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.
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)
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.
Parallel
Post isometrics Relaxation Techniques (PIR)
Other interventionPost-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 interventionReciprocal 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.
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
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
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