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Information on Botox and Piriformis Syndrome

Piriformis syndrome is a painful and uncomfortable myofacial pain condition in which the muscles of the buttocks, hips and pelvis are affected. This condition is not well understood, and recent reports of the use of Botox for relief of piriformis syndrome have raised questions about the effectiveness of this form of treatment. Botox is relatively well known for immobilizing muscles of the face and is commonly used by dermatologists to treat wrinkles and the natural signs of aging.

  1. About

    • Piriformis myofacial syndrome--also known as PMS--is not a well understood condition. According to Martin Childers DO, PHD of Wake Forest University Health Services, patients with this condition are commonly female and most often have recently suffered a fall in which their hips or buttocks have been injured. The pain may radiate from the hips and buttocks, down into the legs and even reach as far as the feet and toes.

    Botox

    • Dr. Childers has studied the various treatments available for the treatment of PMS. One of the treatments being examined for effectiveness is Botox, which is the trademark name of botulinum toxin, otherwise known as botulism. Botox has gained in popularity in a wide variety of uses besides dermatology, including the treatment of painful muscle conditions wherein immobilizing the muscles may provide pain relief.

    Negative Effects

    • Botox primarily works by blocking the nerve endings that stimulate pain that is felt in piriformis syndrome. As a result, there are rarely lethal effects from the doses of Botox that are injected when used for pain management in PMS. However, negative side effects can be present shortly after an injection. These include flu-like symptoms of muscle soreness, headaches, lightheadedness, dizziness, fever, chills and abdominal pain.

    Symptoms

    • The symptoms of piriformis myofacial pain include deep pain at the pressure point that is midway between the base of the spine and the length of the buttock. Dr. Childers states that this pain may be increased when the pressure point is touched or pressed down upon. Additionally, pain and tingling may radiate down from either leg and to the feet and toes. Tingling may feel like a burning sensation or as if the leg or foot were cold.

    Alternative Treatments

    • The use of Botox for piriformis syndrome is considered an off-label or FDA non-approved treatment plan. The more conservative approach to treatment of PMS is to use electrical stimulation of the muscles, injection of local anesthetics and/or steroids. For many individuals, these approaches may be more than adequate to address the pain of PMS. However, if these conservative approaches fail, using Botox for PMS pain may be a reasonable option.

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