My dr. is going to try to get my insurance to cover botox injections into my obturator internus and levator ani muscles. Any advice or thoughts would be appreciated. I just had two trigger point injections last week in the psoas and q lumbaris?? no change...actually made the pain worse.
is botox a good idea? she said I would be put totally under and that it would be painful...she mentioned a few possible risks, and said she cannot say if it will work or not....but that this is the last trick up her sleeve. My PT seemed glad this was going to be done...I just feel like I am on this endless cycle of doctors, meds, procedures and nothing has helped....can't take it anymore..but no where to run. I guess I will try anything...but am nervous and concerned since the last injections made me have more pain than before.
Dr. wants to try botox, I don't know what to think
- helenlegs 11
- Posts: 1779
- Joined: Fri Sep 17, 2010 9:39 am
- Location: North East England
Re: Dr. wants to try botox, I don't know what to think
I had botox into my piriformis muscle (just rh side, which is the worst one) and I have to say it is the only thing that has worked, even though it didn't work completely (nerve still trapped in scar tissue I think) but the effect lasted for about 3 months. I had the other side as a comparison so when that side tightened up ridiculously I really knew that the botox was working as that worst side would have been absolutely dreadful at that stage, and it wasn't.
I'd had some steroid shot into both muscles previously and they hadn't worked at all.
This process is diagnostic as well as used as a treatment. I must say that I haven't had any cause to regret having botox and would get my other side done if I EVER get my NHS referral sorted out.
A few have said that having too many injections could cause scar tissue, I'm not sure about that one, maybe, but I can't see 1 doing too much harm. I have also heard of someone who has had many botox shots and the process has been very therapeutic for them.
The only other thing I can say is that it hurt like hell!! which kinda proved that my P muscle is spasmed/scarred/weird?? Fine through the skin and glute (so brave ) but as soon as it hit my P muscle WOW!! I almost levitated!
Maybe it's a good plan to be sedated, but I wasn't given that option.
Good luck with whatever you decide, it is a tricky one as there are a very few stories where people have been worse off afterwards. Thankfully that is usually short lived.
take care.
Helen
I'd had some steroid shot into both muscles previously and they hadn't worked at all.
This process is diagnostic as well as used as a treatment. I must say that I haven't had any cause to regret having botox and would get my other side done if I EVER get my NHS referral sorted out.
A few have said that having too many injections could cause scar tissue, I'm not sure about that one, maybe, but I can't see 1 doing too much harm. I have also heard of someone who has had many botox shots and the process has been very therapeutic for them.
The only other thing I can say is that it hurt like hell!! which kinda proved that my P muscle is spasmed/scarred/weird?? Fine through the skin and glute (so brave ) but as soon as it hit my P muscle WOW!! I almost levitated!
Maybe it's a good plan to be sedated, but I wasn't given that option.
Good luck with whatever you decide, it is a tricky one as there are a very few stories where people have been worse off afterwards. Thankfully that is usually short lived.
take care.
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
Re: Dr. wants to try botox, I don't know what to think
I had botox into my obturator internus and levator ani and it made me much worse. I think maybe because I have sacroiliac joint dysfunction so the botox knocked out muscles that were stabilizing my SI joint causing my quadratus lumborum and hamstrings to spasm. It also greatly incrased my ischial tuberosity area pain. I am of course not a fan of botox after my experience, but even if this hadn't happened I think that you have to really think about the whole pelvis and not just the pelvic floor. Botox works to relax smooth muscles, but the pelvic floor tightness might not be the pain generator...it just might be a symptom of the pain. I think a lot of docotrs who offer botox need to stop, look at the patient's history/syptoms, and ask "what am I trying to accomplish here" because in reality botox cures very few people, if any. Most people have to continue getting the botox every 3-4 months (if it even helps) and that's because the botox is just treating a symptom not the cause of the pain. Not to mention it is ridiculously expensive and very difficult to get insurance companies to pay for it because it is still considered expirmental for the pelvic floor.
I don't know your history or where your pain is exactly, but because they did trigger points in your quadratus lumborum and psoas it is likely you have multiple issues going on (such as a labral hip tear or SIJD in addition to PN) or that those other issues are the cause of your PN. Did the TP injectiosn make the pain in your pelvic floor worse or the pain in your psoas/quadratus lumborum worse? If you have SIJD or a labral hip tear it makes sense why these TP injections made you worse because those muscles are working to stabilize the hip/SI joint so injecting a spasmed/painful muscle like that often will only irritate it more. I encourage you to think through your pain (and share more about your situation if you would like) and even ask your doctor what he/she is really trying to accomplish with the botox. If you have known SIJD I would reccommend not to get the botox because it will not help your situation.
I don't know your history or where your pain is exactly, but because they did trigger points in your quadratus lumborum and psoas it is likely you have multiple issues going on (such as a labral hip tear or SIJD in addition to PN) or that those other issues are the cause of your PN. Did the TP injectiosn make the pain in your pelvic floor worse or the pain in your psoas/quadratus lumborum worse? If you have SIJD or a labral hip tear it makes sense why these TP injections made you worse because those muscles are working to stabilize the hip/SI joint so injecting a spasmed/painful muscle like that often will only irritate it more. I encourage you to think through your pain (and share more about your situation if you would like) and even ask your doctor what he/she is really trying to accomplish with the botox. If you have known SIJD I would reccommend not to get the botox because it will not help your situation.
-11/08 vulvodynia began around conception of first & only pregnancy
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
Re: Dr. wants to try botox, I don't know what to think
I had botox for levitor ani muscle spasms and it stopped the spasms. I was put under and do not remember any pain. Insurance would not pay but because I think It was in network I did not pay and the hospital had to get a special letter from ins to stop hounding me. Good luck
Janet
Janet
2007-08 pelvic muscles spasms treated by EGS. 6/27/10 sat too long on hard chair- spasms, EGS not work Botox help, cortisone shots in coccyx help, still pain, PT found PNE & sent me to Dr Marvel nerve blocks & MRN, TG left surgery 5/9/11. I have chronic bunion pain surgery at age 21. TG gave me back enough sitting to keep my job & join in some social activities. I wish the best to everyone! 2019 luck with orthotics from pedorthist & great PT allowing me to get off oxycodone.
Re: Dr. wants to try botox, I don't know what to think
hey:).. so far did any one of you guys achieve a good result from injections?
Injections... what is it suppose to do? stop the pain altogether? or few targetted regions? and if it works does it affect sexual function?
Injections... what is it suppose to do? stop the pain altogether? or few targetted regions? and if it works does it affect sexual function?
- helenlegs 11
- Posts: 1779
- Joined: Fri Sep 17, 2010 9:39 am
- Location: North East England
Re: Dr. wants to try botox, I don't know what to think
Hopefully they should stop a muscle from being in spasm as Janet said. The idea being that the muscle will stay relaxed. Although that may take more than one shot sometimes.
Can't comment about sexual function as mine was further up.
Helen
Can't comment about sexual function as mine was further up.
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.