A Comparative Study of Laser Therapy and Shockwave Therapy in the Treatment of Piriformis Syndrome: The Role of Exercise as an Adjunctive Treatment

Abstract

Background Chronic gluteal and lower back discomfort, often caused by piriformis syndrome, may severely limit a person's ability to carry out daily tasks. While there is encouraging evidence for the use of non-invasive modalities like radial extracorporeal shockwave therapy (rESWT) and low-level laser therapy (LLLT) to treat musculoskeletal conditions, there is a lack of comparative evidence regarding the efficacy of these therapies, particularly when combined with therapeutic exercise. Methods There were 70 participants in the experiment, split equally between two groups, and it was a prospective randomised controlled trial: Compare the Use of Shockwaves with Lasers for Exercise. Treatments were administered for a duration of four weeks. Baseline, post-treatment, and 3-month follow-up assessments of the following outcome measures were conducted: Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), range of motion (ROM), and Short Form-36 (SF-36). Results There were significant improvements in pain and disability levels (p < 0.001) in both groups. There were significant time × group interactions for VAS, ODI, and hip ROM, and shockwave treatment produced better functional improvements in ODI (mean reduction: 15.80 vs. 11.71, p = 0.049) and hip ROM (mean increase: 15.43° vs. 9.91°, p = 0.063). Conclusion When exercised with LLLT or rESWT, piriformis syndrome may be safely and effectively treated. When compared to other methods, shockwave treatment improved functional recovery and mobility the most.