Piriformis muscle: A muscle that stretches across the sacrum to the hip located in the buttocks.
Frequency: This is typically repeated in 2 weeks if you have gained some relief from the initial procedure.
Anesthetic: Local
Indications:
This injection is used to treat muscle/myofascial pain located in the piriformis muscle. This can be a significant source of buttock pain resulting from persistent spasms. Pain can radiate down the leg as the sciatic nerve typically runs through this muscle. When this muscle spasms, this contracts on the sciatic nerve, producing pain down the back of the thigh and leg. If there is pain traveling down the leg, a steroid may be added to the injection mixture to help with this nerve irritation. This condition is typically not fixed by surgery.
See trigger point injections for further details.
Contraindications/Reasons why you may not have your injection today:
- Bleeding disorders/low platelet counts
- Medications that thin your blood (please review this section)
- Current infection
- Your symptoms have changed and/or improved
- Patient refusal
- Procedure not approved by your insurance
- Poorly controlled high blood pressure that may be giving you symptoms
- Allergies to the any of the medications that is being used
Potential side effects/risks of the procedure:
- Increased pain
- Infection
- Bleeding
- Allergic reaction to medications used to clean your skin and/or medications injected
- Seizures
Procedure:
The location of the piriformis muscle is identified and marked. At times, an x-ray machine may be used to help determine the location of this muscle. After your skin is cleaned with an antiseptic solution, a very tiny needle is inserted into the muscle bundle. When you start experiencing the pain in the muscle, contrast may be injected to confirm that the needle is within the muscle. Subsequently, a mixture of local anesthetic +/- steroid is injected. You may experience increased pressure/pain during the injection which is normal. However, if at any time the pain is too intense, please tell your provider to slow down your injection. After the medication is injected, the needle is removed.
Typical length of the procedure:
5 minutes. Expect to be at the clinic no more than 15 minutes after you have been checked in by the medical assistant into the preoperative area. If this is your first time at our clinic, you will likely be at the clinic for at least one hour. Please plan accordingly.
How long do you expect pain relief:
It is difficult to determine how long and how much pain relief you may experience. It varies depending on multiple factors. Some patients do not gain any relief from the procedure and some may have permanent pain relief. If you experience relief right after this procedure, this can be diagnostic that your pain is coming from the specific muscle that was injected today.
