Comparison of Ultrasound-guided Steroid Injection and Dry Needling in Piriformis Muscle Syndrome

Not Applicable

Not yet recruiting

• Conditions: Piriformis Muscle Syndrome
• Interventions: Other: dry needling; Other: corticosteroid injection; Other: exercise

• Registration Number: NCT06095180
• Lead Sponsor: Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

Brief Summary

The aim of this study is to to compare its effectiveness ultrasound-guided steroid injection, dry needling treatments and exercises in patients diagnosed with piriformis syndrome.

Detailed Description

Piriformis syndrome is a painful entrapment neuropathy caused by compression of the sciatic nerve under the piriformis muscle. The most common cause is myofascial pain syndrome. There is no gold standard treatment for piriformis syndrome. The main purpose of treatment methods is to reduce local pain, muscle tension and spasm. This work; it will contribute to the literature by comparing steroid, dry needling and exercise treatments in patients with piriformis syndrome.

Study Timeline

• Status Verified: 2023-10
• Study First Submitted: 2023-10-18
• Study First Submitted QC: 2023-10-18
• Last Update Submitted: 2023-10-18
• Study First Posted: 2023-10-23
• Last Update Posted: 2023-10-23
• Study Start: 2023-11-28
• Primary Completion: 2024-08-26
• Study Completion: 2024-08-26

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1. Age between 18-60,
2. Hip pain for ≥1 month
3. Local piriformis pain with prolonged sitting (>20 minutes) and increased sensitivity
4. Patients with suspected piriformis syndrome based on clinical maneuvers
5. Signing and informed consent from showing consent to participate in the study

Exclusion Criteria

1. Hip surgery
2. Lumbar disc disease
3. History of inflammatory hip disease
4. Medical treatment for pain is started
5. Neurological deficit
6. Breastfeeding or pregnant
7. Allergy to local anesthetic
8. Use of anticoagulants
9. Body mass index >35
10. Active psychiatric illness
11. Uncontrolled hypertension and diabetes mellitus disease
12. Noncompensated chronic lung/heart/renal failure
13. History of vascular/tumoral disease

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
dry needling group	dry needling	In the dry needling group, a total of 3 sessions of dry needling will be performed once a week using a 0.60×100 mm sterile needle under ultrasound guidance and conventional treatment will be given ((conventional treatment includes piriformis stretching exercises. It will be stated that patients should do 2 sets a day and each set should be 10 repetition)
corticosteroid group	corticosteroid injection	In the steroid group, 4 mL lidocaine 2% + 1 mL betamethasone injection will be administered under ultrasound guidance and conventional treatment will be given (conventional treatment includes piriformis stretching exercises. It will be stated that patients should do 2 sets a day and each set should be 10 repetition)
control group	exercise	The conventional treatment group (control group) will be given piriformis stretching exercises including hip and knee flexion, hip abduction and external rotation in the supine position. It will be stated that patients should do 2 sets a day and each set should be 10 repetitions.

Primary Outcome Measures

Name	Time	Method
Visual Analog Scale (VAS) (Resting)	at baseline and change from baseline VAS (resting) at 4 weeks and 12 weeks	Average hip pain intensity at rest over the past week is a visual analog scale. (VAS; ranging from 0 to 10, 0 = no pain and 10 = worst possible pain)
Visual Analogue Scale (VAS) (Sitting)	at baseline and change from baseline VAS (sitting) at 4 weeks and 12 weeks	Average hip pain intensity in a sitting position over the past 24 hours, a visual analog scale. (VAS; ranging from 0 to 10, 0 = no pain and 10 = worst possible pain)
Visual Analog Scale (VAS) (Movement)	at baseline and change from baseline VAS (movement) at 4 weeks and 12 weeks	Average hip pain intensity during movement over the past 1 week is a visual analog scale. (VAS; ranging from 0 to 10, 0 = no pain and 10 = worst possible pain)

Secondary Outcome Measures

Name	Time	Method
Oswestry disability index (ODI)	at baseline and change from baseline ODI at 4 weeks and 12 weeks	ODI includes questions regarding pain severity, sexual function, sleep quality and personal care, ability to work, sit, walk, lift, stand and travel. Total score ranges from 0-50, with higher scores indicating more injury.