Comparative Effects of Post-Isometric Relaxation and Reciprocal Inhibition Techniques inPiriformis Syndrome

Comparative Effects of Post-Isometric Relaxation and Reciprocal Inhibition Muscle Energy Techniques on Pain, ROM and Function in Piriformis Syndrome

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.

This study will highlight the clinical relevance of METs in piriformis syndrome management and supports the integration of these techniques into routine physiotherapy practice to optimize patient outcomes.This study will be a randomized controlled trial involving -- patients diagnosed with piriformis syndrome. 40 participants will be randomly assigned into two groups. Both groups will receive conservative treatment, including a 10-15minutes cold pack and TENS and 5 minutes of ultrasound therapy application along with stretching (gluets and hamstrings) and strengthening exercises of core and hip stabilizers (gluteus medius, gluteus maximus). Group A will receive an additional 10-minute session of post isometrics relaxation technique of muscle inhibition techniques (METs). In contrast, Group B will receive reciprocal inhibition techniques of muscle energy techniques (METs) for 10 minutes. The intervention will be administered daily for four weeks. Pain intensity, ROM, and functional disability will be measured at baseline and post-intervention using standardized assessment tools

Inclusion Criteria:

- Piriformis syndrome clinically confirmed via special tests (e.g., FAIR test, Freiberg sign, Pace test)

• 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)
• Voluntary consent to participate in the study.
• Medically stable, no acute or unstable medical conditions that would interfere with participation.

Exclusion Criteria:

• 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.
  • Pregnancy due to potential risks and altered biomechanics.
  • Inability to follow instruction
  • Ongoing physiotherapy or alternative treatments