A 45 year old lady presented to the Pain Clinic with Sciatica- like symptoms, including intermittent shooting pain travelling down the back of her right leg several times a day. She also complained of pain in the middle of the right buttock.
On examination of the spine there was a full range of movement. On palpation of the buttock- the centre of the pain a small, extremely tender spot was palpated. On palpation the symptoms of shooting pains, as described above were reproduced.
On A diagnosis of Piriformis Syndrome was made- classically described as sciatica- like symptoms with buttock pain in the absence of lower back pain. On The lady was given a choice of Acupuncture or local injection of local anaesthetic. On She chose the injection. This was performed using an aseptic technique. The tender piriformis muscle was identified and injected with a mixture of local anaesthetic and hydrocortisone. On At 4 weeks the lady was reviewed and the symptoms had completely resolved.