Original Article: JRCRS. 2025; 13(4):203-209
3- Comparative Effects of Neural Mobilization of Sciatic Nerve Versus Stretching Among Patients with Piriformis Syndrome: A Randomized Clinical Trial
Muhammad Usman1, Rabia Khan2, Syeda Anum Riaz3, Ghousia Shahid4, Sayyeda Tahniat Ali5, Abida Arif6
1 2 4 5 6 Assistant Professor, Bahria University Health Sciences Campus Karachi, Pakistan
3 Consultant Physiotherapist, Neuro Clinic Karachi, Pakistan
Read Full-Text Full-Text PDF DOI: https://dx.doi.org/10.53389/JRCRS.2025130403
ABSTRACT:
Background: Piriformis syndrome is considered as painful musculoskeletal condition resembling sciatica. It is responsible for 6% of cases of low back pain and is frequently unrecognized in clinical setting.
Objective: To compare the effects of neural mobilization of Sciatic nerve versus stretching of piriformis muscle in patients with piriformis syndrome.
Methodology: All patients coming to Physiotherapy OPD complained about radiating pain in back and legs were screened for sciatica and piriformis syndrome. A total of 40 patients were selected. They were randomly divided into 2 groups; each group contained 20 patients. Group A received neural mobilization of sciatic nerves while Group B received stretching of piriformis muscle. Both groups received treatment for 3 days a week for 2 weeks. Visual analogue Scale (VAS), hip range of motion (ROM) (flexion, abduction and external rotation) and FAIR test were performed pre and post intervention and results were compared for any improvements. SPSS version 25 (IBM Corp., Armonk, NY, USA) was used for Statistical analyses. Paired t-tests were applied for within-group comparisons, and independent t-tests for between-group comparisons. Effect sizes (Cohen’s d) and 95% confidence intervals were also calculated. (Clinical Trial Registry Number: NCT06808659)
Results: The difference in means for all the assessment parameters pre and post treatment showed significant improvement in both groups. Hip flexion ROM, Hip external rotation, Hip abduction ROM, FAIR test, and VAS showed no significant difference when both groups were compared.
Conclusion: This study concluded that both neural mobilization of the sciatic nerve and piriformis stretching significantly improved pain and hip function, but neither technique was superior. These findings suggest that both approaches are effective and may be considered equally viable treatment options for piriformis syndrome.
Keywords: Visual analogue scale, physiotherapy, pain management, Piriformis syndrome, FAIR test, Range of motion.