Comparing Two Soft Tissues Technique on Piriformis Syndrome Patients (MPR-PIR)

Effect of Myofascial Release as Compared to Post Isometric Relaxation in Improving Pain and Lower Extremity Function in Piriformis Syndrome

Piriformis Syndrome is a neuromuscular condition with symptoms of pain, numbness and tingling tracing the route of the sciatic nerve, due to the nerve impingement by the piriformis muscle. Two common manual therapy techniques used to treat musculoskeletal conditions are myofascial release and post-isometric relaxation. The intent of the research is to evaluate the effects of myofascial release (MFR) as compared to post-isometric relaxation (PIR) in improving pain and lower extremity function in piriformis syndrome (LEFS). The study population involved 32 individuals aged between 20 to 50 years who will be randomly assigned to two groups; a group that received MFR and a group that received PIR. Both groups received the baseline treatment for four weeks. The Visual Analog Scale (VAS) will be employed to gauge the amount of pain, while the LEFS was used to measure functional mobility

Study Overview

• Status: Not yet recruiting
• Conditions: Sciatica; Musculoskeletal Abnormalities; Piriformis Syndrome
• Intervention / Treatment: Other: Myofascial Release; Other: Post Isometric Relaxation

Detailed Description

This is Multiple-center, randomized controlled trail. Participants age 20-50 years with diagnosed piriformis syndrome will be referred from neuro physician and orthopedic department of Madina Teaching hospital (MTH) to Physiotherapy ward, Jafar Physiotherapy Clinic and Madina Specilaists Clinic. After informed consent Participants will be randomly assign to one of two parallel groups using a random number generator. Group A (Experimental): Receive MFR 3 sessions per week for total duration 4 weeks. Group B (Active Comparator) receive the PIR 3 sessions per week for total duration 4 weeks. Outcome measures (pain via VAS, functional status via LEFS) are taken at baseline and end of treatment. Data will be analyzed using Spss version 20.

• Study Type: Interventional
• Enrollment (Estimated): 26
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Dr. Muhammad Muneeb Jafar, PhD Physiotherapy; Phone Number: +923127000616; Email: Muneebjafar.DPT@tuf.edu.pk
• Study Contact Backup: Name: Dr. Muhammad Ateeb, PhD Public Health; Phone Number: +923357333383

Study Locations

• Pakistan
  • Punjab Province
    • Faisalābad, Punjab Province, Pakistan, 38000
      • The University of Faisalabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Positive Lasegue sign
• Positive FAIR test
• Grade 1-3 tenderness on palpation of piriformis between sacrum and greater trochanter of femur
• 4 or more pain intensity on the VAS scale

Exclusion Criteria:

• Lower extremity injuries including ligament, tendon injuries, muscle strains as well as nerve injuries

  • Systemic diseases including tuberculosis, multiple sclerosis, Parkinson's disease as well as chronic inflammatory conditions
  • Congenital deformities including hip dysplasia, limb length discrepancy, scoliosis and congenital pelvic asymmetry
  • Cognitive issues including dementia, severe depression and severe psychotic disorders
  • Lumbar Radiculopathy
  • SIJ Dysfunction
  • Lower Extremity Fractures
  • Pregnancy
  • Malignancy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Myofascial release; Myofascial release was then performed with the patient positioned in prone lying. The piriformis muscle was identified. Sustained pressure was applied directly to the trigger point/piriformis muscle for 10-100 seconds while the patient actively moved the affected limb repeatedly from internal to external rotation. Kneading strokes parallel to the muscle fibers were then performed for 5 minutes to promote elongation. This sequence was repeated three times.	Other: Myofascial Release; Myofascial release is performed with the patient positioned in prone lying. The piriformis muscle was identified. Sustained pressure was applied directly to the trigger point/piriformis muscle for 10-100 seconds while the patient actively moved the affected limb repeatedly from internal to external rotation. Kneading strokes parallel to the muscle fibers were then performed for 5 minutes to promote elongation. This sequence was repeated three times.
Experimental: Post Isometric Relaxation; The patient is in supine and the hip in neutral rotation. The affected hip was passively moved into horizontal adduction until a mild stretch was felt, while the lumbar spine was stabilized. The patient performed a gentle isometric contraction into hip abduction for 7-10 seconds, followed by 2-3 seconds of relaxation. The leg was then moved into further adduction to a new barrier. This contraction-relaxation-stretch cycle was performed for 3 sets of 5 repetitions.	Other: Post Isometric Relaxation; Post-isometric relaxation (PIR) is performed with the patient in supine and the hip in neutral rotation. The affected hip was passively moved into horizontal adduction until a mild stretch was felt, while the lumbar spine was stabilized. The patient performed a gentle isometric contraction into hip abduction for 7-10 seconds, followed by 2-3 seconds of relaxation. The leg was then moved into further adduction to a new barrier.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual analogue scale	Comparison on effect of pain. The Visual Analog Scale is a self-reported measure of pain intensity. Participants rate their pain on a 10-cm scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain."	Baseline and 4 week post intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lower Extremity Functional Scale	Comparison on effect of functional outcomes. The Lower Extremity Functional Scale (LEFS) is a self-reported questionnaire used to assess functional status and difficulty performing everyday activities in individuals with lower extremity musculoskeletal conditions. The scale consists of 20 items, each scored from 0 to 4, yielding a total score ranging from 0 to 80.	Baseline and 4 week of post intervention

Collaborators and Investigators

• Sponsor: University of Faisalabad

Publications and helpful links

General Publications

• Ajimsha MS, Al-Mudahka NR, Al-Madzhar JA. Effectiveness of myofascial release: systematic review of randomized controlled trials. J Bodyw Mov Ther. 2015 Jan;19(1):102-12. doi: 10.1016/j.jbmt.2014.06.001. Epub 2014 Jun 13.
• This citation will not be hyperlinked on ClinicalTrials.gov. Aleem A, Arfan MT, Razzaq et al. (2022) Effectiveness of post isometric relaxation versus reciprocal inhibition technique on hamstring muscle flexibility. Annals of King Edward Medical University 28(2): 205-209.

Study record dates

Study Major Dates

• Study Start (Estimated): June 30, 2026
• Primary Completion (Estimated): August 30, 2026
• Study Completion (Estimated): September 30, 2026

Study Registration Dates

• First Submitted: June 16, 2026
• First Submitted That Met QC Criteria: June 16, 2026
• First Posted (Actual): June 22, 2026

Study Record Updates

• Last Update Posted (Actual): June 30, 2026
• Last Update Submitted That Met QC Criteria: June 25, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: physiotherapy; Post isometric relaxation; Piriformis syndrome; Radiculopathy; myofasical release
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Nervous System Diseases; Neuromuscular Diseases; Peripheral Nervous System Diseases; Congenital Abnormalities; Neuralgia; Pelvic Pain; Mononeuropathies; Nerve Compression Syndromes; Sciatic Neuropathy; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Radiculopathy; Musculoskeletal Abnormalities; Sciatica; Piriformis Muscle Syndrome; Therapeutics; Complementary Therapies; Physical Therapy Modalities; Rehabilitation; Therapy, Soft Tissue; Musculoskeletal Manipulations; Massage; Myofascial Release Therapy
• Other Study ID Numbers: TUF/EIRB/148/2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No