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Pain in the butt- Injections?

Lala329LLala329 Posts: 283
Hi guys,

My questions is this: I've got an S1 radiculopathy caused by a tarlov cyst on the nerve root. A month ago my primary complaint was hamstring cramping, but now it seems to be affecting the gluteal muscles more than the hamstring. There seems to be some piriformis involvement (but it is not a "piriformis syndrome" because the nerve root irritation is causing the piriformis to cramp rather than the piriformis causing the nerve root irritation). I know for piriformis syndrome they can can inject the muscle to give relief. I was wondering if with a neurological cause there would be any benefit to trying either gluteal trigger point injections or a piriformis injection? Has anyone with radicular symptoms done any type of injections to help with the muscular pain? I'm not sure if there would be any lasting benefit since it wouldn't really correct the underlying nerve problem...Of course, this is something I'll ask my doctor about, but it helps to hear if you guys have tried anything like this.

I am currently in process of moving forward with scheduling a SCS trial, but we are hoping that maybe since the leg symptoms came on insidiously they might resolve enough to where I could possibly just need leads to cover my low back. My thought is maybe if the gluteal muscle pain can be treated with injections that might put me closer to not needing leg coverage with the SCS? My hamstring cramps have responded well to a muscle relaxer, and the burning pain down my leg has improved a little with oral steroids, so now I just need something for my butt muscle pain :)

P.S. Does anyone know the mechanism of action for why nerve root irritation causes muscle cramps? My guess is that erratic nerve impulses set off action potentials in the muscles causing them to fire and cramp?


  • I just had a lumbar epidural and SI and upper butt and hip nerve block and it helps with the sciatica and butt and leg pain. She injects the blocks where the sciatic nerve runs along in the muscle so in the butt it was in the muscle. My Dr. also increased Cymbalta to 120mg day for nerve pain and I have less cramps and tingling.

    I know nerve root causes muscle contractions as there are motor nerves and sensory receptors that go along your spine and a compressed or irritated nerve keeps repeatably firing the motor nerve in turn causes a muscle reflex. http://www.spine-health.com/conditions/chronic-pain/anatomy-nerve-pain I hope the injections would help you as they have me. Best wishes if you do the trial after the injections. How long are you out of surgery? Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hi Lala,

    On a few times in the past when I had bad sciatic flares, I was given trigger point injections in the butt. It does take about 2-3 days for them to begin working, but they did help some. I was also given percoset & muscle relaxers when I had these flares, so there is a good chance it was the combination of meds that helped. Please keep us posted and hope today is better for you pain wise.

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