Piriformis syndrome can cause pain in the hip and buttock and may radiate down the back of your leg, called sciatica. This pain occurs due to compression of the sciatic nerve by the piriformis muscle. The cause of this occurrence varies and can include overuse and repetitive trauma to the muscle from sitting on hard surfaces or from training the muscle too hard. The piriformis muscle may become swollen, tight, and irritated, causing it to push on the sciatic nerve. Piriformis syndrome is a diagnosis of exclusion, meaning it is reached by the process of elimination. One helpful tool for this is a piriformis injection, which can be both diagnostic and therapeutic.
Piriformis injections are done in a clinic room. It is comprised of both a local anesthetic and a steroid medication and can be used for both diagnostic and therapeutic purposes. The anesthetic medication alleviates muscular pain rapidly while the steroid medicine reduces inflammation and can provide long lasting relief. The steroid medication can take 2-3 days up to a week to fully work. Ultrasound guidance is used to ensure that the medication is injected into the correct muscle.
The side effects are similar to that of all procedures and include: bleeding, infection, and nerve damage. The chance of this happening is very rare as the doctor uses ultrasound guidance to ensure he is in the correct location. Potential side effects to the steroid medication include high blood sugar, facial flushing, and difficulty falling asleep. This only lasts about a day.
Reduce procedural discomfort by applying ice for 15-20 minutes every 2-3 hours to reduce injection site swelling and irritation. NSAIDs and/or Tylenol are also recommended.