Piriformis Syndrome
Conditions
Keywords
Piriformis, Pain, Disability, Manual Therapy
Brief summary
Piriformis Syndrome (PS) is a condition which is characterized by pain, numbness, and limited range of motion (ROM) due to compression or irritation of the sciatic nerve by the piriformis muscle. It often leads to discomfort in the buttock region, radiating pain along the posterior thigh, and functional limitations in daily activities. Manual therapy techniques, particularly Muscle Energy Techniques (METs), have been widely used for the management of musculoskeletal dysfunctions, including piriformis syndrome.
Detailed description
This study will highlight the clinical relevance of METs in piriformis syndrome management and supports the integration of these techniques into routine physiotherapy practice to optimize patient outcomes.This study will be a randomized controlled trial involving -- patients diagnosed with piriformis syndrome. 40 participants will be randomly assigned into two groups. Both groups will receive conservative treatment, including a 10-15minutes cold pack and TENS and 5 minutes of ultrasound therapy application along with stretching (gluets and hamstrings) and strengthening exercises of core and hip stabilizers (gluteus medius, gluteus maximus). Group A will receive an additional 10-minute session of post isometrics relaxation technique of muscle inhibition techniques (METs). In contrast, Group B will receive reciprocal inhibition techniques of muscle energy techniques (METs) for 10 minutes. The intervention will be administered daily for four weeks. Pain intensity, ROM, and functional disability will be measured at baseline and post-intervention using standardized assessment tools
Interventions
OTHERPost isometrics Relaxation Techniques (PIR)
Post-Isometric Relaxation is a type of MET in which the target muscle is gently contracted isometrically (without movement) against resistance, followed by a passive stretch during the post-contraction relaxation phase. To reduce muscle tension, increase flexibility, and lengthen tight muscles (like the piriformis in Piriformis Syndrome). Position the patient in a stretch position for the tight muscle just before the point of resistance. Then ask the patient to perform a gentle isometric contraction of the tight muscle (e.g., piriformis) for about 5-10 seconds against minimal resistance. After contraction, the patient relaxes for a few seconds. During this relaxation, the therapist passively stretches the muscle to a new barrier and holds for 15-30 seconds. Repeat 3-5 times. So, the whole treatment session will be of 50 minutes. This technique will be applied twice a week for 4 weeks.
Reciprocal Inhibition is another MET technique where the antagonist of the tight muscle is contracted, which reflexively causes the tight (agonist) muscle to relax. To inhibit the overactive muscle by activating its opposing muscle group, allowing for greater stretch and flexibility. Place the muscle (e.g., piriformis) into a gentle stretch. Ask the patient to contract the antagonist muscle (e.g., hip adductors/internal rotators) for about 5-10 seconds. Therapist then passively stretches the target muscle (e.g., piriformis) further. Repeat 3-5 times. So, the whole treatment session will be of 50 minutes. This technique will be applied twice a week for 4 weeks.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
25 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
\- Piriformis syndrome clinically confirmed via special tests (e.g., FAIR test, Freiberg sign, Pace test) * Both gender male and female. * Age between 25 and 40 years. * Presence of antalgic gait due to pain. * Moderate to severe pain (e.g., NPRS score ≥ 4) * Voluntary consent to participate in the study. * Medically stable, no acute or unstable medical conditions that would interfere with participation.
Exclusion criteria
* Lumber disc herniation or radiculopathy confirmed by imaging or neurological signs * History of hip or pelvis surgery. * Other neuromuscular or musculoskeletal disorders e.g., stroke, multiple sclerosis, or rheumatoid arthritis * Recent lower limb fracture or injury within the last 6 months. * Pregnancy due to potential risks and altered biomechanics. * Inability to follow instruction * Ongoing physiotherapy or alternative treatments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| NPRS for assessment of pain | 4 weeks | To determine the degree of pain that the patient will report, the Numeric Pain Rating Scale (NPRS) will be utilized. |
| Lower Extremity Function Test (LEFT) | 4 weeks | The LEFT protocol includes a timed sequence of agility-based tasks, typically performed in a zigzag pattern or shuttle-based layout over a 120-foot course |
| GONIOMETERY | 4 weeks | Goniometry is the measurement of joint angles in the human body using a tool called a goniometer. It is a standard and essential part of physical therapy and rehabilitation for assessing range of motion (ROM) in various joints |
Countries
Pakistan
Contacts
CONTACTImran Amjad
PRINCIPAL_INVESTIGATORHira Shaukat, Mphill
Riphah International University
Outcome results
None listed