The piriformis muscle is located in the lower buttock region; when this muscle impinges the sciatic nerve, it is called piriformis syndrome. The sciatic nerve branches out from the lumbar, or lower back, spine and passes through the piriformis muscle. Patients may experience pain in the lower limb area such as the buttock, thigh and leg, which are all connected to the sciatic nerve. Piriformis syndrome affects many different people such as athletes and patients who have undergone surgery in or near the area of the piriformis muscle. Sometimes the cause is idiopathic, or unknown. Piriformis injection can help with this pain.
How is Piriformis Injection Performed?
The piriformis injection is performed with a nerve stimulator under fluoroscopic guidance. After the area is anesthetized, a small needle with a stimulating tip is then passed onto the sciatic nerve at the level of the piriformis. The stimulating needle transmits an electrical signal that causes a nerve to fire. When the muscles in the sciatic distribution begin to twitch, it is confirmation that the sciatic nerve has been located. A steroid injection is then placed on the sciatic nerve to decrease inflammation on the sciatic nerve. The needle is then withdrawn and contrast dye is injected into the region, in order to outline the piriformis muscle. Some anesthetic and steroid are injected into the muscle to decrease the spasm of the muscle.
What should be expected?
A local anesthetic is used in the piriformis injection, so there is a chance that the muscles connected to the sciatic nerve can be weak or numb for a short period. Other risks include a small chance of soreness after the injection. As with any minimally-invasive pain relief procedure, there is the small risk of bleeding or hematoma, infection, and nerve damage. Most cases of piriformis syndrome may be treated without surgery. Treatment for piriformis syndrome focuses on trying to restore the normal pathway of the sciatic nerve through or around the muscle. Typical treatments for piriformis syndrome include: physical therapy, exercise and chiropractic manipulations.
If you need an evaluation or consultation, please contact us at (201) 729-0001 and ask for one of our specialists. Our conveniently located clinics are in West Orange, Aberdeen, Lyndhurst, and Fort Lee. We offer weekday and weekend appointments.