Piriformis Muscle Injection (Piriformis Syndrome)

What is Piriformis Syndrome?

Piriformis syndrome occurs when the piriformis muscle, a small muscle located deep in the buttock, irritates or compresses the sciatic nerve. This can lead to buttock pain, tenderness, and symptoms that may radiate down the back of the leg, often mimicking sciatica from the spine.

The condition may develop after injury, overuse, prolonged sitting, muscle imbalance, or biomechanical changes. Because symptoms can resemble lumbar spine disorders, careful evaluation is essential to ensure the correct diagnosis and treatment.

What is a Piriformis Muscle Injection?

A piriformis injection is a minimally invasive procedure used to reduce inflammation and relax the piriformis muscle. The injection typically contains a local anesthetic and anti-inflammatory medication delivered directly into the muscle to relieve irritation around the sciatic nerve.

At Resolution Spine & Joint, this procedure is performed using imaging guidance to ensure precise placement and maximize both safety and effectiveness.

Conditions Treated

Piriformis injections may help patients experiencing:

• Deep buttock pain or tenderness
• Sciatic-type pain radiating down the leg without clear spinal compression
• Pain worsened by sitting, walking, or climbing stairs
• Muscle spasm or tightness in the gluteal region
• Persistent symptoms despite physical therapy or medications

What to Expect During the Procedure

The procedure is typically completed in a short outpatient visit.

After positioning and sterile preparation, imaging guidance is used to identify the piriformis muscle. A small needle is then advanced into the muscle, and medication is delivered to reduce inflammation and muscle tension.

Most patients tolerate the procedure very well. The injection itself usually takes only a few minutes.

Recovery and Results

Some patients experience immediate temporary relief from the anesthetic, while the anti-inflammatory medication may provide longer-lasting improvement over several days.

Relief duration varies, but many patients experience meaningful reductions in buttock and leg pain, improved mobility, and better tolerance of sitting and activity. Injections can also support progress with physical therapy by reducing muscle guarding and nerve irritation.

Benefits of Piriformis Injection

• Targeted treatment of a common but often overlooked pain generator
• Minimally invasive with little downtime
• Helps confirm diagnosis while providing therapeutic relief
• Can improve participation in rehabilitation and stretching programs
• May reduce reliance on oral medications

Is This Procedure Right for You?

A piriformis injection may be appropriate if you have persistent buttock or sciatic-type pain that has not improved with conservative care, especially when spinal imaging does not fully explain your symptoms.

Our providers perform a comprehensive evaluation to distinguish piriformis syndrome from lumbar radiculopathy and other causes of nerve irritation, ensuring treatment is directed at the true source of pain.

Frequently Asked Questions

How do I know if my pain is piriformis syndrome or a pinched nerve in my back?

Piriformis syndrome often causes deep buttock pain that may radiate down the leg and worsen with sitting, climbing stairs, or prolonged activity. Lumbar radiculopathy more commonly involves back pain with nerve symptoms linked to spinal findings on imaging.

Because symptoms can overlap, a detailed physical exam and diagnostic imaging help determine the true source of irritation. In some cases, a piriformis injection can also serve as a diagnostic tool by confirming the muscle as the pain generator.

Is a piriformis injection painful?

Most patients tolerate the procedure very well. You may feel brief pressure or mild discomfort during the injection, but the procedure is quick and performed with imaging guidance for accuracy and comfort.

Temporary soreness at the injection site can occur but typically resolves within a few days.

How long does relief last?

Relief varies depending on the underlying cause and severity of muscle irritation. Some patients experience weeks to months of improvement, especially when injections are combined with stretching, strengthening, and physical therapy.

The injection can also help reduce muscle spasm enough to allow more effective rehabilitation.

How quickly will I feel relief?

The local anesthetic may provide temporary same-day relief, while the anti-inflammatory medication typically begins working within several days.

Gradual improvement over one to two weeks is common.

Are piriformis injections safe?

When performed with imaging guidance by experienced providers, piriformis injections are considered safe and minimally invasive. Risks are uncommon but may include temporary soreness, bleeding, infection, or incomplete relief.

Your provider will review individual risks and benefits before the procedure.

Can this injection help with sciatica symptoms?

Yes. When sciatic nerve irritation is caused by compression or inflammation from the piriformis muscle rather than the spine, this injection can significantly reduce buttock and leg pain.

Proper diagnosis is key to achieving the best outcome.

Related Conditions and Treatments

Patients with piriformis syndrome may also benefit from evaluation for other overlapping pain generators. You may find these pages helpful:

• Lumbar Radiculopathy and Sciatica
• Sacroiliac (SI) Joint Dysfunction
• Facet Joint Pain
• Gluteal Myofascial Pain
• Physical Therapy and Rehabilitation Options

References

Cleveland Clinic. (2022). Piriformis syndrome: Symptoms, causes and treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23495-piriformis-syndrome