BOTOX and physical therapy in the treatment of piriformis syndrome.
OBJECTIVE
This study evaluates the efficacy of botulinum toxin A injections used in conjunction with physical therapy for the treatment of piriformis syndrome.


METHODS
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.
Fishman
Loren M
LM
Columbia College of Physicians and Surgeons, New York Flushing Hospital of Queens, New York, NY 10028, USA.
Anderson
Christopher
C
Rosner
Bernard
B
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006181:H-Reflex / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D026761:Physical Therapy Specialty / Q000379:methods*; D012585:Sciatica / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
D019274:Botulinum Toxins, Type A