An injection in the piriformis muscle is a simple and quick procedure that can be done either with or without fluoroscopy. If you experience fluoroscopy, you will lie on your stomach and an image is taken of your pelvic area. Between the hip and the sacrum lies the piriformis muscle. One this area is identified, a lateral view of the pelvis is taken and the needle is advanced to approximately the depth of the sacrum. Contrast is injected and the familiar piriformis pattern is seen. Steroid and local anesthetic are injected and the needle is removed. While the local anesthetic is active, you may experience dramatic pain relief, which can help your doctor diagnose piriformis syndrome. The steroid can take several days to reach full effect but usually provides more sustained relaxation of the piriformis muscle and pain relief.
Side effects of Piriformis Injections are rare and your physician will discuss them with you. You will be asked to sign a written consent prior to the procedure. Please make sure you fully understand the risks and benefits of any procedure prior to signing the consent form.
Piriformis Injections, as with most other procedures, are performed in our in-office fluoroscopy suite. X-ray is used for all injections. Intravenous sedation is typically not offered but a mild oral sedative may be offered, depending on your medical condition. You will not be able to drive following this procedure, so please make arrangements for transportation.
You may resume normal activities the day after the procedure, unless otherwise directed by your physician. It may take a week or more for you to feel relief. Typically a follow-up evaluation is scheduled two weeks from the date of the procedure, so that you can discuss your response to the injection with your physician.
Piriformis Injections can be a valuable diagnostic procedure when conservative therapy has failed. Please contact our office if you have additional questions regarding this procedure.
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Side effects of Pirifomis Injections
Side effects are rare, but fluid retention, insomnia, elevated blood sugar, bleeding, and infection have occurred. These side effects usually occur on patients taking strong anti-coagulants or blood thinners, or those with a high fever or an active infection. If you are diabetic, you will need to monitor your blood sugar before and after the procedure as steroid can cause blood sugar to rise. As long as a diabetic patient’s blood sugar is normal before the procedure and monitored after the procedure, the risk of a dangerously high blood sugar is low. Other less common risks include increased pain, kidney failure, bowel or bladder dysfunction, paralysis, and death. Your physician should be notified if you are taking medications such as Coumadin, Plavix, Ticlid, Lovenox, Aggrenox, Insulin, or Metformin. Your physician should also be made aware of any allergies you have, especially if you are allergic to iodine or contrast. Notify your physician immediately if you have concerns about your condition after the procedure.
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