Low Back Pain, Mechanical, Piriformis Syndrome, Somatic Dysfunction of Sacral Region (Finding)
Conditions
Brief summary
The purpose of this investigator-initiated study is to provide an efficient and non-invasive treatment option for pain caused by the piriformis muscle.
Detailed description
There are two arms to the study: treatment and sham. The treatment group will receive strain-counterstrain for the piriformis muscle. The sham group will receive strain-counterstrain treatment for the hamstring muscle. There will be two treatments, 1-2 weeks apart ideally. Participants will fill out the Oswestry Disability Index Questionnaire before the first treatment and after the second treatment (which is 1-2 weeks after the first treatment). Participants will also identify pain using the Visual Analog Scale (VAS) before and after each treatment. Participants will identify pain at rest prior to treatment using VAS. Participant will then identify pain at the start of treatment while pressure is applied to the piriformis muscle (4.5kg/cm2) and post treatment while pressure is applied to the piriformis muscle (4.5 kg/cm2). An algometer will be used pre and post each treatment (2 treatments that are 1-2 weeks apart) to objectively measure any change in pain pressure threshold.
Interventions
OTHERStrain-Counterstrain treatment of piriformis muscle
Participant will lay prone on table with affected leg close to edge of table. Piriformis muscle tender point is identified and palpated. Then patient leg is passively moved off table and passive hip flexion, abduction, and possible internal/external rotation is added to reduce tender point by 70% or more. This is done passively. This position is held for 90 seconds and then participant is passively returned back to neutral prone position with leg on table. Tender point is palpated again to reassess for change in pain (using subjective visual analog scale). An algometer is also used pre and post to assess objective change in pressure pain threshold.
Sponsors
Loma Linda University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Participant will not know the true positioning for strain counterstrain treatment of piriformis muscle versus hamstring muscle.
Intervention model description
There are two arms to the study: treatment and sham. The treatment group will receive strain-counterstrain for the piriformis muscle. The sham group will receive strain-counterstrain treatment for the hamstring muscle.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* 18 to 65 years of age * Tender point (or trigger point) in piriformis muscle determined by physical exam
Exclusion criteria
* Less than 45 degrees of active hip flexion, less than 5 degrees of active hip internal rotation or less than 30 degrees of active hip external rotation, on side of affected piriformis * Unable to lay prone * Non-English speaker * Inability to attend 2 sessions within the same month * Active cancer * Pregnant * Diagnosis of lumbar radiculopathy * Greater than grade 1 lumbar spondylolisthesis * Presence of lumbar region Pars Defect * Receiving massage, acupuncture, chiropractic treatments, osteopathic treatments during study period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Algometer - Change in pressure pain threshold | Pre and post each treatment. There are 2 treatments, 1-2 weeks apart from one another. | Objective improvement in pressure/pain threshold |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Visual Analog Scale | Pre and post each treatment. There are 2 treatments, 1-2 weeks apart from one another. | Subjective improvement in low back/leg pain |
| Change in Oswestry Disability Index | Before first treatment and after second treatment. Each treatment is 1-2 weeks apart (anticipated). | Assesses pain with doing different activities (sleeping, walking, sitting, etc), assesses ability to do activities of daily living |
Countries
United States
Contacts
CONTACTRoya Vahdatinia, DO
CONTACTMickey Lui, DO
PRINCIPAL_INVESTIGATORMickey Lui
Loma Linda University Health
Outcome results
None listed