The piriformis muscle is found deep within the buttock (see the Anatomy) pages). It can cause a pain that may be similar in nature to sciatica as it can irritate the sciatic nerve.
Alternatively it may cause a pain deep within the buttock on sitting down. This procedure may be classed as both therapeutic and diagnostic. The substance injected is usually a combination of local anaesthetic and a low dose of steroid. The local anaesthetic is thought to give a rapid albeit often quite brief benefit whilst the steroid can take longer to work but is expected to provide longer relief. Sometimes this mix may be replaced with botulinum toxin – “botox”.
This has an action on the muscles themselves but is also thought to have a positive action on some of the chemical changes that are responsible for pain. It may be performed in conjunction with sacroiliac joint injections.
The procedure is similar to triggerpoint injections but is performed under x-ray guidance. The duration of benefit is variable although several months would be expected, and it can be repeated if it is felt to last long enough.
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