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3112530 tn?1434035633
Treatment for piriformus muscle
Recently I had an injection to the piriformis muscle with a Botox injection and it seemed to help. How come there is not more information about this and what is the current treatment for problems with the piriformis muscle? Can anyone please advise? Thank you for your time,.
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Avatar universal
Piriformis syndrome is a disorder that occurs when the sciatic nerve is compressed by the piriformis muscle causing pain in the buttocks and along the path of the sciatic nerve descending down the the leg.

Runners, bicyclists and other athletes engaging in forward-moving activities are particularly susceptible to developing piriformis syndrome if they do not engage in stretching and strengthening exercises. Repeated forward movements can lead to disproportionately weak hip abductors and tight adductors.Thus, disproportionately weak hip abductors, combined with very tight adductor muscles, can cause the piriformis muscle to shorten and severely contract.

I recommend physical therapy, including the teaching of stretching techniques, massage, and strengthening of the hip abductors, as well as, the core muscles (abdominals, back, etc.) to reduce strain on the piriformis. Patients may also find relief from ice. Ice can be helpful when the pain starts, or immediately after an activity that causes pain. On the other hand, hot compress is advisable for chronic and recurrent pains.

I hope this information will help you.
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3112530 tn?1434035633
Now that I had the Botox injection I can go back to doing Pilates which has helped at one time. I am walking for the first time in years.
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3112530 tn?1434035633
I understand what you are saying but I have had this issue for years. The exercise on increased when I tried stretching. I had been doing Pilates but I have also had many physical therapy sessions including pool therapy and so much more. Nothing helped. This had been going on for years when one of my doctors mentioned the piriformis muscle. I have had nerve blocks, steroid injections and so much more but nothing helped until they pin pointed this area. I had to fight with my pain management dr. to get this treatment, all she would do is refill my morphine but the drugs do no good when it come to the nerve. I have had fentanyl patches, morphine and so much more but that does not work on the nerve pain. The drugs only work on the brains perception of pain and I wound up with pancreatic side effects from all the pain medication. Once I got this Botox injection, and started exercising again because there was limited pain, most of the pain issues calmed down and I was able to exercise again better this time.
Is It my imagination that the Botox injection worked? Do you have any information on Botox working on the piriformis muscle? Appreciate any medical information you can offer.
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The Botox injection works by preventing the motor nerve and the muscle communicating so the nerve does not send any pain signals to the brain.

Botox should only be use as secondary treatment, where the condition does not respond well to conventional treatment.  This is not because it is unsafe, but a lesser known fact about the use of Botox to treat piriformis syndrome, is that the muscle will never fully regain all its strength. Usually patients will find that it is around 90% as strong as it was prior to the treatment, after a year or so, but it will never be fully restored.

The pain is a symptom that something is wrong and it is important to treat the cause of the pain, rather than the symptom.  If Botox is used, but no stretching or physiotherapy is undertaken, when the Botox wears off the pain will still be there because the piriformis muscle is still contracted. So for this reason, Botox should be viewed as simply one half of the story; it is really only effective with physiotherapy.

I hope this information helps answer your concerns.  Take care!



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3112530 tn?1434035633
Thank you for the information. Please understand, I have had many, many injections and treatment including experimental treatments. Nothing has helped this piriformis muscle, including physical therapy. After two weeks, my physical therapist would freak out and send me back to my doctor. I have tried every treatment imaginable. This pain has been going on for years with no end in site.
The botox injections has calmed down the pain to a manageable level. The pain is almost non-existent. I am doing stretching exercises including walking daily which I could not do before. What ever the trick was, it worked for me.
Thanks for the info.
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You're welcome! Just continue engaging in a general stretching program that includes the bilateral piriformis muscles to prevent recurrence of pain.  Take care!
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What kind of Dr do you go to for the Botox injections for Piriformis Syndrome? My mom has this and I think she will benefit from the Botox injection from what I've read.
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3112530 tn?1434035633
I originally went to a sport medicine doctor. Now the VA is treating me but only because they have recognized this symptom. I got for another Botox injection in October. The VA has come a long way in this area but I had to go to many a doctor to get this diagnosed. Check on line, that is how I found the sports medicine doctor.
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3112530 tn?1434035633
More and more doctors are recognizing this 'piriformis syndrome' along with failed back surgery and new diagnosis in the medical field. Check you symptom on line and then look for a doctor that treats this symptom. He/she will want a full medical history and my case is the exception some what. I have had this for years but not to many doctors knew how to treat these symptoms besides drugs. RFA's (radio frequency obliteratuion is a continued treatment I receive but the Botox injections help keep the pain at a minimum. Research before you jump. There are many related symptoms that could be the cause of something else.
Scar tissue is one area of interest. Because of my prior surgeries, I am limited on what can be done to my back. This scar tissue is common with major surgery but check into all possibilities before commitment. The more YOU are educated, the more You are in control of what happens!
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I have had worsening sciatica for about 1 year now. I initially had been diagnosed with piriformis syndrome and had a piriformis steroid injection that didn't help. Because it did not help I was given an epidural injection. I have done PT and accupuncture to no avail. I feel my symptoms are more consistent with piriformis, worse with sitting and ascending. I am unable to sit for long periods or walk for prolonged periods. Did you have a steriod piriformis injection before your botox and did it help? Also how did they do your botox injection, under ultrasound, MRI or another way? Did you have any side effects?
Sandy
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3112530 tn?1434035633
Wish I could answer your question. I have had so many treatments but the only thing that worked for me was an Radio Frequency Ablation. (burning the nerve) Any other treatments were only temporary and never really did any good.
The Botox treatment was something the doctor lied about I found out later. They were steroid injections which a person with DJD/DDD is not supposed to have. Doctor who have me these treatment never really explained to me what they were. He lied to me and after obtaining a copy of my medical records, I found out the truth. So did Medicare!
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3112530 tn?1434035633
For informational purposes.
With all the treatments I have received and insisted on a Botox injection, I found a sports doctors who advertised that he does Botox injections of which I asked for one.
I found out after reading all my charts that I was NOT given and Botox injection but steroid injections. But the doctor insisted they were Botox injections and would not discuss anything further with me. This happened on more than one occasion because he asked me to return for many more visits (which naturally was a billing advantage for him).
I kept asking why the Botox injection was not working because I still had pain. His answer was that I needed more treatments and then the Botox injection would kick in. After thinking all this information over and looking at the way he handled me with a lack of personal care to give me the information I wanted, (I always had to pull information out of him), I finally quit him and reported him to the insurance company.
I felt he was lying to me and did not give me the treatment I requested so I left the rest up to the insurance company.
Still looking for a doctor to do a botox injection????
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