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Sciatica is characterized by radiating pain, functional limitations, reduced flexibility, disturbed sleep, and impaired quality of life. Extracorporeal Shockwave Therapy (ESWT) and Therapeutic Ultrasound are commonly used physiotherapy modalities for pain relief and tissue healing; however, evidence directly comparing their effectiveness remains limited. This randomized controlled trial compares the effects of Shockwave Therapy and Ultrasound Therapy, each combined with conventional physiotherapy, on pain intensity, hamstring range of motion, sleep quality, and quality of life in patients with chronic sciatica.
This randomized controlled trial compares two physiotherapy interventions for chronic sciatica. Sixty-six participants will be randomly allocated to either Shockwave Therapy plus Conventional Physiotherapy or Ultrasound Therapy plus Conventional Physiotherapy. Both groups will receive identical conventional physiotherapy consisting of heat therapy, myofascial release, stretching, and strengthening exercises. Treatment will be administered four sessions per week for eight weeks. Outcomes including pain intensity, hamstring range of motion, sleep quality, and quality of life will be measured at baseline, Week 4, and Week 8 by a blinded outcome assessor.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Shockwave Therapy + Conventional Physiotherapy | Experimental | Participants will receive radial extracorporeal shockwave therapy in addition to standardized conventional physiotherapy four times per week for eight weeks. |
|
| Ultrasound Therapy + Conventional Physiotherapy | Active Comparator | Participants will receive therapeutic ultrasound in addition to standardized conventional physiotherapy four times per week for eight weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Extracorporeal Shockwave Therapy | Device | Radial extracorporeal shockwave therapy will be applied to the sciatic nerve origin and piriformis region using standardized treatment parameters for approximately 10 minutes during each treatment session. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Intensity | Numeric Pain Rating Scale (0-10). Higher scores indicate greater pain. | Baseline, Week 4, Week 8 |
| Hamstring Range of Motion | Hip flexion measured with a universal goniometer during the Straight Leg Raise test. | Baseline, Week 4, Week 8 |
| Measure | Description | Time Frame |
|---|---|---|
| Sleep Quality | Sleep Quality Scale. Higher scores indicate poorer sleep quality. | Baseline, Week 4, Week 8 |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ULTH | Lahore | Pakistan |
Individual participant data will not be shared because this study was conducted as an academic research project. The informed consent obtained from participants did not include provisions for public data sharing, and the dataset contains sensitive personal health information. Data will be stored securely and used only for academic and research purposes in accordance with institutional ethics approval.
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| ID | Term |
|---|---|
| D012585 | Sciatica |
| D011843 | Radiculopathy |
| ID | Term |
|---|---|
| D020426 | Sciatic Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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| ID | Term |
|---|---|
| D000074059 | Extracorporeal Shockwave Therapy |
| D014464 | Ultrasonic Therapy |
| D014463 | Ultrasonography |
| ID | Term |
|---|---|
| D003972 | Diathermy |
| D006979 | Hyperthermia, Induced |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
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Participants will be randomly assigned in a 1:1 ratio to receive either Shockwave Therapy plus Conventional Physiotherapy or Ultrasound Therapy plus Conventional Physiotherapy. Both groups will receive the same conventional physiotherapy program, while the experimental intervention will differ according to treatment allocation. Outcome assessments will be conducted at baseline, Week 4, and Week 8 by a blinded assessor.
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The outcome assessor will remain blinded to treatment allocation throughout the study. Due to the nature of the interventions, participants and treating physiotherapists cannot be blinded.
|
| Therapeutic Ultrasound | Device | Therapeutic ultrasound will be applied to the gluteal and lumbar regions using standardized frequency and intensity parameters for approximately 10 minutes during each treatment session. |
|
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| Conventional Physiotherapy | Other | Conventional physiotherapy will include moist heat therapy, myofascial release, stretching exercises, and strengthening exercises administered during every treatment session. |
|
| D009422 | Nervous System Diseases |
| D009437 | Neuralgia |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012046 |
| Rehabilitation |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |