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1: Am J Phys Med Rehabil. 2002 Dec;81(12):936-42. Links

BOTOX and physical therapy in the treatment of piriformis syndrome.

Fishman LM, Anderson C, Rosner B.

Columbia College of Physicians and Surgeons, New York Flushing Hospital of Queens, New York, NY 10028, USA.

OBJECTIVE: This study evaluates the efficacy of botulinum toxin A injections used in conjunction with physical therapy for the treatment of piriformis syndrome. DESIGN: This a double-blind, placebo controlled clinical trial using electrophysiologic criteria for patient selection and a visual analog scale to assess treatment efficacy in relieving pain. RESULTS: As measured on the visual analog scale, patients injected with botulinum toxin A experienced more relief from pain than patients receiving lidocaine with steroid (P < 0.05) and more relief than patients receiving placebo (P = 0.001). CONCLUSIONS: Injection with botulinum toxin A is an effective adjunct to physical therapy in the treatment of piriformis syndrome. H-reflex prolongation by flexion, adduction, and internal rotation (FAIR test) beyond 1.86 msec (3 SD) of the mean is a clinical indication of piriformis syndrome.

PMID: 12447093 [PubMed - indexed for MEDLINE]

Patient Drug Information

  • Botulinum Toxin Type A Injection (Botox® , Botox Cosmetic® )

    Botulinum toxin type A injection (Botox) is used to relieve the symptoms of cervical dystonia (spasmodic torticollis; uncontrollable tightening of the neck muscles that may cause neck pain and abnormal head positions), s...

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