This clinical study aimed to compare the effectiveness of Post-Facilitation Stretch (PFS) and Active Release Technique (ART) on pain, disability, quality of life, and range of motion of hip internal and external rotation in female patients with piriformis syndrome. After recruitment, participants were randomly allocated into two groups using the chit-box method, either in group A Post-Facilitation Stretch, and group B Active Release Technique. Clinical outcomes including pain, disability, quality of life, and hip range of motion (abduction and internal rotation) were assessed at baseline, during the third week of treatment, and at the sixth-week follow-up from the National Institute of Rehabilitation and Medicine (NIRM) Hospital.

Background: Piriformis syndrome (PS) is a neuromuscular condition in which the piriformis muscle irritates the sciatic nerve, causing pain, numbness, and tingling in the buttock, hip, and posterior thigh, sometimes radiating to the low back or sacroiliac joint. Women are more commonly affected, comprising 35-79% of cases (Hopayian et al., 2010). Conservative physiotherapy interventions are effective in improving pain, function, and quality of life.

Literature / Rationale: Post-Facilitation Stretch (PFS) involves isometric contraction followed by stretching of the piriformis to enhance hip range of motion (ROM) and reduce pain. Active Release Technique (ART) targets soft tissue adhesions to improve mobility and function. Prior studies indicate benefits of these techniques individually, but direct comparisons in female patients are limited.

Methods: Forty female patients with PS at NIRM Islamabad were randomly allocated via chit-box into PFS and ART groups. Interventions were administered twice weekly for 3 weeks.

PFS: Supine, hip >60° flexion, slight adduction/external rotation; 10-sec isometric external rotation contraction + 30-sec relaxation; stretch into internal rotation/adduction 15 sec; repeat 5× per session(Shahzad et al., 2020).

ART: Targeted soft tissue release of the piriformis muscle.

Outcomes included pain (measured by NPRS), hip IR and abduction ROM (measured by goniometer), functional disability (measured by LEFS-U), and quality of life (measured by SF-36), assessed at baseline, week 3, and week 6.

Inclusion Criteria:

• 25 to 45-year-old women.
• Clinically diagnosed with piriformis syndrome by Orthopaedic Surgeon.
• Unilateral pain.
• Sitting exacerbates buttock pain.
• External soreness in the vicinity of the greater sciatic notch.
• Positive findings on standard piriformis syndrome clinical tests (FAIR, Beatty, Freiberg, and Pace).
• Limited SLR ability

Exclusion Criteria:

• History of trauma and malignancies.
• Hip dislocation, osteoporosis, and femur fractures.
• Any postural abnormality, including disc pathology.
• Patients with neurological symptom, metabolic disease (RA) and diagnosed psychological problem.
• Pregnancy.

Female