This study is a randomized controlled trial and the purpose of this study is to compare the effects of reciprocal inhibition versus post facilitation muscle energy technique along with conventional physical therapy in patients with piriformis syndrome in terms of pain, range of motion at hip joint and functional disability.
Age: 20-50 years
Both Genders
Chronic pain in buttock and hip area (≥ 3 on NPRS) lasting more than 3 months.
Shortened piriformis muscle (Internal rotation less than 30°) on muscle length assessment.
Active infection
Lower lumbar radiculopathy
Sacroiliac joint dysfunction
Malignancies
Parallel
Reciprocal Inhibition MET
Other interventionReciprocal Inhibition MET will be applied to the shortened piriformis muscle in supine and prone positions with participants using 30-50% of their maximum voluntary isometric contraction. It will include 30-50% isometric contraction of the muscle opposite to the muscle to be stretched for 7-10 seconds, followed by inhalation, exhalation and rest period of 5 seconds and then a stretch (through the new barrier with patients' assistance) of 10-60 seconds hold. RI-MET group will receive 3-5 repetitions.
Post-facilitation MET
Other interventionPost-facilitation stretch technique for shortened piriformis muscle in supine and prone positions will be applied with participants using 20% of their maximum voluntary isometric contraction. It will include 20% maximal isometric contraction of the muscle to be stretched for 6-10 seconds, followed by a rapid stretch (through the new barrier) of 15 seconds hold. After stretch, the muscle is allowed to relax in the midrange for up to 30 seconds. PFS-MET group will receive 3-5 repetitions.
Conventional physical therapy
Other interventionTENS and hot pack application to provide heating effect over the painful area (10 minutes) Both groups will receive conventional physical therapy which they will be taught as a home plan. Following exercises are guided to the patient as home plan. * Resisted abduction with Thera/resistance band * Resisted bridging with Thera/resistance band * Resisted clam exercise with Thera/resistance band
Pain Intensity
The pre and post pain intensity will be measured using Numeric Pain Rating Scale (NPRS) comprising of 11 points from 0 - 10 where 0 indicates "no pain" while 10 is "maximally felt pain".
Hip range of motion
Goniometer will be used to measure the pre and post treatment ranges of internal rotation, external rotation, abduction and adduction at hip joint in supine and sitting positions.
Functional Disability
Lower Extremity Functional Scale comprising of 20 questions regarding lower extremity function will be used. The maximum possible score is 80 points, indicating very high function. The minimum possible score is 0 points, indicating very low function.
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