What is Piriformis Syndrome?
Symptoms of piriformis syndrome include:
- Irritation, swelling, or tightness of the piriformis muscle
- Compression of the sciatic nerve
- 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 helps:
Stabilize the hip joint
Lift and rotate the thigh away from the body
Walk, shift weight from one foot to another, and maintain balance
The piriformis muscle plays a role in nearly every motion of the hips and legs.
The sciatic nerve passes alongside or through the piriformis muscle, and down the back of the leg, and eventually branches off into smaller nerves in the feet. If the piriformis muscle is tightened or swollen, it can cause compression of the sciatic nerve.
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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
Once the patient arrives at the clinic and fills out the necessary paperwork, they will be instructed to lie on a table. A nurse will cleanse the injection site and cover it with a special sheet.
A physician will then use a special X-ray technique to view the area and apply a local anesthetic to numb the injection site.
The doctor may also inject contrast dye to help highlight the area on X-rays. Next, he or she will inject a steroid and numbing agent combination into the piriformis muscle.
The entire procedure is usually completed in 10 minutes. The patient remains awake throughout the procedure.
Potential Risks And Side Effects
Piriformis injections are relatively safe, with rare instances of complications. Possible side effects may include:
- Increased pain
- Bruising or bleeding at the injection site
- Nerve injury
- Allergic reaction to the medications used or contrast used
After The Procedure
Patients may feel soreness at the injection site for a few days after the injection. To help minimize soreness, patients 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.
Patients will experience pain relief once the steroid begins to work — within two weeks after the procedure. While patients wait for the steroid to begin working, they may take over-the-counter pain medications or muscle relaxants to treat pain during this period.
The duration of pain relief from a piriformis injection may be several months. However, this may differ from patient to patient.
If patients experience significant pain relief, they may have three to four steroid injections a year. However, if a patient doesn’t experience pain relief from the first injection, they may need to pursue other treatment options.
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