Piriformis Injection

What is a Piriformis Injection?

A piriformis injection is a targeted injection of anesthetic and steroid medication into the piriformis muscle to diagnose or treat piriformis syndrome—a condition where the muscle compresses or irritates the sciatic nerve, causing buttock pain, and sometimes sciatica-like symptoms down the leg.

What are the benefits of a Piriformis Injection?

A piriformis injection is used to diagnose and treat pain related to the piriformis muscle (which is located in the buttocks), particularly when it compresses or irritates the sciatic nerve—a condition known as piriformis syndrome.

Common Indications:
– Piriformis syndrome
Buttock pain worsened by sitting, walking, or hip rotation
Sciatica symptoms not explained by lumbar spine imaging
Diagnostic clarification between lumbar vs. peripheral nerve source of pain

How does a Piriformis Injection work?

A piriformis injection is a targeted injection to the piriformis muscle, meant to target lower back/buttock pain. It is performed using one or two medications, depending on the goals of the injection.
When used for diagnostic (test) goals only, the piriformis muscle is injected with an anesthetic (numbing medication) to help identify immediate pain relief and validate the piriformis muscle as the source of the patient’s pain.
When used for diagnostic and therapeutic goals, the piriformis muscle is injected with an anesthetic as well as a steroid medication, to help reduce inflammation in the muscle, which may help relieve pain for more extended period of time.

How to prepare for a Piriformis Injection?

The first step to determine your eligibility to receive a piriformis injection is to perform a thorough physical examination and carefully consider your medical and family history.

-Blood thinners (e.g., aspirin, Plavix, Eliquis, warfarin):
You will NOT need to stop them before the procedure
-Diabetes
Steroids can temporarily raise blood sugar levels. Adjustments may be needed.
– Medical Clearance (if needed)
If you have heart conditions, bleeding disorders, or infections, your provider may require clearance from your primary doctor or specialist.

What to expect after the procedure?

Piriformis injections are usually performed in under 20 minutes with the patient’s ability to go home the same day after a short recovery period.

When using diagnostic testing of the piriformis muscle with numbing medication, the expectation is to get temporary relief from pain that only lasts for a day or so. Once this injection is performed, we want you to engae in physical activity to test if it was helpful. This confirms that the muscle is the source of pain.

When using diagnostic and therapeutic testing of the piriformis muscle with numbing and steroid medication, the above still applies. In addition, it can take 2 to 3 days for the steroids to take effect and provide long-term relief.