Piriformis Injections

What is a Piriformis Steroid Injection?

A piriformis steroid injection pertains to the administration of a local anesthetic—usually lidocaine or bupivacaine—and a steroid into the muscle of your buttock. The piriformis muscle is attached to the sacrum, a flat bone located just above the tail bone. This muscle responsible for rotating the hips, legs, and feet as well as holding the hip in joint when it bears weight. Tightness of this muscle can result in sciatica, pain which radiates down the back of the leg. Symptoms of pain can exist in the lower back and hip regions along with the rectum, genitals, and the groin.

 

What is the purpose of a piriformis steroid injection?

The medication used for a piriformis steroid injection helps to reduce inflammation and swelling in the nerves that surround the muscle. This in turn reduces symptoms associated with inflammation, swelling, or irritation of the nerves e.g. pain, tingling, numbness, etc.

 

How is a piriformis steroid injection performed?

This procedure takes approximately 30 minutes to do. The doctor will have you lay on the examination table with your knees bent towards your chest. The skin on your back will then be cleaned with an antiseptic cleanser and a sterile drape will be applied to isolate the region. The doctor will be using the guidance of a special X-Ray machine, fluoroscopy, throughout the procedure to determine where exactly he will administer the injection. He may also choose to push at different locations on your buttock in order to find the area(s) that are most, as it can further signify the region that contains the most inflamed or tight nerves and muscles.

The area where the injection will be inserted will be injected with a local anesthetic, and then doctor will use the X-Ray machine once again to guide the needle into the correct location. The medication will then be administered to the piriformis muscle. The skin will be cleansed after the needle is removed and a band-aid dressing will be applied.

 

What are the potential risks and side effects?

  • Temporary pain
  • Infection at the injection site
  • Temporary leg weakness
  • Possible sciatic nerve block
  • Dizziness during or soon after the injection
  • Nerve injury (rare)
  • Allergic reactions to the medications used
  • Increased fluid retention

*** For diabetic patients: The use of a steroid (an anti-inflammatory) can cause an increase in blood sugar levels up to two weeks after the procedure. You should check your sugar levels more often for a few days after the injection and adjust your diet accordingly.

 

For how long will a piriformis steroid injection help me?

Any immediate pain relief is likely due to the local anesthetic used during the procedure; however, more longer lasting relief can begin within 3 to 7 days after the injection. The best effects usually occur if stretching exercises are done during the recovery period, with heat used prior and ice used afterwards. For pain after the injection, you can apply ice for up to 15 minutes 3-4 times a day. Relief may last for a few days, months, or even years; this varies per individual. Depending on the circumstance, physical therapy and/or another round of injections may be recommended during your follow up appointment(s).

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