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Piriformis Muscle Injection

Piriformis muscle injections provide diagnostic information and therapeutic relief for those suffering with piriformis syndrome. Common conditions for which this procedure is used include piriformis muscle spasm and inflammation.

Arriving at the diagnosis of piriformis muscle injection requires a thorough history, physical exam, and the exclusion of more common diagnoses, including lumbar stenosis, lumbar radiculopathy, lumbar facet joint arthritis, sacroiliac (SI) joint dysfunction, trochanteric bursitis, and myofascial pain syndrome. 

Treatment for piriformis syndrome includes physical therapy, non-steroidal anti-inflammatory medications, analgesics, and muscle relaxants. Leg length discrepancies and abnormal biomechanics and posture should be corrected. If these therapies are unsuccessful, you may be a candidate for an injection of steroid into the muscle. Surgery may be an option if there is a documented abnormality of the piriformis muscle. 

How It Works

To help ensure safety and accuracy, piriformis muscle injections are performed under live fluoroscopic guidance. 

  • You will be asked to lay on your stomach. 
  • Your back and buttock area will be cleaned with an antiseptic, and a sterile drape will be placed.  
  • Your JLR Center for Pain Medicine physician will inject a numbing medication (local anesthetic) to numb the skin overlying the buttock area. 
  • Then, a needle will be guided into your piriformis muscle. 
  • Contrast dye will be injected to outline the muscle. 
  • Then, steroids will be injected into the muscle to decrease inflammation of this muscle. 
  • Finally, the needle will be removed, and a sterile dressing will be applied.

Risks

Potential risks — although very low — include infection, bleeding, allergic reaction, and prolonged increases in pain. Your JLR Center for Pain Medicine physician will use sterile techniques and x-ray guidance throughout the procedure reduce the risks and nerve damage.