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

Sponsor: Riphah International University • ClinicalTrials.gov ID: NCT07646314

Registry updated: 2026-09-24

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Description

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.

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.
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.

Eligibility criteria

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

Conditions

Piriformis Syndrome

Locations

Ghurki Hospital Lahore — Lahore, Punjab Province, Pakistan

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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