Effectiveness of Dry Needling versus Cupping Therapy for Pain in Piriformis Syndrome

Main Article Content

Hamza Shahzad
Waqas Ashraf Chaudhary
Muhammad Imran Baig
Ghalia safdar
Aiman Alam
Hanan Azfar
Khizra Moeen
Muhammad Arslan
Rafia Imtiaz

Abstract

Background: Piriformis syndrome is characterized by discomfort in the buttocks and throughout the course of the sciatic nerve. Dry needling modulates pain perception, disrupts pain signaling pathways, and induces local tissue responses. Cupping therapy facilitates localized blood flow, lymphatic drainage, and tissue oxygenation to alleviate muscular tension and improve circulation. Both interventions have shown promise in improving symptoms of piriformis syndrome.


Objective: The purpose of this study was to evaluate the efficacy of dry needling versus cupping therapy in managing piriformis pain syndrome.


Methods: This experimental study was conducted at Chaudhary Muhammad Akram Teaching and Research Hospital, Lahore, from October 2023 to May 2024. Eighty participants diagnosed with piriformis syndrome, aged between 18 and 65 years, were randomly assigned to one of two groups: Group A (dry needling) and Group B (cupping therapy). Exclusion criteria included pregnancy and previous surgical interventions for piriformis syndrome. Both groups received their respective treatments three times a week for six weeks. Pain intensity was measured using the Visual Analogue Scale (VAS), disability was assessed with the Oswestry Disability Index (ODI), and quality of life was evaluated using a standardized questionnaire. Data were analyzed using SPSS version 25, with paired sample t-tests used for within-group comparisons and independent sample t-tests for between-group comparisons. Statistical significance was set at p < 0.05.


Results: In the dry needling group, the mean VAS score decreased from 6.216 ± 1.931 to 3.432 ± 0.987 (p < 0.001), while the cupping therapy group saw a reduction from 6.108 ± 2.195 to 4.189 ± 1.697 (p < 0.001). The mean ODI score in the dry needling group decreased from 27.432 ± 7.617 to 10.054 ± 3.036 (p < 0.001), and in the cupping therapy group from 26.270 ± 7.209 to 12.918 ± 7.495 (p < 0.001). Quality of life scores improved significantly in both groups, with the dry needling group showing a mean reduction from 12.702 ± 3.673 to 7.270 ± 1.627 (p < 0.001), and the cupping therapy group from 13.027 ± 3.523 to 8.270 ± 1.609 (p < 0.001).


Conclusion: Both dry needling and cupping therapy are effective interventions for managing piriformis pain syndrome, with dry needling showing greater improvements in pain reduction, disability reduction, and quality of life. These findings support the use of dry needling as a preferred therapeutic option for piriformis syndrome.

Article Details

How to Cite
Shahzad, H., Waqas Ashraf Chaudhary, Muhammad Imran Baig, Ghalia safdar, Aiman Alam, Hanan Azfar, Khizra Moeen, Muhammad Arslan, & Imtiaz, R. (2024). Effectiveness of Dry Needling versus Cupping Therapy for Pain in Piriformis Syndrome. Journal of Health and Rehabilitation Research, 4(2), 1090–1094. https://doi.org/10.61919/jhrr.v4i2.935
Section
Articles
Author Biographies

Hamza Shahzad, Superior UniversitY Pakistan.

MS- Physical Rehabilitation and Pain Management Superior University, Pakistan.

Waqas Ashraf Chaudhary, Superior University Lahore, Pakistan.

Assistant Professor at Faculty of Allied Health Sciences, Superior University Lahore, Pakistan.

Muhammad Imran Baig, Superior UniversitY Pakistan.

MS- Physical Rehabilitation and Pain Management Superior University, Pakistan.

Ghalia safdar, Shifa Tameer E Millat University Islamabad Pakistan.

Lecturer, Shifa Tameer E Millat University Islamabad, Pakistan.

Aiman Alam, Riphah International University Islamabad- Pakistan.

MS-OMPT, Riphah International University Islamabad, Pakistan.

Hanan Azfar, Medline Healthcare Gujranwala Pakistan.

Consultant Physiotherapist, Medline Healthcare Gujranwala, Pakistan.

Khizra Moeen, Riphah International University Lahore Pakistan.

MS, Riphah International University Lahore, Pakistan.

Rafia Imtiaz, Government College University Faisalabad Pakistan.

Government College University Faisalabad Pakistan.

References

Lo JK, Robinson LR. Piriformis Syndrome. Handbook of Clinical Neurology. 2024;201:203-26.

Zhu Q, Zhu S, Xiong J, Lu L, Chen J, Zhong Z, et al. Little Needle-Scalpel for Piriformis Syndrome: A Protocol for Systematic Review and Meta-Analysis. Medicine (Baltimore). 2021;100(12).

Son B-c. Importance of Sacrotuberous Ligament in Transgluteal Approach for Sciatic Nerve Entrapment in the Greater Sciatic Notch (Piriformis Syndrome). Journal of Korean Neurosurgical Society. 2024;67(2):217-26.

Kanumuri S, Andrew D, Kumar S, Chhabra A. Piriformis Syndrome and Deep Gluteal Syndrome: Presentation, Diagnostic Imaging, and Management. Springer; 2024.

Chuapoco R, Linford RE. Piriformis Syndrome With a Variant Presentation. 2024.

Sharma S, Kaur H, Verma N, Adhya B. Looking Beyond Piriformis Syndrome: Is It Really the Piriformis? Hip & Pelvis. 2023;35(1):1.

Kalánková D, Stolt M, Scott PA, Papastavrou E, Suhonen R. Unmet Care Needs of Older People: A Scoping Review. Nursing Ethics. 2021;28(2):149-78.

Pope RP, Herbert RD, Kirwan JD, Graham BJ. A Randomized Trial of Preexercise Stretching for Prevention of Lower-Limb Injury. Medicine & Science in Sports & Exercise. 2000;32(2):271.

Wang L, Cai Z, Li X, Zhu A. Efficacy of Cupping Therapy on Pain Outcomes: An Evidence-Mapping Study. Frontiers in Neurology. 2023;14:1266712.

Qiangqiang W, Yingang L. Research Progress of Chinese Medicine in the Treatment of Sciatica. Academic Journal of Medicine & Health Sciences. 4(12):35-41.

Lee MS, Kim J-I, Ernst E. Is Cupping an Effective Treatment? An Overview of Systematic Reviews. Journal of Acupuncture and Meridian Studies. 2011;4(1):1-4.

Gulati S. Importance of Wet Cupping in Sciatica Patients: A Literature Review. International Journal of Convergence in Healthcare. 2024;4(1):4-.

Qureshi T, Hannan A. Clinical Efficacy and Safety of Cupping Therapy. Hamdard Medicus. 2016;59(1):5-16.

Guner D, Ozcete ZA. Evaluation of the Efficacy of Ultrasound-Guided Dry Needling Therapy and Exercise in Piriformis Muscle Syndrome. Cureus. 2023;15(8).

Wang Y. Walking Balance in Individuals With Acromegaly. 2023.

Fusco P, Di Carlo S, Scimia P, Degan G, Petrucci E, Marinangeli F. Ultrasound-Guided Dry Needling Treatment of Myofascial Trigger Points for Piriformis Syndrome Management: A Case Series. Journal of Chiropractic Medicine. 2018;17(3):198-200.

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.

Markowski A, Sanford S, Pikowski J, Fauvell D, Cimino D, Caplan S. A Pilot Study Analyzing the Effects of Chinese Cupping as an Adjunct Treatment for Patients With Subacute Low Back Pain on Relieving Pain, Improving Range of Motion, and Improving Function. Journal of Alternative and Complementary Medicine. 2014;20(2):113-7.

Cao H, Li X, Yan X, Wang NS, Bensoussan A, Liu J. Cupping Therapy for Acute and Chronic Pain Management: A Systematic Review of Randomized Clinical Trials. Journal of Traditional Chinese Medical Sciences. 2014;1(1):49-61.

Astokorki AHY. The Effects of Dry Needling and Physical Therapy on Improvement of Pain in Patients With Piriformis Syndrome. Journal of College of Physical Education. 2023;16(6):786-811.