Piriformis Steroid Injection

What is a piriformis steroid injection?

A piriformis steroid injection is an injection of a long lasting steroid into the piriformis muscle of your buttock. This muscle attaches to the side of the sacrum, which is the side, flat bone at the base of your spine just above your tailbone. Its main job is to rotate the leg outward, but is also helps to hold the hip in joint when it is bearing weight. Your sciatic nerve goes down the back of your leg and passes through or under this muscle. Tightness in the piriformis muscle can cause sciatica, which is pain down the back of the leg. There may also be pain symptoms in the hip and low back and even in the groin, genitals and rectum.

What is the purpose of a piriformis steroid injection?

The steroid medication injected will help reduce the inflammation and /or swelling around the nerves that pass near or through the piriformis muscle. This in turn may reduce your pain, numbness, tingling or other symptoms that may contribute to nerve inflammation, irritation or swelling.

How does the physician perform a piriformis steroid injection?

The doctor will have you lay on your least sore side with your knees bent toward your chest. He will examine you by pushing on your buttock to find the spot or trigger points that are the most painful. This is where the nerve and muscles are the most inflamed or tight. The most painful spot will be marked with an ink pen. An assistant will place a sticky electrode patch on your skin. A rubber-coated wire will be clipped onto this electrode patch. This wire is connected to a stimuplex electronic nerve stimulator and a second wire is attached to a special insulated needle. After cleansing the skin with an antiseptic solution, the skin is numbed with a local anesthetic. The doctor will insert the insulated needle into the piriformis muscle. A small electric current will pass through this needle into the muscle. You may feel a "thumping" sensation in the buttock muscle causing a rhythmic mild contraction of the muscle. This procedure will help the doctor find your most painful spot. The doctor will then inject the steroid and anesthetic into this area.

After the physician is finished with the injection, an assistant will clean the antiseptic from your skin and place a dressing on the injection site. The sticky electrode patch will be removed from your skin also. Ice may be applied to the injection area.

When can I eat and drink?

We ask that you not have anything to eat six hours prior to your appointment and nothing to drink three hours prior to your appointment. After the procedure is finished, you will be given something to drink. Crackers are available upon request. After you leave the Pain Medicine Clinic you may have a meal. You will then want to have your driver take you home so you can rest.

Will the piriformis steroid injection help me? If so, for how long?

It's difficult to predict. Time will tell if the injection will help. You may start to feel some relief within 3 to 7 days. The combination of heat prior to exercise, ice after exercise and stretching exercises will assist in your recovery. You may need follow-up appointments for piriformis steroid injections until your home therapy is effective. Physical therapy may be recommended to assist setting up a home care program for you.

What are the risks and side effects?

Generally speaking, this procedure is safe. However, with any procedure, there are risks. Some of the risks include temporary pain or infection and possible sciatic nerve block with temporary leg weakness. The physician will discuss these risks with you.