Piriformis Muscle Injection
WHAT IS A PIRIFORMIS MUSCLE INJECTION?
The piriformis muscle, a pear-shaped muscle, attaches at the sacrum and greater trochanter (hip socket). A piriformis muscle injection involves injecting local anaesthetic and either steroid or botox into the muscle. Botox is used to prevent the piriformis muscle from spasming for up to 3 months, while steroids are injected to reduce inflammation, irritation, and swelling around the muscle.
HOW IS THE PROCEDURE PERFORMED?
During your procedure, an anaesthetist will provide intravenous sedation for relaxation. This minimally invasive process is conducted in a hospital theatre or day procedure centre with specialised imaging guidance, enabling your doctor to safely position a needle near the nerves supplying the piriformis muscle. They will then administer a small amount of local anaesthetic and either steroid or botox for the treatment.
HOW LONG DOES THE EFFECT LAST?
Botox is designed to stop the piriformis muscle from spasming for a period of up to 3 months.
WHAT SHOULD BE DONE BEFORE THE PROCEDURE?
Prior to the procedure, you may need to stop blood thinning products as directed by your doctor. Other regular medications can be taken with a sip of water on the morning of the procedure. Insulin-dependent diabetics will likely be prioritised on the list and should bring their insulin for potential administration after the procedure. Hospital staff will call you the day before the procedure to provide fasting and admission times. DO NOT eat, drink, smoke, or chew gum before the procedure. Arrange for someone to drive you home afterward, as you won’t be able to drive for 24 hours due to the received anaesthesia.
WHAT IS THE NEXT STEP AFTER THE PROCEDURE?
After the procedure, you will spend a short time in the recovery ward before being discharged home. For the first 24 hours, gentle activity and rest are recommended, with a possible return to normal activity unless advised otherwise by your doctor or physiotherapist. The local anaesthetic wears off after 12 to 18 hours, and the steroid may take 3 to 5 days to start working, potentially causing an increase in pain and discomfort during this period. Botox will take approximately 5 days to start working and may lead to pain at the injection site. You can shower 24 hours after the procedure. If leg heaviness/weakness occurs, you may need to stay overnight in the hospital until it resolves and it is safe to be discharged. If you feel well enough, you may return to work the day after the procedure.
WHAT ARE THE RISKS AND SIDE EFFECTS?
Serious side effects and complications are rare. The most common problem after the procedure is having pain in the area of the procedure for 1 to 3 weeks. Please contact your local GP or the rooms if you have any allergic reaction to the medication administered in hospital, signs of infection at your procedure site.