to long-standing pain and complex conditions. Many have tried other approaches and are looking for a more individualized assessment and treatment plan.

  • Back and neck pain, including sciatica
  • Shoulder, hip and knee pain
  • Migraines and headaches
  • Sports injuries and repetitive-use conditions
  • Tendon, ligament and soft-tissue injuries
  • Neuropathy and nerve pain
  • Carpal tunnel syndrome
  • Plantar fasciitis and foot pain
  • Car accident and motor vehicle injuries.
  • Pre- and post-surgical care
  • Concussion and trauma
  • Autoimmune conditions
  • Chronic and complex pain conditions
  • Non-surgical approaches to pain and injury

Explore the conditions we treat →

Our Clinical Framework

Patient Centered

We treat the individual presentation rather than applying a fixed protocol.

Result-driven

We monitor response and adjust when necessary.

Root-cause oriented

We look beyond symptoms to identify and address the patterns contributing to pain and dysfunction.

Our goal is to help you improve in as few treatments as possible. We adjust your care based on how you respond, and if another practitioner or approach may be a better fit, we’ll tell you.
Chad Johnson providing  trigger point therapy and dry needling in Asheville,  NC

Dry Needling Within Orthopedic Acupuncture

Dry Needling may be integrated when trigger points contribute to restricted movement, nerve irritation, or joint compression. This can be called Trigger Point Therapy or Dry Needling in Asheville.

Because we are licensed acupuncturists trained in both traditional and orthopedic systems, Dry Needling is incorporated within a broader structural treatment plan. Tissue release is paired with evaluation of why that muscle became overloaded.

Orthopedic Acupuncture for Athletes and Active Adults in Asheville

Asheville’s active population places sustained mechanical demand on the body. We work with dancers, gymnasts, strength athletes, runners, cyclists, climbers, basketball players, football players, and competitive high school and collegiate athletes.

We also support those navigating frozen shoulder, persistent joint stiffness, or injuries that arise from everyday activities such as dog walking, gardening, yard work, or hiking. Many people are not training for competition, but they still want to move comfortably and maintain independence.
Treatment focuses on restoring joint integrity, improving tissue resilience, and reducing recurring flare patterns so daily activity and training can continue with greater stability.

What to Expect

Your first appointment includes a comprehensive intake, assessment and treatment. We take time to understand what is going on, what you’ve already tried and what you hope to improve, then evaluate your individual presentation and begin treatment during that same visit.

Chad explains what he is finding and walks you through the treatment as he goes, so you understand what we’re doing and why.

Your response to treatment helps guide what happens next. Care is adjusted as you improve, with the goal of helping you get better in as few treatments as possible.

Meet Chad Johnson, L.Ac

Chad Johnson, L.Ac. is Clinic Director and co-founder of Asheville Orthopedic Acupuncture | Moxa House. He has practiced acupuncture in Asheville since 2011, with a clinical focus on pain, injuries and complex conditions.

His approach is gentle, practical and highly individualized. Chad takes time to explain what he is finding, what he is doing and why, walking patients through each step of their care. He has a particular knack for making the principles of this ancient medicine understandable and relevant to the person on the table.

Many of Chad’s patients are themselves physicians, nurses and other healthcare professionals. He also works collaboratively with Western medical providers and is comfortable being part of a larger care team when a patient’s condition calls for it.

His treatments combine Orthopedic Acupuncture, Japanese acupuncture styles, detailed assessment and hands-on therapies, with a focus on providing the care a patient needs without unnecessary treatment.

Chad also teaches continuing education for acupuncture and massage professionals, sharing advanced clinical techniques and treatment approaches with other practitioners.

Voted #1 Best Acupuncturist — Mountain Xpress Best of WNC 2026

Learn More About Chad →

Chad Johnson, L.Ac., greeting a patient at Asheville Orthopedic Acupuncture

How Many Treatments Will I Need?

Acute conditions often respond more quickly. Chronic or complex patterns generally require a more structured plan. We are committed to helping you improve in as few treatments as possible while still addressing the root cause.

Acute Issues

For a recent injury or issue, we typically begin with three treatments and assess your response.

Chronic or Complex Patterns

For long-standing pain or more complex conditions, we typically begin with five treatments and reassess from there.

Severe Pain

When pain is severe, treatment may begin more frequently to help settle symptoms, then space out as you improve.

After the initial series, we reassess together and determine whether additional care is needed.

Frequently Asked Questions

How do I choose an acupuncturist in Asheville?

Look for a licensed acupuncturist whose training and clinical experience fit the reason you’re seeking care. It can also help to understand how they assess patients, what styles of acupuncture they practice and how they determine a treatment plan.

Does my first acupuncture appointment include treatment?

Yes. Your first appointment includes a comprehensive intake, assessment and treatment during the same visit.

What makes our approach to Orthopedic Acupuncture distinctive?

Our clinical approach was developed by Chad Johnson, L.Ac., drawing from his advanced training in Acupuncture Physical Medicine, Kiiko Matsumoto Style Japanese Acupuncture, Acupuncture Zone Treatment and seven levels of Zheng Gu Tui Na orthopedic bodywork. Chad uses this framework when training practitioners at Asheville Orthopedic Acupuncture, creating a consistent approach to assessing joints, muscles, fascia and movement patterns.

Do I need a diagnosis before scheduling?

No. Many patients come to us with an existing diagnosis, imaging or recommendations from another provider, while others are still trying to understand the source of their symptoms. Your first appointment includes a comprehensive intake, assessment and treatment. Bring any relevant records or imaging reports you already have.

Is Orthopedic Acupuncture gentle?

Yes. Treatment intensity is adjusted to your condition, sensitivity and response.We incorporate gentle Japanese Acupuncture styles, fine needles and hands-on techniques based on what your body needs.

How many treatments will I need?

It depends on the condition and your response to care. We typically begin with three treatments for acute conditions and five for chronic or complex conditions, then reassess.

Do you only treat pain and injuries?

No. Pain and complex conditions are a major focus of our practice, but we also work with patients seeking care for autoimmune conditions, neurological symptoms, Alpha-Gal Syndrome, migraines, concussion and other complex health concerns.

Is Our Practice Right for You?

If you’re dealing with pain, an injury or a complex condition and aren’t sure whether our approach is right for you, start with a conversation.

We’ll listen to what is going on, answer your questions and let you know whether we think we can help. If another type of care may be more appropriate, we’ll tell you.