How many botox vials for a piriformis?

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HerMajesty
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Joined: Sat Sep 18, 2010 12:41 am
Location: North Las Vegas, Nevada

How many botox vials for a piriformis?

Post by HerMajesty »

I got steroid injections to my piriformis a month ago and it madethe piriformis muscle worse, as evidenced by the fact that it made me more symptomatic in the pudendal and gave me sciatica which I did not have previously.
I really want to try botox...I have a friend who had piriformis syndrome (sciatic & hip pain), and had multiple steroid injections wth no effect, and was then improved dramatically by 1 botox injection. My Doc agreed to do the injection "as a technician" although he has not done botox to the piriformis before. He was speculating it would take at least 1 1/2 vials per muscle, if not more, due to the size of the piriformis muscle.
Well, we are still checking but chances are the insurance will not pay for the vials of botox. My friend got his results with ONE vial, and that cost $600. That was on one side, and I need it bilateral so I accept that I might need at least 2, one for each side. But I prefer not to pay for extra if it's really not needed. Does anyone know how many vials are standard for a piriformis, or can anyone working with a Doc who does these injections regularly, find this out for me? Thanks.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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Violet M
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Re: How many botox vials for a piriformis?

Post by Violet M »

HM, how many units are in a vial? I've heard you need 100 units into a muscle to be effective but I think some docs are reluctant to give that much.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
HerMajesty
Posts: 1134
Joined: Sat Sep 18, 2010 12:41 am
Location: North Las Vegas, Nevada

Re: How many botox vials for a piriformis?

Post by HerMajesty »

Violet, I am an RN, so I know I sound like a moron when I say "vial" instead of giving any idea of units, mg/ml, or whatever. However that is the way it keeps being expressed to me by numerous sources, so I had made the assumption that there is only a single standard dosage per vial available. I need to look into that more, and find out how many units per vial. I don' think my Doc is relucatant to give a large dose, because he kept talking about how the piriformis is a large muscle and would need a lot of the stuff. But we are trying to balance this with price as it is likely I will pay for the vials out of pocket. Thanks for the 100 units figure; I will have to work on learning more after I get the big news as to whether or not my insurance will buy botox for me.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
stellaortega
Posts: 1
Joined: Mon Jan 15, 2024 11:49 am

Re: How many botox vials for a piriformis?

Post by stellaortega »

So, you need to clearly understand how many Botox vials have units, as a standard, there are Botox vials 50iu, 100iu on sale https://fillercloud.com/product/botox/. There is also a Botox vial 200iu, but I haven't seen them on sale for a long time.
adelphos2
Posts: 12
Joined: Sat Jan 15, 2022 9:13 pm

Re: How many botox vials for a piriformis?

Post by adelphos2 »

Branded Botox for non-cosmetic use is only available as 100 and 200 unit vials. I have done many Botox injections into the piriformis muscle (and other pelvic muscles). How much one uses depends on the size of the muscle. For the piriformis I use 75-100 units per side.
As an aside, I recommend not allowing someone to inject steroid into any of your muscles. Most studies show no benefit, but there is risk of muscle atrophy. Trigger point injections with local anesthetic are fine.
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