What is the role of injections in the workup and treatment of piriformis syndrome?

Updated: Dec 21, 2018
  • Author: Shishir Shah, DO; Chief Editor: Sherwin SW Ho, MD  more...
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  • Diagnostic injection of the piriformis syndrome trigger point is performed as follows:

    • Localize the pain at the sciatic notch, transvaginally or transrectally.

    • Draw 5-7 mL of 2.5% lidocaine or bupivacaine into a 10-mL syringe with a 27-gauge needle.

    • Prepare a sterile field and apply Betadine over the trigger-point area.

    • Inject the anesthetic after aspirating to confirm that the needle is not in a vascular bundle.

    • Remove the needle, and apply pressure to the area to ensure hemostasis.

    • Allow the patient to ambulate and to abduct and externally rotate the affected leg.

    • If the pain subsides, the likely cause of the pain is piriformis syndrome.

    • This procedure is both therapeutic and diagnostic.

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