Piriformis Injections

A piriformis injection is done to treat pain in the buttock area caused by piriformis syndrome.

What is Piriformis Syndrome?

Piriformis syndrome is characterized by irritation, swelling, or tightness of the piriformis muscle. This may lead to compression of the sciatic nerve and pain, tingling, or numbness along the buttock and down the back of the leg and into the thigh.

The piriformis muscle is a flat, band-like muscle located in the buttock near the top of the hip joint that serves to stabilize the hip joint and lift and rotate the thigh away from the body. The muscle enables us to walk, shift our weight from one foot to another, and maintain balance. It is used in nearly every motion of the hips and legs.

The sciatic nerve passes alongside or through the piriformis muscle, down the back of the leg, and eventually branches off into smaller nerves in the feet.

Doctor explaining piriformis injection procedure to patient.

Digital illustration of sciatic nerve needing piriformis injection

Compression of the sciatic nerve can be caused by the constant pressure of a tightened or swollen piriformis muscle.

Benefits of a Piriformis Injection

Injury and twitching can cause the piriformis muscle to become irritated, swollen, and tight. It can then press upon the nearby sciatic nerve and cause hip and buttock pain that extends down the leg.

A piriformis injection can be done to treat this pain. During the procedure, the physician injects a steroid (or medication used to reduce swelling) into the piriformis muscle. This reduces swelling, decreases pressure on the nerves, and reduces pain. The effects of the injection may also allow the muscle to heal.

What to Expect During The Procedure

The patient will be instructed to lie on a table and the injection site will be cleansed and covered with a special sheet. Next, the physician will use a special X-ray to view the area and numb the injection site with a local anesthetic.

The doctor may inject contrast dye to help highlight the area on X-rays and go on to inject a steroid and numbing agent combination into the piriformis muscle.

The procedure usually takes no more than 10 minutes, and the patient remains awake the entire time.

Potential Risks And Side Effects

Complications from piriformis injections are rare. Possible side effects may include:

Infection
Nerve injury
Increased pain
Bruising or bleeding at the injection site
Allergic reaction to the medications used or contrast used

After The Procedure

For a few days after the procedure, the patient may feel sore at the injection site. The patient can apply an ice pack (wrapped in a towel) to the injection site for 15-20 minutes at least four times a day for several days to help minimize soreness.

A woman suffers from pain in the buttock

The patient may continue to experience pain until the steroid begins to work. This can take up to two weeks. The doctor may recommend over-the-counter pain medications or muscle relaxants to treat pain during this period.

Pain relief from a piriformis injection may last several months, but this may differ from patient to patient.

The patient may have three to four steroid injections a year, if the first injection delivers significant pain relief. However, if a patient doesn’t experience pain relief from the steroid, they’ll be introduced to other treatment options.