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Treatment for piriformus muscle
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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_m_tn
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?1342559764
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?1342559764
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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Avatar_m_tn
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?1342559764
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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Avatar_m_tn
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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