Lumbar spine
Injection of the piriformis and iliopsoas muscles, trochanteric bursitis
The deep muscles of the lumbar and pelvic region and the greater trochanter bursa can be reached with an ultrasound-guided needle to treat referred pain and local inflammation.
How it is performed
Pain that radiates from the back down to the buttock, hip or groin does not always originate from the spine. The piriformis muscle can irritate the sciatic nerve, the iliopsoas tendon can become inflamed deep in front of the hip, and the greater trochanter region is a typical site of gluteal tendinopathy and bursitis. Ultrasound allows each of these structures to be reached with precision, avoiding vessels and nerves, and to deposit anaesthetic and anti-inflammatory medication there.
Who it is for
- Piriformis syndrome with buttock pain and pseudo-sciatica
- Groin pain from iliopsoas tendinopathy/bursitis
- Greater trochanteric pain syndrome (lateral hip pain, pain when lying on the side)
Recovery
You can walk immediately after the procedure. In the following days a targeted exercise programme is recommended, which strengthens and extends the benefit of the injection.
Conditions treated in this area: chronic low back pain, disc herniation and sciatica, sacroiliac joint pain, muscle tension and pain (paraspinal, piriformis).
Scientific evidence
Randomised studies show the effectiveness of ultrasound-guided piriformis injection in reducing pain and disability in piriformis syndrome. For greater trochanteric pain syndrome, meta-analyses indicate that injection provides rapid relief, while therapeutic exercise is key to long-term outcomes: the combined approach is the one recommended.
References on PubMed
- Efficacy of ultrasound-guided piriformis muscle corticosteroid injection versus extracorporeal shockwave therapy in patients with piriformis syndrome: A randomized controlled trial
Fu YS, Shih KS, et al. — J Formos Med Assoc, 2025 · PMID 40016058
- Effect of conservative treatment on greater trochanteric pain syndrome: a systematic review and network meta-analysis of randomized controlled trials
Wang SQ, Guo NY, et al. — J Orthop Surg Res, 2025 · PMID 39891188
- Conservative treatments for greater trochanteric pain syndrome: a systematic review
Barratt PA, Brookes N, et al. — Br J Sports Med, 2016 · PMID 27834675
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of injection of the piriformis and iliopsoas muscles, trochanteric bursitis?
It is an outpatient procedure performed with a thin needle under local anaesthesia and continuous ultrasound guidance, which makes it possible to see the needle, the target and the structures to avoid in real time. The most common issues are transient: pain or swelling for 24-48 hours, a small bruise. Joint infection is a rare event, prevented by sterile technique. In treatments with cortisone, facial flushing or a temporary rise in blood sugar may occur in diabetic patients. Personal risks and contraindications are assessed during the consultation.
How much does the injection of the piriformis and iliopsoas muscles, trochanteric bursitis cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "how long does the benefit last?" and "can I repeat it?". The answer depends on the diagnosis and the stage: some injections resolve the painful episode, others serve to open a window in which rehabilitation becomes effective. Experiences read in forums concern cases different from yours. During the consultation we review your imaging and I tell you frankly what to expect, how many sessions may be needed and when another approach is better.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.