Nilgun- I have not had botox or surgery, so I can not
speak definitively. However, the "cycles" you describe
are quite similar to my experience. For 16 years, I
had sciatica. And every month, there would be three
days of unbearable pain, where I could barely get out
of bed. The pain was so bad I felt like cutting my leg
off or killing myself just to be released from the
pain. I would eat every drug I had & drink a bottle of
wine but it only dulled the pain a little.

In my case, the onset of the acute pain was ALWAYS
movement. I had moved the "wrong way" or did something
that set things off. The real frustrating part was I
could do something one day & I'd do the very same
thing the next day & I would be in agony.

Today, I know I was having massive muscle spams, which
were causing the sciatica. The spasms stemmed from the
pelvis being held in wrong positions by muscle spasm &
activated trigger points. It was a self-perpetuating
problem.

It was not until I got a long term program of
myeofascial therapy, muscle rebalancing & correcting
the position of the pelvis (Treatment for chronic SI
joint dysfunction) that the scaitica went away.

The botox is giving you relief because it prevents the
muscle from clamping down on the nerve. The fact you
still have pain despite the botox indicates to me
something else is causing your sciatica beside
piriformis spasm. What? - I don't know. Could be scar
tissue pressing on nerve or other muscles spasming &
pressing on the nerve. And the fact you have more pain
& immobility before your period also indicates to me
something other than the piriformis muscle is pressing
on the nerve.

Can you find an expert in pelvic pain to evaluate you?
They are very few & hard to find.

Once the muscles are in massive spasm, it seems to
take three days of bedrest before the muscle can start
to relax.

I can't really tell you what to do. At this point, I
think it is up to you to choose when you want to do
something (activity) knowing the pain and immobility
you will suffer afterwards. Recognize your pattern &
plan accordingly. Just knowing your pattern gives you
some control over the pain. Choose in advance what
activity is worth doing knowing the price you will pay
for doing it. You will feel like you have a little
control over the pain rather than the pain controlling
you & your life.




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