Piriformis SyndromeNCT07403045

McGill Strengthening With and Without Integrated Neuromuscular Inhibition Technique in Piriformis Syndrome

A study testing McGill strengthening exercises program, Integrated neuromuscular inhibition technique and Standardized physiotherapy treatment in people with Piriformis Syndrome, run by Riphah International University at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

The study was conducted to determine the effects of McGill strengthening exercises program with and without integrated neuromuscular inhibition technique on pain, range of motion and function in patients with piriformis syndrome. Read more about this study

Who is it for?: Ages 25 to 45 years
Conditions the study is for: Piriformis Syndrome
What is being tested?: McGill strengthening exercises program, Integrated neuromuscular inhibition technique and Standardized physiotherapy treatment
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 56 participants
Where: 1 sitePakistan
Study dates: 26 May 2025to 5 Nov 2025
Phase: Interventional
Are there results?: None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

Ages 25 to 45 years
All sexes
No healthy volunteers
Adult

Who may be able to join

Both genders with age ranged from 25 and 45 years
Sedentary
Non-traumatic
Idiopathic
External tenderness near the greater sciatic notch
Pain for more than 1 month's duration

Show all 13Show fewer

NPRS ranging from >3 to ≤ 6
Positive results on three of the following five tests:
FAIR
Beatty
Laségue
Pace
Freiberg

Who cannot join

Acute low back pain and/or acute lumbar radiculopathy
History of Stroke or any other neurological disorders
Recent buttock trauma
Inflammatory, infectious or tumor diseases
Severe vascular disease
Osteoporosis
Pregnancy

Trial locations and contacts

1 site in 1 country.

Pakistan1 site

Mumtaz Bakhtawar Memorial Trust Hospital, Mustafa Town
Lahore, Punjab Province

Other trials in Pakistan

About this study

Official title: Effects of McGill Strengthening Exercises Program With and Without Integrated Neuromuscular Inhibition Technique on Pain, Range of Motion and Function in Patients With Piriformis Syndrome

Conditions: Piriformis Syndrome
Being tested: McGill strengthening exercises program, Integrated neuromuscular inhibition technique, Standardized physiotherapy treatment
Keywords: integrated neuromuscular inhibition technique, McGill exercises, pain, physical functional performance, piriformis syndrome, range of motion, trigger points
Medical subject headings: Piriformis Muscle Syndrome, Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

McGill strengthening exercises programOther
These exercises were divided into 3 phases, each lasting 2 weeks. Patients performed 4 repetitions of each exercise during 1st and 2nd week at each hospital visit. Then, increased by 4 repetitions every 2 weeks for up to 6 weeks. These exercises were performed with a maximum of 12 repetitions with a 1-minute of rest interval between each exercise. These exercises were performed by patients at each clinical visit, 3 days per week for total of 6 weeks.
Integrated neuromuscular inhibition techniqueOther
This technique was applied at piriformis muscle. The procedure was repeated 3 times for up to 10 minutes at each clinical visit. This intervention was performed 3 days per week for total of 6 weeks.
Standardized physiotherapy treatmentOther
These exercises were performed by patients at the end of each hospital visit (3 days per week for total of 6 weeks) and also at home twice a week during the 2 months follow-up period after treatment ends.
1. Continuous-mode ultrasound therapy was applied at a frequency of 1 MHz and an intensity of 1.0 W/cm² for 3 minutes to the tender or trigger points on the posterior aspect of the pelvis.
2. A hydrocollator pack (40°C) was applied for 10 minutes at lumbopelvic region.
3. Piriformis, hamstring/calf stretching was performed progressively in phases.
- Phase 1 consists of weeks 1 and 2 with 1 set of 3 repetitions with 30 seconds hold per day.
- Phase 2 consists of weeks 3 and 4 with 2 sets of 3 repetitions with 30 seconds hold per day.
- Phase 3 consists of weeks 5 and 6 with 2 sets of 3 repetitions with 30 seconds hold twice per day.
- Follow-up period consists of 2 sets of 3 repetitions with 30 seconds hold twice per day.

Study groups in NCT07403045
Study group	Role	What they receive
McGill strengthening exercises program with integrated neuromuscular inhibition technique	Experimental	Not described Receives: Other: McGill strengthening exercises program; Other: Integrated neuromuscular inhibition technique; Other: Standardized physiotherapy treatment
McGill strengthening exercises program	Active comparator	Not described Receives: Other: McGill strengthening exercises program; Other: Standardized physiotherapy treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

Numeric Pain Rating Scale
Numeric Pain Rating Scale (NPRS) was used to assess the patient's pain intensity. This scale ranges from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst pain.
Measured: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.

Secondary outcomes (3)

Range of Motion (Hip Abduction)
The universal goniometer was used to assess hip abduction range of motion.
Measured: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Range of Motion (Hip Internal Rotation)
The universal goniometer was used to assess hip internal rotation range of motion.
Measured: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Lower Extremity Functional Scale
Lower Extremity Functional Scale was used to assess the patient's functional status. Maximum score of this scale is 80. The greater the score, the lower the disability.
Measured: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

26 May 20255 Nov 2025

First posted11 Feb 2026
Study start26 May 2025
Primary completion5 Sep 2025
Study completion5 Nov 2025

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Publications (23)Papers the sponsor has linked to this study.
Other trials for Piriformis SyndromeStudies of the same condition, open and under way.
More trials run by Riphah International UniversityThe sponsor's other registered studies.
What the trial phases meanHow a treatment moves from first tests in people to approval.

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design

Study type: Interventional
Phase: Phase N/A
Primary purpose: Treatment
Allocation: Randomised
Intervention model: Parallel groups
Masking: Double blind
Who is masked: Participant, Outcomes assessor
Enrolment: 56 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT07403045
Sponsor's protocol ID: REC/RCR & AHS/24/0176
Status last verified: Feb 2026
First submitted: 4 Feb 2026
Last updated: 11 Feb 2026
Results posted: No
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: No

Publications

Nazlikul H, Ural FG, Ozturk GT, Ozturk ADT. Evaluation of neural therapy effect in patients with piriformis syndrome. J Back Musculoskelet Rehabil. 2018;31(6):1105-1110. doi: 10.3233/BMR-170980.
PubMed 30010101
Jamaly A, Mohsenifar H, Amiri A. The effects of dry needling in combination with physical therapy on improvement of pain and hip internal rotation range in patients with piriformis syndrome. Journal of Clinical Physiotherapy Research. 2018;3(3):118-22.
Awan WA, Babur MN, Ali S, Janjua U. The effectiveness of electrotherapy with manual therapy in the treatment of piriformis syndrome. Int J Rehabil Sci. 2018;1(1):16-9.
Laha K, Sarkar B, Kumar P, Patel L, Sarkar N. Efficacy of hip abductor and extensor strengthening on pain, strength and lower extremity function in piriformis syndrome: a randomized clinical trial. Int J Health Sci Res. 2018;8(9):80-.
Velappanchavadi C. Effectiveness of muscle energy technique versus stretching in subjects with piriformis syndrome. Int J Physiother Res. 2019;7(5):3252-56.
Alarab A, Unver F. Stretching exercise versus tissue mobilization technique in piriformis syndrome. European Journal of Medical and Health Sciences. 2020;2(6).
Kutty NN, Siddeeque S, Tamphaibema H, Othayoth N, Bineesh CP. Effect of Muscle Energy Technique with Deep Friction Massage on Pain, Disability and Internal Rotation Range of Motion of Hip Joint in Individuals with Piriformis Syndrome. Indian Journal of Physiotherapy & Occupational Therapy. 2020 Jan 1;14(1).
Athawale VK, Jethwani D, Qureshi MD, Dadgal R. Combined Effect of Neural Tissue Mobilization and Deep Friction Massage in Piriformis Syndrome: A Research Protocol. Indian Journal of Forensic Medicine & Toxicology. 2021 Apr 1;15(2).
Chaudhary S, Sheikh M, Chaudhary NI, Ambad R, Bankar N. Effect of neural tissue mobilization in combination with ultrasonic therapy verses ultrasonic therapy in deep gluteal syndrome-a comparative study.
RAZA H, ARSLAN HR, IQBAL A, HAMID MF, WASEEM A, MANZOOR S. Comparison Of Gluteal Muscle Strengthening Versus Conventional Isometrics In Pain Management Of Piriformis Syndrome. Age (years). 2021 Nov 1;50(5.79):45-31.
Roy S, Solanki N, Phd AC. Effectiveness of muscle energy technique versus static stretching in subject with tight piriformis in male office going subjects: a randomized clinical trial. IJRAR-International J Res Anal Rev. 2022;9(3):295-321.
Idrees KI, Khan KH, Sharif KH, Ahmad KH, Rahman HA, Fahad FA. Efficacy Of Hip Abductors Strengthening As Compared To Piriformis Muscle Stretching In Improving Lower Extremity Function In Patients With Piriformis Syndrome. Pakistan Journal of Medical & Health Sciences. 2022 Sep 16;16(07):721.
Ahmad N, Akram MJ, Hussain H, Imtiaz I, Khan N, Qi L. Effectiveness of post facilitation stretch technique versus myofascial release in piriformis syndrome: A Randomized controlled trial. Rawal Medical Journal. 2022 Nov 12;47(4):936.
Shahzadi B, Taj S, Nawaz S, Hamid I, Talpur MA, Hussain SA, Sajjad AG, Kiyani M. Sacroiliac joint manipulation helps to improve pain pressure threshold in chronic piriformis syndrome: a 6-week randomized controlled trial. The Rehabilitation Journal. 2023 Mar 31;7(01):476-82.
Ergezen G, Sahin M. Comparison of self-myofascial release and stretching exercises in individuals with piriformis syndrome: a randomised controlled trial. International Journal of Therapy And Rehabilitation. 2023 Nov 2;30(11):1-0.

Want to know more?

The sponsor has not listed a contact. The official record may have more details.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

See locations

Not yet recruitingPhase 2
Efficacy of Botulinum Toxin Versus Placebo on Pain and Health Related Quality of Life of Patients With Piriformis Muscle Syndrome
Piriformis Muscle Syndrome
Recruiting
Interfascial Hydrodissection Added to Ultrasound-Guided Piriformis Injection for Piriformis Syndrome
Piriformis Syndrome
Recruiting
Comparative Effects of Post-Isometric Relaxation and Reciprocal Inhibition Techniques inPiriformis Syndrome
Piriformis Syndrome
Enrolling by invitation
Neural Gliders With and Without ESWT for Deep Gluteal Syndrome
Deep Gluteal Syndrome
Enrolling by invitation
Comparative Effects of the Bowen Technique With and Without Extracorporeal Shock Wave Therapy in Patients With Deep Gluteal Syndrome
Deep Gluteal Syndrome

All Piriformis Syndrome trials

Study at a glance

From the registry record, last updated by the sponsor on 11 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Effects of McGill Strengthening Exercises Program With and Without Integrated Neuromuscular Inhibition Technique on Pain, Range of Motion and Function in Patients With Piriformis Syndrome
ClinicalTrials.gov ID: NCT07403045
Acronym / sponsor ID: REC/RCR & AHS/24/0176
Conditions: Piriformis Syndrome
Keywords: integrated neuromuscular inhibition technique, McGill exercises, pain, physical functional performance, piriformis syndrome, range of motion, trigger points
Study type: Interventional
Recruitment status: Completed
Enrolment: 56 participants (actual)
Lead sponsor: Riphah International UniversityUniversity, hospital or other
Study start: 26 May 2025 (actual)
Primary completion: 5 Sep 2025 (actual)
Study completion: 5 Nov 2025 (actual)
First posted: 11 Feb 2026 (actual)
Results: Not posted in the source record

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

Study design

Primary purpose: Treatment
Allocation: Randomised
Intervention model: Parallel groups
Masking: Double blind (participant, outcomes assessor)
Number of arms: 2

Arm	Type	Receives
McGill strengthening exercises program with integrated neuromuscular inhibition technique	Experimental	Other: McGill strengthening exercises program, Other: Integrated neuromuscular inhibition technique, Other: Standardized physiotherapy treatment
McGill strengthening exercises program	Active comparator	Other: McGill strengthening exercises program, Other: Standardized physiotherapy treatment

Who may qualify

Ages: 25 to 45 years
Sex: All
Healthy volunteers: Not accepted
Age groups: Adult

Key inclusion criteria (13 listed)

Both genders with age ranged from 25 and 45 years
Sedentary
Non-traumatic
Idiopathic
External tenderness near the greater sciatic notch

Key exclusion criteria (7 listed)

Acute low back pain and/or acute lumbar radiculopathy
History of Stroke or any other neurological disorders
Recent buttock trauma
Inflammatory, infectious or tumor diseases
Severe vascular disease

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Interventions

Intervention	Type	Arms
McGill strengthening exercises programThese exercises were divided into 3 phases, each lasting 2 weeks. Patients performed 4 repetitions of each exercise during 1st and 2nd week at each hospital visit. Then, increased by 4 repetitions every 2 weeks for up to 6 weeks. These exercises were performed with a maximum of 12 repetitions with a 1-minute of rest interval between each exercise. These exercises were performed by patients at each clinical visit, 3 days per week for total of 6 weeks.	Other	McGill strengthening exercises program, McGill strengthening exercises program with integrated neuromuscular inhibition technique
Integrated neuromuscular inhibition techniqueThis technique was applied at piriformis muscle. The procedure was repeated 3 times for up to 10 minutes at each clinical visit. This intervention was performed 3 days per week for total of 6 weeks.	Other	McGill strengthening exercises program with integrated neuromuscular inhibition technique
Standardized physiotherapy treatmentThese exercises were performed by patients at the end of each hospital visit (3 days per week for total of 6 weeks) and also at home twice a week during the 2 months follow-up period after treatment ends. 1. Continuous-mode ultrasound therapy was applied at a frequency of 1 MHz and an intensity of 1.0 W/cm² for 3 minutes to the tender or trigger points on the posterior aspect of the pelvis. 2. A hydrocollator pack (40°C) was applied for 10 minutes at lumbopelvic region. 3. Piriformis, hamstring/calf stretching was performed progressively in phases. * Phase 1 consists of weeks 1 and 2 with 1 set of 3 repetitions with 30 seconds hold per day. * Phase 2 consists of weeks 3 and 4 with 2 sets of 3 repetitions with 30 seconds hold per day. * Phase 3 consists of weeks 5 and 6 with 2 sets of 3 repetitions with 30 seconds hold twice per day. * Follow-up period consists of 2 sets of 3 repetitions with 30 seconds hold twice per day.	Other	McGill strengthening exercises program, McGill strengthening exercises program with integrated neuromuscular inhibition technique

Primary outcome

Numeric Pain Rating Scale
Time frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Numeric Pain Rating Scale (NPRS) was used to assess the patient's pain intensity. This scale ranges from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst pain.

3 secondary outcomes

Range of Motion (Hip Abduction)
Time frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Range of Motion (Hip Internal Rotation)
Time frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Lower Extremity Functional Scale
Time frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.

Results and safety

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 11 Feb 2026.
Background: PubMed 30010101Nazlikul H, Ural FG, Ozturk GT, Ozturk ADT. Evaluation of neural therapy effect in patients with piriformis syndrome. J Back Musculoskelet Rehabil. 2018;31(6):1105-1110. doi: 10.3233/BMR-170980.
BackgroundJamaly A, Mohsenifar H, Amiri A. The effects of dry needling in combination with physical therapy on improvement of pain and hip internal rotation range in patients with piriformis syndrome. Journal of Clinical Physiotherapy Research. 2018;3(3):118-22.
BackgroundAwan WA, Babur MN, Ali S, Janjua U. The effectiveness of electrotherapy with manual therapy in the treatment of piriformis syndrome. Int J Rehabil Sci. 2018;1(1):16-9.
BackgroundLaha K, Sarkar B, Kumar P, Patel L, Sarkar N. Efficacy of hip abductor and extensor strengthening on pain, strength and lower extremity function in piriformis syndrome: a randomized clinical trial. Int J Health Sci Res. 2018;8(9):80-.
BackgroundVelappanchavadi C. Effectiveness of muscle energy technique versus stretching in subjects with piriformis syndrome. Int J Physiother Res. 2019;7(5):3252-56.
BackgroundAlarab A, Unver F. Stretching exercise versus tissue mobilization technique in piriformis syndrome. European Journal of Medical and Health Sciences. 2020;2(6).
BackgroundKutty NN, Siddeeque S, Tamphaibema H, Othayoth N, Bineesh CP. Effect of Muscle Energy Technique with Deep Friction Massage on Pain, Disability and Internal Rotation Range of Motion of Hip Joint in Individuals with Piriformis Syndrome. Indian Journal of Physiotherapy & Occupational Therapy. 2020 Jan 1;14(1).
BackgroundAthawale VK, Jethwani D, Qureshi MD, Dadgal R. Combined Effect of Neural Tissue Mobilization and Deep Friction Massage in Piriformis Syndrome: A Research Protocol. Indian Journal of Forensic Medicine & Toxicology. 2021 Apr 1;15(2).
BackgroundChaudhary S, Sheikh M, Chaudhary NI, Ambad R, Bankar N. Effect of neural tissue mobilization in combination with ultrasonic therapy verses ultrasonic therapy in deep gluteal syndrome-a comparative study.
BackgroundRAZA H, ARSLAN HR, IQBAL A, HAMID MF, WASEEM A, MANZOOR S. Comparison Of Gluteal Muscle Strengthening Versus Conventional Isometrics In Pain Management Of Piriformis Syndrome. Age (years). 2021 Nov 1;50(5.79):45-31.
BackgroundRoy S, Solanki N, Phd AC. Effectiveness of muscle energy technique versus static stretching in subject with tight piriformis in male office going subjects: a randomized clinical trial. IJRAR-International J Res Anal Rev. 2022;9(3):295-321.
BackgroundIdrees KI, Khan KH, Sharif KH, Ahmad KH, Rahman HA, Fahad FA. Efficacy Of Hip Abductors Strengthening As Compared To Piriformis Muscle Stretching In Improving Lower Extremity Function In Patients With Piriformis Syndrome. Pakistan Journal of Medical & Health Sciences. 2022 Sep 16;16(07):721.
Individual participant dataSharing planned: No

Related trials for Piriformis Syndrome

Not yet recruitingPhase 2
Efficacy of Botulinum Toxin Versus Placebo on Pain and Health Related Quality of Life of Patients With Piriformis Muscle Syndrome
Piriformis Muscle Syndrome
Recruiting
Interfascial Hydrodissection Added to Ultrasound-Guided Piriformis Injection for Piriformis Syndrome
Piriformis Syndrome
Recruiting
Comparative Effects of Post-Isometric Relaxation and Reciprocal Inhibition Techniques inPiriformis Syndrome
Piriformis Syndrome
Enrolling by invitation
Neural Gliders With and Without ESWT for Deep Gluteal Syndrome
Deep Gluteal Syndrome
Enrolling by invitation
Comparative Effects of the Bowen Technique With and Without Extracorporeal Shock Wave Therapy in Patients With Deep Gluteal Syndrome
Deep Gluteal Syndrome

Referral and contact

AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.

Syed Shakil ur Rehman, PhD study director

Riphah International University

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Numeric Pain Rating Scale (time frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07403045, which also lists 23 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Feb 2026.