Comparative Effects of Post-Isometric Relaxation Technique and Strain Counterstrain in Patients with Piriformis Syndrome

Background: Piriformis syndrome is a neuromuscular disorder causing pain and mobility limitations due to sciatic nerve compression. This study compares post-isometric relaxation and strain counterstrain techniques to determine which approach provides superior pain relief, mobility improvement, and functional recovery in affected patients. Objective: To evaluate the comparative effects of the post-isometric relaxation technique and strain counterstrain in patients with piriformis syndrome. Methodology: Single-blinded, randomised clinical trial with clinical trial ID No. IRCT2024718062453N1 was conducted. Participants were selected from the outdoor patient department of Allied Hospital, National Hospital, Faisalabad, from February to June 2024. The study included 66 participants using convenient sampling, both male and female, between the ages of 30-50 years. Group A received post-isometric relaxation therapy while Group B received strain counterstrain therapy three times a week for four consecutive weeks. Both groups also received conventional therapy, which included the application of a hot pack to the gluteal area for 15 minutes. Pain was assessed by the Numeric Pain Rating Scale, while hip abduction and internal rotation range of motion were measured through a universal goniometer and functional activity was assessed by the Lower Extremity Functional Scale before and after four weeks of treatment. Within and between-group analysis of pain and range of motion was done using the Wilcoxon Signed-Rank and Mann-Whitney U tests respectively. Results: Overall, the findings of the randomized clinical research highlight the advantages of post-isometric relaxation against strain counterstrain in the treatment of piriformis syndrome. Patients who had post-isometric relaxation treatment showed significant decreases in pain, increased range of motion, and reduced impairment (p<0.05). Conclusion: Post-isometric relaxation demonstrated superior efficacy in reducing pain, improving range of motion, and enhancing functional recovery in patients with piriformis syndrome compared to strain counterstrain. These findings support post-isometric relaxation as an effective therapeutic approach for managing musculoskeletal impairments associated with piriformis syndrome.