An interventional study of Post isometrics Relaxation Techniques (PIR) and Reciprocal Inhibition Technique in Piriformis Syndrome, sponsored by Riphah International University. Recruiting at 1 site in Pakistan. Open to participants aged 25 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-09-24.
Sponsored by Riphah International University · Not applicable, Interventional, and Treatment
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.
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
58 studies on the registry are indexed under Piriformis Muscle Syndrome; 23 are open to participants now.
This study's planned enrollment of 42 is close to the median of 42 across 52 interventional studies indexed under Piriformis Muscle Syndrome.
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- Piriformis syndrome clinically confirmed via special tests (e.g., FAIR test, Freiberg sign, Pace test)
Exclusion Criteria:
Lumber disc herniation or radiculopathy confirmed by imaging or neurological signs
In this group First conventional treatment will be applied for 20 minutes including Hot Pack and TENS (for 15 minutes) and sonics (for 5 minutes) Followed by PIR.
Other: Post isometrics Relaxation Techniques (PIR)
This group will receive Hot Pack and TENS (for 15 minutes) and Sonics (for 5 minutes) Followed by METs.
Other: Reciprocal Inhibition Technique
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.
NPRS for assessment of pain
To determine the degree of pain that the patient will report, the Numeric Pain Rating Scale (NPRS) will be utilized.
Time frame: 4 weeks
Lower Extremity Function Test (LEFT)
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
Time frame: 4 weeks
GONIOMETERY
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
Time frame: 4 weeks
Plan to share: No
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