Effectiveness of Positional Release Therapy Technique Among Individuals with Wallet Neurities- A Single Case Study

Abstract

   Introduction: Wallet neuritis, also known as fat wallet syndrome is an extra-spinal neuropathy       caused by prolonged compression of the sciatic nerve due to sitting on a wallet. The condition leads to unilateral gluteal pain radiating to the posterior thigh, often mimicking lumbar radiculopathy. Continuous mechanical pressure beneath the piriformis muscle can cause      ischemia, demyelination, and neural irritation.

Objectives: The aim of this study is to determine the effectiveness of Positional Release Therapy (PRT) in reducing pain and improving functional mobility among individuals diagnosed with wallet neuritis.

Methods: A 50-year-old male software employee presented with right-sided gluteal pain radiating to the posterior thigh for three months, aggravated by prolonged sitting on a wallet. Clinical findings included tenderness over the piriformis muscle and mild sensory reduction in the posterior thigh. Diagnostic tests such as the piriformis stretch test reproduced symptoms, while SLR was negative. The intervention involved the application of Positional Release Therapy targeting the piriformis and gluteal muscles. Outcome measures included the Visual Analog Scale (VAS) for pain intensity and the Oswestry Disability Index (ODI) for functional disability assessment. Results Post-treatment, the patient demonstrated a significant reduction in pain scores on the VAS and improvement in daily functional activities as reflected by decreased ODI scores. Increased range of motion and reduced muscle tenderness were also observed following therapy sessions.

Conclusions: PRT proved to be an effective, gentle, and non-invasive technique in the management of wallet neuritis. By reducing muscle tension and neural compression, PRT alleviated pain and improved function. The findings suggest that PRT can be considered a valuable conservative intervention for extra-spinal sciatic nerve compression syndromes