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ICD-9 code: 355.9 Piriformis syndrome (mononeuritis) CPT codes: 20552 Trigger point injections, 1-2 muscles 77002 Fluoroscopic guidance, non-spinal Remember to bill for the injectables (contrast, steroid) if done in an office procedure room Solution (injectable): Corticosteroids: 40-mg of Depo-Medrol or Kenalog Local anesthetics: 3-5-ml of local anesthetic (lidocaine or bupivacaine) Note: Can also be done with botulinum toxin (Botox, Myobloc, Dysport) for longer relief than steroid and local anesthetic

This got so bad I had to shut all the blinds and curtains in my entire house for weeks

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It is caused by repeated amplification of the CAG trinucleotide in the huntingtin (Htt) gene on the short arm of chromosome 4, which leads to a prolonged polyglutamine stretch at the N-terminus of the protein