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The aim of this study is to to compare its effectiveness ultrasound-guided steroid injection, dry needling treatments and exercises in patients diagnosed with piriformis syndrome.
Piriformis syndrome is a painful entrapment neuropathy caused by compression of the sciatic nerve under the piriformis muscle. The most common cause is myofascial pain syndrome. There is no gold standard treatment for piriformis syndrome. The main purpose of treatment methods is to reduce local pain, muscle tension and spasm. This work; it will contribute to the literature by comparing steroid, dry needling and exercise treatments in patients with piriformis syndrome.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| corticosteroid group | Active Comparator | In the steroid group, 4 mL lidocaine 2% + 1 mL betamethasone injection will be administered under ultrasound guidance and conventional treatment will be given (conventional treatment includes piriformis stretching exercises. It will be stated that patients should do 2 sets a day and each set should be 10 repetition) |
|
| dry needling group | Active Comparator | In the dry needling group, a total of 3 sessions of dry needling will be performed once a week using a 0.60×100 mm sterile needle under ultrasound guidance and conventional treatment will be given ((conventional treatment includes piriformis stretching exercises. It will be stated that patients should do 2 sets a day and each set should be 10 repetition) |
|
| control group | Other | The conventional treatment group (control group) will be given piriformis stretching exercises including hip and knee flexion, hip abduction and external rotation in the supine position. It will be stated that patients should do 2 sets a day and each set should be 10 repetitions. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| corticosteroid injection | Other | In the steroid group, 4 mL lidocaine 2% + 1 mL betamethasone injection will be administered under ultrasound guidance and conventional treatment will be given (conventional treatment includes piriformis stretching exercises. It will be stated that patients should do 2 sets a day and each set should be 10 repetition) |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analogue Scale (VAS) (Sitting) | Average hip pain intensity in a sitting position over the past 24 hours, a visual analog scale. (VAS; ranging from 0 to 10, 0 = no pain and 10 = worst possible pain) | at baseline and change from baseline VAS (sitting) at 4 weeks and 12 weeks |
| Visual Analog Scale (VAS) (Resting) | Average hip pain intensity at rest over the past week is a visual analog scale. (VAS; ranging from 0 to 10, 0 = no pain and 10 = worst possible pain) | at baseline and change from baseline VAS (resting) at 4 weeks and 12 weeks |
| Visual Analog Scale (VAS) (Movement) | Average hip pain intensity during movement over the past 1 week is a visual analog scale. (VAS; ranging from 0 to 10, 0 = no pain and 10 = worst possible pain) | at baseline and change from baseline VAS (movement) at 4 weeks and 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Oswestry disability index (ODI) | ODI includes questions regarding pain severity, sexual function, sleep quality and personal care, ability to work, sit, walk, lift, stand and travel. Total score ranges from 0-50, with higher scores indicating more injury. | at baseline and change from baseline ODI at 4 weeks and 12 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ayşenur Şimşek Yağlıoğlu, MD | Contact | +903122912444 | aysenursimsek33@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Ayşenur Şimşek Yağlıoğlu, MD | Ankara Gaziler Physical Medicine and Rehabilitation Education and Research Hospital | Principal Investigator |
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| ID | Term |
|---|---|
| D055958 | Piriformis Muscle Syndrome |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D020426 | Sciatic Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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| ID | Term |
|---|---|
| D000305 | Adrenal Cortex Hormones |
| D000079245 | Dry Needling |
| D015444 | Exercise |
| ID | Term |
|---|---|
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
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Outcome measures will be evaluated by an independent physiatrist, blinded for the assigned treatment.
|
| dry needling | Other | In the dry needling group, a total of 3 sessions of dry needling will be performed once a week using a 0.60×100 mm sterile needle under ultrasound guidance and conventional treatment will be given ((conventional treatment includes piriformis stretching exercises. It will be stated that patients should do 2 sets a day and each set should be 10 repetition) |
|
| exercise | Other | The conventional treatment group (control group) will be given piriformis stretching exercises including hip and knee flexion, hip abduction and external rotation in the supine position. It will be stated that patients should do 2 sets a day and each set should be 10 repetitions. |
|
| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D009437 | Neuralgia |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D017699 | Pelvic Pain |
| D001519 | Behavior |
| D026741 | Physical Therapy Modalities |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |