Guest guest Posted August 3, 2006 Report Share Posted August 3, 2006 Hi Bonnie, My pain management doctor also recommended a botox injection into my piriformis muscle. Unfortunately for me, my health insurance company would not cover it, labeling it an experimental procedure (although they did cover a steroid injection into the piriformis). For me, the out of pocket expense would have been about $1000. I never did have it done. A few months later, I had all of my hardware removed, and the reason for the botox injection disappeared. My piriformis stopped spasming as soon as the hardware was removed. Carol from Chicago Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2006 Report Share Posted August 3, 2006 Hi Bonnie... I have heard of them being recommended. Unfortunately, I’ve also heard that most insurance companies balk at paying for them. Regards, On 8/3/06 3:02 PM, " Bonnie " <bonnie@...> wrote: Hi All, A new PT told me today that my piriformis muscle on the right side is the tightest he's ever seen and highly recommends I get a botox shot directly into the muscle. My pain doc, who would do the injection, had earlier said that botox is something we can try. So, my question is, is anyone familiar with botox injections in the piriformis joint? I'm interested in whatever you know. (My goodness, I can almost hear the jokes already! And, no, I would not otherwise need a botox shot in my butt and despite my age, my butt is not terribly old looking! And, yes, this would be my first botox shot!) Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2006 Report Share Posted August 3, 2006 Hi Carol from Chicago, Thank you. This is important information. I'll let you know my outcome with this issue. Is the piriformis problem the reason you had your hardware removed? Who did your surgery and who removed the hardware? How else did the hardware removal effect you? Anybody? Bonnie Re: [ ] Piriformis; Botox Hi Bonnie, My pain management doctor also recommended a botox injection into my piriformis muscle. Unfortunately for me, my health insurance company would not cover it, labeling it an experimental procedure (although they did cover a steroid injection into the piriformis). For me, the out of pocket expense would have been about $1000. I never did have it done. A few months later, I had all of my hardware removed, and the reason for the botox injection disappeared. My piriformis stopped spasming as soon as the hardware was removed. Carol from Chicago Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2006 Report Share Posted August 3, 2006 Bonnie, I recall someone from the " old " group....(no pun intended)....had good luck with the botox. I am thinking it was Beth Bunce perhaps. Anyway, I was very interested in trying it...but then after I signed up for the revision I figured I would wait and see what that did. Does the doc think the piriformis is spasming or just tight? I bet it will work a miracle. I don't think there is much of a " downside " if my memory serves me from my research....except an outlay of buckeroos, of course! Let us know what you decide. Take Care, Cam Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2006 Report Share Posted August 4, 2006 Hi Bonnie, The piriformis problem was part of the reason I had my hardware removed. It had been spasming for almost a year without resolving, despite all my efforts. I was also having weird spasms in my thighs and lower back, all new areas. These spasms were getting worse, and no matter what I did, I could not resolve them through stretching, muscle relaxers, steroid injections. My surgeon was not the one who brought up the hardware removal - I must emphasize that. I brought it up and then he explained that some people have an ultra-sensitivity to the hardware, etc. I've had the same surgeon for all my surgeries - Dr. Hammerberg at Rush University Medical Center in Chicago. When he did the removal surgery, he found there was a reason for the spasms - I had developed this "sticky inflammation" on the wires wrapped around my lamina. This inflammatory response is rare, though. The biggest challenge that I have faced with the hardware removal is the "re-education" of my muscles. It has been a bigger challenge than I expected but it is coming along, with the help of physical therapy, and a lot of work on my part! I am very glad I had the hardware out, and especially glad that my surgeon listened so carefully to all my complaints. I have not had any of those weird spasms, including the piriformis, since the hardware came out! Carol in Chicago Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2006 Report Share Posted August 4, 2006 Hi Carol in Chicago, Cam, Thanks. This information is very helpful to me. But, I have more questions. :-) Carol, how long after your last surgery did you have the hardware removed? Were you told of any downsides to removal of your hardware? And what do you mean by having to "re-educate" your muscles? I mean, why do your muscles need re-education? And what kind of PT are you having? My piriformis is not in spasm. It's just as tight as could be and inflamed. And I can't take anti-inflammatories. Whenever the therapists do anything to loosen it up, well, it tightens right back up. They can feel it. And I stretch many times a day. I need to have something done. If this could be fixed, I would be pain free. Right now, the only help I get is lying down and, I have found some relief with ThermaCare heatwraps, found at most drugstores as well as Costco. I use the size they call "neck to arm wraps", cut off half the tape on one side, apply that side very near the spine and the other side goes over to my hip. It feels good. It gets expensive, though, to use them on a daily basis. And I take oxycontin, 10mg 2x day. And cymbalta for nerve pain. They think my sciatic nerve is entwined in the piriformis muscle. I feel like I've won the battle with my revision surgery, but lost the war, as the saying goes, all because of this darn muscle. It is very painful and debilitating. Bonnie Re: [ ] Piriformis; Botox Hi Bonnie, The piriformis problem was part of the reason I had my hardware removed. It had been spasming for almost a year without resolving, despite all my efforts. I was also having weird spasms in my thighs and lower back, all new areas. These spasms were getting worse, and no matter what I did, I could not resolve them through stretching, muscle relaxers, steroid injections. My surgeon was not the one who brought up the hardware removal - I must emphasize that. I brought it up and then he explained that some people have an ultra-sensitivity to the hardware, etc. I've had the same surgeon for all my surgeries - Dr. Hammerberg at Rush University Medical Center in Chicago. When he did the removal surgery, he found there was a reason for the spasms - I had developed this "sticky inflammation" on the wires wrapped around my lamina. This inflammatory response is rare, though. The biggest challenge that I have faced with the hardware removal is the "re-education" of my muscles. It has been a bigger challenge than I expected but it is coming along, with the help of physical therapy, and a lot of work on my part! I am very glad I had the hardware out, and especially glad that my surgeon listened so carefully to all my complaints. I have not had any of those weird spasms, including the piriformis, since the hardware came out! Carol in Chicago Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2006 Report Share Posted August 5, 2006 Bonnie, I know exactly the pain you speak of....it is awful. (I used frozen gel packs successfully....maybe could help keep your costs down in the meantime) If there is no " downside " ($$ aside)...why not try the botox and see where it gets you? It would confirm that it is the piriformis and not the SI joint right? Could the pain mgmt doc you see now do it for you? Cam Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2006 Report Share Posted August 5, 2006 Hi Cam, Thanks for understanding, though I do wish for your sake that you had not been familiar with this pain! Yes, my pain doc would be the one to do the botox shot. I'm going to talk to his office tomorrow about arranging it. Bonnie [ ] Re: Piriformis; Botox Bonnie,I know exactly the pain you speak of....it is awful. (I used frozen gel packs successfully....maybe could help keep your costs down in the meantime)If there is no "downside"($$ aside)...why not try the botox and see where it gets you? It would confirm that it is the piriformis and not the SI joint right? Could the pain mgmt doc you see now do it for you?Cam Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2006 Report Share Posted August 5, 2006 Bonnie, I hope this shot hits the spot! Literally. kam Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2006 Report Share Posted August 6, 2006 Hi Bonnie, My initial fusion surgery was in 1999, fused T10-L5. Fused to S1 in 2002, and iliac bolts out in 2003. Hardware removal in 2006. I was fully fused at the time of hardware removal; my surgeon was very sure of that, otherwise he would not have done the removal surgery. The only downside to the removal surgery was the need to "re-educate" my muscles, a phrase I now find wonderfully descriptive. You don't realize how much your muscles depend on the hardware until it's gone. My back felt very weak, unsupported, especially my upper back. This kind of surprised my surgeon and me as my fusion did not go very high. It manifested in a very fatigued kind of feeling. I couldn't stand upright to wash the dinner dishes, I had to prop myself up to do so, etc. Sleeping was also very difficult - I wound up drugging myself for many, many weeks to sleep, with a combination of flexeril and Ambien. I sleep on my side, and no matter how I propped myself with pillows, my body did not know how to "slump". This is very hard to describe in words. But I could feel my muscles trying to slump down while I was on my side, and it was very, very uncomfortable. It was like my muscles didn't know what to do with themselves. So I had to "teach" my muscles to do the work of the hardware. It was obvious to me that the hardware had made these muscles lazy, so I went to physical therapy to learn to strengthen them. Again, it's really hard to describe all of this. But being thin and small built, I could feel all of this going on in my body. The physical therapy had two goals; 1), to work out some areas of spasm, and 2), to strengthen. Having had piriformis problems for years, I fully appreciate the difficulties you are experiencing now with yours. I sincerely hope the botox injection will help you get out of your pain! Carol from Chicago Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2006 Report Share Posted August 7, 2006 Hi Bonnie, Cam, I’ve been reading your posts about Piriformis Syndrome – and I think I have it! Can you please tell me (sorry to ask you to repeat this) what your symptoms are/were? I have chronic tailbone pain that spreads down the backs of my legs (but it’s not quite as painful as the sciatica I had before my revision), as well as groin muscle pain and outer hip muscle pain. It all gets worse when I sit or walk. Thanks, Andy (Revision 2003/Boachie) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2006 Report Share Posted August 8, 2006 Carol from Chicago, My computers haven't worked for a few days, so I'm late in replying. Thank you. You have been a tremendous help!!! Re: [ ] Piriformis; Botox Hi Bonnie, My initial fusion surgery was in 1999, fused T10-L5. Fused to S1 in 2002, and iliac bolts out in 2003. Hardware removal in 2006. I was fully fused at the time of hardware removal; my surgeon was very sure of that, otherwise he would not have done the removal surgery. The only downside to the removal surgery was the need to "re-educate" my muscles, a phrase I now find wonderfully descriptive. You don't realize how much your muscles depend on the hardware until it's gone. My back felt very weak, unsupported, especially my upper back. This kind of surprised my surgeon and me as my fusion did not go very high. It manifested in a very fatigued kind of feeling. I couldn't stand upright to wash the dinner dishes, I had to prop myself up to do so, etc. Sleeping was also very difficult - I wound up drugging myself for many, many weeks to sleep, with a combination of flexeril and Ambien. I sleep on my side, and no matter how I propped myself with pillows, my body did not know how to "slump". This is very hard to describe in words. But I could feel my muscles trying to slump down while I was on my side, and it was very, very uncomfortable. It was like my muscles didn't know what to do with themselves. So I had to "teach" my muscles to do the work of the hardware. It was obvious to me that the hardware had made these muscles lazy, so I went to physical therapy to learn to strengthen them. Again, it's really hard to describe all of this. But being thin and small built, I could feel all of this going on in my body. The physical therapy had two goals; 1), to work out some areas of spasm, and 2), to strengthen. Having had piriformis problems for years, I fully appreciate the difficulties you are experiencing now with yours. I sincerely hope the botox injection will help you get out of your pain! Carol from Chicago Quote Link to comment Share on other sites More sharing options...
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