Hi!

I have the privilege of having both steroids and botox injections into my
priformis muscle with fluorescence guided injection method in the pain clinic
here in Istanbul. I do not advice steroids at all. I had no benefit except the
lidocaine that is used with the steroids gives some temporary relief. They harm
your metabolism way more than the relief you get. Botox worked finally I do not
have piriformis syndrome anymore but I was injected 200 units which was too much
for me and it took a long time (one year) to get rid of the spasticity. It was a
very painful period as all the priformis syndrome is. Although my doctor is a
very experienced prof., I was his first piriformis patient so it was
experimental for him. I was too weak after the injection, I read about some
people having weakness for some time and the botox treatment papers also
describe more pain in the beginning because of spasticity therefore dose is very
important. It is reported maximum should be 100 units so the rest of the body
is not effected. Best is to start with 50 units and see how you are some report
they needed a second one after one year, but better to be safe. Spasticity of
the priformis muscle is not just painful it disturbs all your body, left side in
my case including shoulder and neck. And also you should be careful not lifting
heavy stuff etc. (like me) afterwards think of it like surgery and be patient
during healing time. In my experience I felt very weak and the pain was still
there so I was thinking it did not work. Botox denerves the muscle and new
nerves grow; healhy ones and it takes time. In my case it was too much botox all
my muscle was like not there and it was inflamed all the time. Finally when I
could sit down without tight sciatica altough I had other muscle pains I could
not believe it. I had a lot of massage and physical therapy, I am getting better
everyday. Theoretically I am fine now , I have upgraded to a sports salon from
medical exercise salon. Practically I am weaker than before, It is like I am a
different person for me because I get tired so quickly. You lose muscle strength
for sure. I read other peoples' experience with botox they all seem to think it
heals totally eventually. The problem is getting the muscle-skeleton working
mechanism back after long term piriformis syndrome. The longer you suffer PS the
longer time to heal...

According to www.nervemed.com people it is best to have just lidocaine
injections first; read their published paper they describe just lidocaine or
marcaine injections and it might be treated with least side effects. The paper
is about the piriformis muscle operatation, but describes injection treatment
first. I read it after I had the injections; when I thought it did not work and
I was searching my operation options. If I read it before I would have tried
just lidocaine injections before I went through with botox. No steroids please,
I had it because my doctor believed it was just inflammation, but it does not
treat tight piriformis, it might be even making it worse by hardening the
muscle.

All the research about botox is avaliable in the net, read it yourself and take
to your doctors if they want to inject steroids to you do not accept.

Good Luck,

Nilgun


----- Original Message -----
From: Jeanne Swack
To: piriformissyndrome@yahoogroups.com
Sent: Friday, September 08, 2006 1:15 AM
Subject: [Piriformis syndrome] piriformis


Dear group,
I am a woman post-fusion about 12 years, recently had my fusion hardware
removed. I am
seeing a physical therapist for what is evidently piriformis syndrome. So far
not much has
happened (essentially 3 sessions of ultrasound spaced out over about 5 weeks).
I'm waiting
(for months) for a return appointment to the pain clinic. I was just wondering
if someone can
supply a patient's view of injection treatments (either Botox or steroids).
Was it
uncomfortable, worth it, etc? I have had Botox treatments for spasm in neck.
Thanks.





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