The lidocaine injection is first used as a diagnostic which will ensure that it is, in fact, the piriformis that is causing the pain. Once this is confirmed, the cortisone, dextrose, or botox injection, which is also mixed with lidocaine to numb the affected area, will help reduce the inflammation around the nerves that pass near or through the piriformis muscle.
This may reduce pain, numbness, tingling, or other symptoms that may contribute to the inflammation, irritation, and swelling of the affected nerves.
The severity of the injury as well as its duration and resistance to previous treatments will help the doctor decide whether cortisone, dextrose, or botox will be used to treat the patient’s pain. While cortisone is the standard injection used in most cases, if the patient has not found relief with this method, dextrose or botox may be more helpful.
Dextrose works much like cortisone when injected; it decreases inflammation and allows the body to repair itself.
Botox, however, paralyzes the affected nerves; this causes the nerves to relax and allows the surrounding tissue to heal. The use of botox to manage the symptoms of piriformis syndrome is relatively new but the procedure has recently been shown to provide a more prolonged period of relief than cortisone or dextrose injections in patients who have more severe and resistant cases.
The patient should begin to experience improvements within a few days of the injection but should be prepared for there to be a short period of pain after the lidocaine wears off and before the cortisone, dextrose or botox has begun to take effect.
Patients with diabetes should notify their doctor and monitor their blood sugar following the procedure as the injections can increase blood sugar.
Our office offers piriformis injections to patients suffering from piriformis syndrome.