Effects of a Tailored Exercise Intervention on Pain, Muscle Strength, Functional Performance and Disability in Patients with Piriformis Syndrome: A Pilot Study

Abstract

Background: Piriformis syndrome is a common neuromuscular condition characterized by buttock pain, sciatic nerve irritation, reduced muscle strength, impaired functional mobility, and disability. Although physiotherapy remains the cornerstone of conservative management, evidence regarding individualized exercise interventions is limited. This study evaluated the effectiveness of a tailored exercise intervention on pain, muscle strength, functional performance, and disability in patients with piriformis syndrome. Methodology: A prospective, parallel-group, pilot randomized controlled trial was conducted over four weeks involving 100 patients with clinically diagnosed piriformis syndrome. Participants were randomly allocated into Group A (Tailored Exercise Intervention; n=50) and Group B (Conventional Physiotherapy; n=50). Primary outcome was pain intensity assessed using the Visual Analog Scale (VAS). Secondary outcomes included hip muscle strength measured using a handheld dynamometer, functional performance assessed by the Lower Extremity Functional Scale (LEFS) and Timed Up and Go (TUG) test, hip internal rotation range of motion, and disability evaluated using the Oswestry Disability Index (ODI). Assessments were performed at baseline and at the end of four weeks. Statistical analysis was conducted using SPSS version 27.0 with p<0.05 considered statistically significant. Results: Both interventions significantly improved all clinical outcomes after four weeks. However, participants receiving the tailored exercise intervention demonstrated significantly greater reductions in pain and disability together with superior improvements in hip muscle strength, functional performance, hip internal rotation, and LEFS scores compared with those receiving conventional physiotherapy (p<0.001). Conclusion: A four-week tailored exercise intervention produced superior clinical outcomes compared with conventional physiotherapy in patients with piriformis syndrome. Individualized exercise programs may represent an effective conservative treatment strategy for reducing pain, restoring muscle function, and improving physical performance and quality of life.