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Botox Injections

Botox Injection for Piriformis Syndrome

Botulinum injection also known as Botox® injections is effective in the management of piriformis syndrome. Piriformis syndrome is a condition that occurs due to the irritation of the sciatic nerve by the piriformis muscle. The sciatic nerve is a thick, long nerve passing through or below the piriformis muscle, which is located in the buttock region connecting the sacrum to the outer surface of the hip. This muscle is involved in various movements such as walking and running. Piriformis syndrome can occur when the piriformis muscle undergoes spasm and exerts pressure on the sciatic nerve causing pain in the buttock region which radiates to the back of the thigh and the leg.

Botox® injections are used to ease spasm in the piriformis muscle and relieve pain. This therapy involves the injection of Botox® directly into the piriformis muscle, causing it to paralyse. This results in relaxation of the muscle which provides pain relief.

Botox injections do not provide a permanent solution, but only alleviate the pain for a few months. A stretching and rehabilitation program may also be used to resolve the problem. Once the effect of the injection wears off your symptoms may reappear.

Botox Injection for Axillary Hyperhidrosis

Botox® injections areindicated for the treatment of axillary hyperhidrosis when prescription creams or antiperspirants fail to be effective. Axillary hyperhidrosis is a condition characterized by excessive sweating of the under arms. The condition is a cause of embarrassment for many, especially at social gatherings. The affected individuals may sweat up to 4 times more than normal temperature individuals.

Botox® (Botulinum toxin type A) is a safe and effective treatment to help patients with axillary hyperhidrosis. Botox is injected directly into the skin of the underarm to block excessive sweat secretions. The effect of a single injection can last up to 2 years.

Occipital Nerve Blocks

A greater occipital nerve block involves injecting medication around the greater occipital nerve to relieve pain. The greater occipital nerve travels through the muscles at the back of the head and into the scalp providing sensation to the back and top of the scalp.

Greater occipital nerve blocks are commonly used for patients with a unilateral headache, mainly at the back of the head. This block may also be used in patients with occipital neuralgia experiencing shooting, zapping, stinging, or burning pain in the back of the head. Patients with migraines, cluster headaches, and other painful conditions may also obtain temporary relief with this block.


During the procedure, you will lie down on an examination table. Then your doctor locates the greater occipital nerve by palpation of the scalp. The skin is cleansed with alcohol and your doctor injects a local anesthetics and steroid mix with a fine needle, over the area of the trunk of the nerve. The injected region becomes numb, often relieving pain.

The anesthetic effect wears off over several hours and the steroid begins to act over the next few days. This helps provide pain relief for several days to a few months.


Risks and complications are rare but can include infection, nerve or blood vessel injury, and allergic reaction to medications. You may also feel dizzy for a short period of time. Sometimes, thinning of the scalp at the injection site and hair loss may also occur.

Trigger Point Injections

Trigger point injection (TPI) are used to treat intense pain in the muscles containing trigger points. Trigger points are tight bands or knots that are formed when the muscle fails to relax after the contraction. A trigger point may also cause referred pain(pain in another part of the body) by irritating the adjacent nerves.

Trigger point injections can be used to relieve pain in conditions such as myofascial pain syndrome when other treatments are a failure, fibromyalgia, and tension headaches.

During this procedure, nerve block will be administered by the orthopedist or pain specialist to numb the area of needle penetration and keep you comfortable during the procedure. Further, a small needle containing local anesthetic (lidocaine, procaine) which may or may not containing corticosteroid is directly injected to the trigger point. This makes the trigger point inactive and the pain is relieved.

This is a short procedure and may just take a few minutes. The injection may cause mild pain for a short time. If you are allergic to the local anesthetic medication, a dry-needle technique (without medications) is used.

Numbness at the site of injection may persist for about an hour after the procedure. A bruise may even form at the site of injection. Applying moist heat and ice alternatively to the area for two days relieve the pain. Your orthopedist may also recommended stretching exercises and physical therapy after trigger point injections.