The piriformis muscle lies deep in the buttock and runs from the sacrum to the hip. The sciatic nerve passes either under or through this muscle. When the piriformis or other deep gluteal muscles become tight, inflamed, or hypertrophied, they can compress the sciatic nerve â a condition known as piriformis syndrome or part of the deep gluteal syndrome spectrum.
Under ultrasound or fluoroscopic guidance, your consultant inserts a fine needle into the targeted muscle or fascial plane. The injection may contain:
Local anaesthetic and corticosteroid: to reduce inflammation and provide temporary pain relief
Botulinum toxin (Botox): in selected cases, to reduce sustained muscle tension or spasm contributing to nerve compression
Botulinum toxin acts by temporarily relaxing the muscle, allowing the sciatic nerve to move more freely and reducing irritation.
The treatment may also help clarify whether the pain is muscular or nerve-related.
The treatment may also help clarify whether the pain is muscular or nerve-related.
This is an outpatient procedure, typically lasting 20â30 minutes. Youâll lie on your stomach while the skin is cleaned and numbed. Your consultant uses ultrasound or X-ray guidance to place the needle precisely into the piriformis or relevant deep gluteal muscle.
The injection itself is usually well tolerated. If botulinum toxin is used, the full benefit may take a few weeks to develop. Patients go home the same day and are advised to rest briefly before gradually increasing activity as guided.
Results vary between individuals and cannot be guaranteed. Your consultant will discuss whether this procedure is appropriate for you.
At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.
Driving advice: You should not drive that day if receiving any sedation. Our procedures do vary on whether they are possible to drive home from yourself, please seek advice from your consultant about driving advice. If you are seeing us for an injection and planning on driving, please check with us beforehand about whether it will be possible to drive yourself home afterwards.
Wessex Pain Clinic provides consultant-led assessment and treatment for acute and chronic pain conditions. Our multidisciplinary team includes Consultant Pain Specialists, Physiotherapists and Psychologists, offering evidence-based interventions alongside rehabilitation and self-management support. We welcome patients from across Hampshire, Dorset, Wiltshire, Surrey and Sussex, including Winchester, Basingstoke, Southampton, Portsmouth, and Chichester â with both in-clinic appointments and remote consultations available across the wider Wessex region.
Our friendly team is on hand to support you every step of the way. Please get in touch at any time.
