Piriformis Injection

What is a Piriformis Injection?

A piriformis injection is actually an injection into the piriformis muscle to help relieve severe sciatica pain. A piriformis injection can help reduce inflammation, spasms, and pain.

Your sciatic muscle runs from your back down your leg, through the piriformis muscle. When the piriformis muscle gets irritated, inflamed, or constricted, it can cause back or leg pain often associated with sciatica.

A steroid medication can help reduce the inflammation and alleviate the pain. It’s injected into your piriformis muscle, with a small amount of contrast dye to insure the needle is in the correct location.

How is a piriformis injection performed?

First, you will lie on your abdomen on an x-ray table.

The doctor will numb an area of skin in the area of the piriformis muscle. Then, guided by an x-ray, he or she will:

  • Insert a thin needle into the piriformis muscle
  • Inject dye to confirm that medication is administered into the correct space
  • Inject a mixture of anesthetic (for temporary pain relief) and steroid (for longer term relief)

The medicines then spread in piriformis, thereby hopefully reducing nerve inflammation and pain.

Usually, the procedure takes less than 15 minutes and you can go home the same day.

How effective is a piriformis injection?

A piriformis injection can help severe sciatica pain from piriformis syndrome.



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Some patients report pain relief within 30 minutes after the injection, but pain may return a few hours later as the local anesthetic wears off. Longer-term relief usually begins in two to three days, once the steroid begins to work.

How long the pain relief lasts is different for each patient. For some, the relief lasts several months or longer. If the treatment works for you, you can have periodic injections to stay pain-free. The goal of this injection is to decrease acute pain to enable progress in physical therapy.

What are the risks?

The risk of a complication from a piriformis injection is very low. Rarely, complications include bleeding or infection at the injection site.

Your doctor will discuss with you further the risks and benefits associated with this procedure, as well as other treatment options.

These effects resolve within a few hours.

What happens after the procedure?

Do not drive or do any rigorous activity for 24 hours after your piriformis injection. Take it easy. You can return to your normal activities the next day.

You can continue your regular diet and medications immediately.

It may take up to a week for the steroid to begin working. If you don’t feel better within 10-14 days, see your doctor for additional evaluation and to discuss different treatment options.

Is piriformis injection right for you?

Piriformis injection may be right for you if your pain has lasted longer than four weeks, is severe, or has not improved with other treatments, such as physical therapy.