Strain-Counterstrain Treatment of Piriformis Pain

Loma Linda University30 enrolled

Overview

The purpose of this investigator-initiated study is to provide an efficient and non-invasive treatment option for pain caused by the piriformis muscle.

There are two arms to the study: treatment and sham. The treatment group will receive strain-counterstrain for the piriformis muscle. The sham group will receive strain-counterstrain treatment for the hamstring muscle. There will be two treatments, 1-2 weeks apart ideally. Participants will fill out the Oswestry Disability Index Questionnaire before the first treatment and after the second treatment (which is 1-2 weeks after the first treatment). Participants will also identify pain using the Visual Analog Scale (VAS) before and after each treatment. Participants will identify pain at rest prior to treatment using VAS. Participant will then identify pain at the start of treatment while pressure is applied to the piriformis muscle (4.5kg/cm2) and post treatment while pressure is applied to the piriformis muscle (4.5 kg/cm2). An algometer will be used pre and post each treatment (2 treatments that are 1-2 weeks apart) to objectively measure any change in pain pressure threshold.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Low Back Pain, Mechanical Piriformis Syndrome Somatic Dysfunction of Sacral Region (Finding)

Interventions

Strain-Counterstrain treatment of piriformis muscleOTHER

Participant will lay prone on table with affected leg close to edge of table. Piriformis muscle tender point is identified and palpated. Then patient leg is passively moved off table and passive hip flexion, abduction, and possible internal/external rotation is added to reduce tender point by 70% or more. This is done passively. This position is held for 90 seconds and then participant is passively returned back to neutral prone position with leg on table. Tender point is palpated again to reassess for change in pain (using subjective visual analog scale). An algometer is also used pre and post to assess objective change in pressure pain threshold.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * 18 to 65 years of age * Tender point (or trigger point) in piriformis muscle determined by physical exam Exclusion criteria: * Less than 45 degrees of active hip flexion, less than 5 degrees of active hip internal rotation or less than 30 degrees of active hip external rotation, on side of affected piriformis * Unable to lay prone * Non-English speaker * Inability to attend 2 sessions within the same month * Active cancer * Pregnant * Diagnosis of lumbar radiculopathy * Greater than grade 1 lumbar spondylolisthesis * Presence of lumbar region Pars Defect * Receiving massage, acupuncture, chiropractic treatments, osteopathic treatments during study period.

Locations (1)

Loma Linda University Health

Loma Linda, California, United States

RECRUITING

Outcomes

Primary Outcomes

Algometer - Change in pressure pain threshold

Objective improvement in pressure/pain threshold

Time frame: Pre and post each treatment. There are 2 treatments, 1-2 weeks apart from one another.

Secondary Outcomes

Change in Visual Analog Scale

Subjective improvement in low back/leg pain

Time frame: Pre and post each treatment. There are 2 treatments, 1-2 weeks apart from one another.

Change in Oswestry Disability Index

Assesses pain with doing different activities (sleeping, walking, sitting, etc), assesses ability to do activities of daily living

Time frame: Before first treatment and after second treatment. Each treatment is 1-2 weeks apart (anticipated).

Central Contacts

Roya Vahdatinia, DO

CONTACT

9095586202 rvahdatinia@llu.edu

Mickey Lui, DO

CONTACT

9095586202 Mickey.Lui@va.gov

Data from ClinicalTrials.gov

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