Hi
This is quite a long thread - sorry. I'm a sports massage therapist and I have a client with persistent piriformis syndrome and it's making her life miserable. I can help using trigger points but it only lasts for a week or so.
In a joke she asked if she could have botox in her bottom to stop the muscle contracting and I obviously said no but then I thought -I shouldn't say no as I know nothing about how botox works.
Is there anyone on the site that understands the drug and if it could be used for deep muscles? I know it's used for sweating and other ailments. Any info or links would be very welcome.
Thank you
lin
Hi Lin,
I don't know anything about botox, but have you tried piriformis METs?
Myarka
Hi Myarka, I've tried every trick in my book, MET end Trigger point is the mainstay but nothing seems to hold. I met the client at a training course (I'm training as a counsellor) and by then the hospital had signed her off as disabled with piriformis syndrome - I'd never heard of anything like it. They said all they could do was pain management! She'd been like it a couple of years by the time I started treating her - sometimes she couldn't walk for days on end. I've got her mobile but not pain free. She's good about her stretches and really works at it but for some reason within a week of treating her piriformis tightens up really badly. The sciatic nerve isn't running through the muscle (the MRI confirmed normal structure)so there isn't nerve damage it's just the muscle constantly going into spasm. I think she's going to try western acupuncture (dry needling) next. I can't believe they can't somehow find a way to "freeze" this muscle for good. Any suggestions would be welcome.
Hi Lin,
I'm new to remedial massage and don't have the depth of experience to treat the problem.
You could try dropping Biggaz a PM and see what he recommends, his profile is:
https://www.healthypages.co.uk/forum/member.php?u=6381
Myarka.
Hi LIn,
If you have tried the MET and trigger point route I would definitely be looking at myofascail release or peripheral joint mobilisations ( sometimes referred to as Maitland Mobilisations)
I have had success with each modality and a colleague recently told me that the mobs helped when the myofascial didnt.
The bottom line is the piriformis will be painful if is stays in a shortened position ( usuallycommon in larger clients who turn their feet out for increased base of support, ie their feet are not pointing in the direction they are walking in) It needs to be able to move thru its full range, simple exercises can help, I will try and find a link but you could visit the ExRx site.
hope that helps
regards
BGFL
where is client based ?
Hi Lin,
A couple of years ago, I had an accident and badly hurt my neck, shoulder and upper back - for a while, I couldn't feel my right hand and fingers anymore - will keep this short but basically, I was advised to get Botox injections to help with the pain as nothing had worked before (pain killers, phyisio, etc)
The 1st injection helped a bit as I started to feel my hand again after 4 weeks.. 6 months later, I had a second injection and it didn't solve the problem fully but helped again in reducing the pain.
I had 3 injections in total and decided to stop as it was just hiding my pain partially but not fixing the real problem.
Since Botox is so expensive, the consutant was doing all the injections the same day, so I could chat with the other people there - some with MS, a few who had car crashes, etc
Let me know if you have questions
Lili