Comparative Effects of Post-Isometric Relaxation and Reciprocal Inhibition Techniques inPiriformis Syndrome

NCT07646314 | Not Yet Recruiting

• 1 other identifier: REC/RCR&AHS/25/0120
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

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.

Conditions

Piriformis Syndrome

Keywords

Piriformis; Pain; Disability; Manual Therapy

Outcome Measures

Primary Outcomes (3)

• 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.

  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

  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

  4 weeks

Study Arms (2)

Post isometrics Relaxation Techniques (PIR)

EXPERIMENTAL

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)

Reciprocal Inhibition Technique

ACTIVE COMPARATOR

This group will receive Hot Pack and TENS (for 15 minutes) and Sonics (for 5 minutes) Followed by METs.

Other: Reciprocal Inhibition Technique

Interventions

Post isometrics Relaxation Techniques (PIR) OTHER

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.

Post isometrics Relaxation Techniques (PIR)

Reciprocal Inhibition Technique OTHER

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.

Reciprocal Inhibition Technique

Eligibility Criteria

• Age: 25 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• \- 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.

You may not qualify if:

• 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

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Ghurki Hospital Lahore

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (4)

• Boyajian-O'Neill LA, McClain RL, Coleman MK, Thomas PP. Diagnosis and management of piriformis syndrome: an osteopathic approach. J Am Osteopath Assoc. 2008 Nov;108(11):657-64. doi: 10.7556/jaoa.2008.108.11.657.

  PMID: 19011229 BACKGROUND

• Kean Chen C, Nizar AJ. Prevalence of piriformis syndrome in chronic low back pain patients. A clinical diagnosis with modified FAIR test. Pain Pract. 2013 Apr;13(4):276-81. doi: 10.1111/j.1533-2500.2012.00585.x. Epub 2012 Aug 2.

  PMID: 22863240 BACKGROUND

• Kutty NN, Siddeeque S, Tamphaibema H, Othayoth N, Bineesh C. Effect of Muscle Energy Technique with Deep Friction Massage on Pain, Disability and Internal Rotation Range of Motion of Hip Joint in Individuals with Piriformis Syndrome. Indian Journal of Physiotherapy & Occupational Therapy. 2020;14(1).

  BACKGROUND

• Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. J Orthop Sports Phys Ther. 2010 Feb;40(2):103-11. doi: 10.2519/jospt.2010.3108.

  PMID: 20118521 BACKGROUND

MeSH Terms

Conditions

Piriformis Muscle Syndrome; Pain

Condition Hierarchy (Ancestors)

Sciatic Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Neuralgia; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Pelvic Pain

Study Officials

• Hira Shaukat, Mphill

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad

CONTACT

03324390125; Imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 8, 2026
• First Posted: June 12, 2026
• Study Start (Estimated): June 17, 2026
• Primary Completion (Estimated): October 10, 2026
• Study Completion (Estimated): November 20, 2026
• Last Updated: June 12, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)