Piriformis Muscle Injection
What is the piriformis muscle?
The piriformis muscle begins inside the pelvis. It connects to the sacrum, a triangular-shaped bone that sits between the pelvic bones at the base of the spine. The other end of the piriformis muscle connects to the greater trochanter, the bump on the top of your hip. The piriformis muscle works to help turn your foot and leg outward. The sciatic nerve runs under and sometimes through the piriformis muscle on its way out of the pelvis. Buttock and sciatica type pain can occur when the piriformis muscle goes into spasms, which in turn squeezes and irritates the sciatic nerve.
What is a Piriformis Muscle Injection?
The Piriformis Muscle Injection is an injection of local anesthetic and steroid medication into the piriformis muscle. This injection can be used diagnostically to determine the cause of your buttock and sciatic pain and therapeutically to help relieve your pain. The steroid medication is used to decrease the inflammation and or swelling of piriformis muscle and sciatic nerve. The local anesthetic or numbing medication can temporarily stop the spasms of the piriformis muscle. The local anesthetic will wear off approximately six hours after the injection. Your pain may briefly return before the steroid medication takes affect. This does not mean the block did not work. The steroid or anti-inflammatory medication may not start working for 24 to 72 hours. Sometimes it can take up to one week for the steroid to work or take affect. You may experience soreness over the injection site for a day or two after the procedure. This soreness may be the direct result of the needle being inserted into the piriformis muscle and from the medication injected. The Piriformis Muscle Joint injection can last anywhere from days to months. If you achieved partial sustained relief following the first Piriformis Muscle Injection, then additional injections may be repeated to give you greater degree of sustained pain relief.
How will the procedure(s) be performed?
You will arrive at the George Isaac Center approximately 45 minutes before your scheduled procedure. The nurses will have you change into a hospital gown, complete the necessary medical forms, take your vital signs and start an IV. The IV will be used during the procedure to give you medication to relax you and control your discomfort. It is necessary that you remain awake during the procedure so that you can tell the physician if you have any unusual symptoms or discomfort. You will be transported by cart to a special room and positioned on your stomach on a special x-ray table. The skin on your back will be cleaned with antiseptic cleanser and then draped with sterile towels. Under fluoroscopy, a special X-ray machine, the doctor will determine the exact location for the Piriformis Muscle Injection. The area where the needle will be inserted is injected with local anesthetic (numbing medication similar to what your dentist uses). The needle is then inserted under fluoroscopy, which allows the doctor to see your spine and the needle as it moves into the piriformis muscle. Once the needle is in the correct position the medication is injected. Your skin will be cleansed and a band-aid dressing applied. You may remove the band-aid the following day. You will then be transferred by cart back to the recovery area where you will be monitored closely for the next 30-45 minutes. You will be given specific written discharge instructions and allowed to leave by wheelchair with your ride once the physician authorized your discharge.
What are the complications of these procedures?
There is a remote risk of bleeding, infection, nerve injury, or allergic reaction to the medications used. Short term side effects may occur. These can be the spread of local anesthetic to nearby nerves, which may result in weakness or numbness that can last for several hours. You may experience increased pain for several days after the injection, including localized pain at the injection site. If you are diabetic, your blood sugars may be elevated short term. Individuals that are prone to fluid retention may have increased fluid retention for 1-2 weeks.
What should I do after the procedure?
You will be given a discharge instruction sheet prior to leaving the recovery area. This sheet provides you with detailed information regarding complications, side effects, restrictions and when to contact the Pain Medicine Center or seek immediate treatment at the Emergency Room. A follow up appointment will also be scheduled for you prior to discharge from the Recovery Room.
There are NO GUARANTEES that this injection, or any other type of treatment, will relieve your pain