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

Sponsor

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital (Other)

Overall Status

Not yet recruiting

CT.gov ID

NCT06095180

Collaborator

(none)

Enrollment

Arms

8.9

Anticipated Duration (Months)

Study Details

Study Description

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.

Condition or Disease	Intervention/Treatment	Phase
Piriformis Muscle Syndrome	Other: corticosteroid injection Other: dry needling Other: exercise	N/A

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 Design

Study Type:

Interventional

Anticipated Enrollment :

60 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Single (Outcomes Assessor)

Masking Description:

Outcome measures will be evaluated by an independent physiatrist, blinded for the assigned treatment.

Primary Purpose:

Treatment

Official Title:

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

Anticipated Study Start Date :

Nov 28, 2023

Anticipated Primary Completion Date :

Aug 26, 2024

Anticipated Study Completion Date :

Aug 26, 2024

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: corticosteroid group 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)	Other: 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)
Active Comparator: dry needling group 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)	Other: 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)
Other: control group 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.	Other: 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.

Arm

Intervention/Treatment

Active Comparator: corticosteroid group

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)

Other: corticosteroid injection

Active Comparator: dry needling group

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)

Other: dry needling

Other: control group

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.

Other: exercise

Outcome Measures

Primary Outcome Measures

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) (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 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

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.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 60 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

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