A 45 y/o healthy F c/o of low back pain with leg symptoms. PMH is unremarkable. Aside from biomechanical factors after assessment, I believe her past surgical history of buttock augmentation with silicone injection 10 years ago is one of the causative factors for causing her low back pain with peripheralization.  I am currently avoiding dry needling on her buttock area but also safely paying attention to her leg symptoms during palpation to ensure silicone did not dislodge.  MRI of the buttock showed silicone is up to the fat layer of the skin.

Your thoughts on this case Dr. Frank would be greatly appreciated.