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

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.