The purpose of this investigator-initiated study is to provide an efficient and non-invasive treatment option for pain caused by the piriformis muscle.
18 to 65 years of age
Tender point (or trigger point) in piriformis muscle determined by physical exam
Less than 45 degrees of active hip flexion, less than 5 degrees of active hip internal rotation or less than 30 degrees of active hip external rotation, on side of affected piriformis
Unable to lay prone
Non-English speaker
Inability to attend 2 sessions within the same month
Parallel
Strain-Counterstrain treatment of piriformis muscle
Other interventionParticipant will lay prone on table with affected leg close to edge of table. Piriformis muscle tender point is identified and palpated. Then patient leg is passively moved off table and passive hip flexion, abduction, and possible internal/external rotation is added to reduce tender point by 70% or more. This is done passively. This position is held for 90 seconds and then participant is passively returned back to neutral prone position with leg on table. Tender point is palpated again to reassess for change in pain (using subjective visual analog scale). An algometer is also used pre and post to assess objective change in pressure pain threshold.
Algometer - Change in pressure pain threshold
Objective improvement in pressure/pain threshold
Change in Visual Analog Scale
Subjective improvement in low back/leg pain
Change in Oswestry Disability Index
Assesses pain with doing different activities (sleeping, walking, sitting, etc), assesses ability to do activities of daily living
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