{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:22:34Z","timestamp":1791973354053,"version":"4.3.4"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2015,8,10]],"date-time":"2015-08-10T00:00:00Z","timestamp":1439164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Piriformis muscle syndrome (PMS) is caused by prolonged or excessive contraction of the piriformis muscle associated with pain in the buttocks, hips, and lower limbs because of the close proximity to the sciatic nerve. Botulinum toxin type A (BoNT-A) reduces muscle hypertonia as well as muscle contracture and pain inhibiting substance P release and other inflammatory factors. BoNT-A injection technique is important considering the difficult access of the needle for deep location, the small size of the muscle, and the proximity to neurovascular structures. Ultrasound guidance is easy to use and painless and several studies describe its use during BoNT-A administration in PMS.  In the present review article, we briefly updated current knowledge regarding the BoNT therapy of PMS, describing also a case report in which this syndrome was treated with an ultrasound-guided injection of incobotulinumtoxin A. Pain reduction with an increase of hip articular range of motion in this patient with PMS confirmed the effectiveness of BoNT-A injection for the management of this syndrome.<\/jats:p>","DOI":"10.3390\/toxins7083045","type":"journal-article","created":{"date-parts":[[2015,8,10]],"date-time":"2015-08-10T11:15:00Z","timestamp":1439205300000},"page":"3045-3056","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Ultrasound-Guided Injection of Botulinum Toxin Type A for  Piriformis Muscle Syndrome: A Case Report and Review of  the Literature"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1452-8485","authenticated-orcid":false,"given":"Andrea","family":"Santamato","sequence":"first","affiliation":[{"name":"Physical Medicine and Rehabilitation Section, \"OORR\" Hospital, University of Foggia,  Foggia 71100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Micello","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Section, \"OORR\" Hospital, University of Foggia,  Foggia 71100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Valeno","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Section, \"OORR\" Hospital, University of Foggia,  Foggia 71100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Beatrice","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Section, \"OORR\" Hospital, University of Foggia,  Foggia 71100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Cinone","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Section, \"OORR\" Hospital, University of Foggia,  Foggia 71100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Baricich","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Department of Health Sciences, University of Eastern Piedmont, Novara 28100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3558-8276","authenticated-orcid":false,"given":"Alessandro","family":"Picelli","sequence":"additional","affiliation":[{"name":"Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological,  Biomedical and Movement Sciences, University of Verona, Verona 37134, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Panza","sequence":"additional","affiliation":[{"name":"Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari 70120, Italy"},{"name":"Department of Clinical Research in Neurology, University of Bari Aldo Moro,  \"Pia Fondazione Cardinale G. Panico\", Tricase, Lecce 73039, Italy"},{"name":"Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS \"Casa Sollievo della Sofferenza\", San Giovanni Rotondo, Foggia 71013, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Logroscino","sequence":"additional","affiliation":[{"name":"Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari 70120, Italy"},{"name":"Department of Clinical Research in Neurology, University of Bari Aldo Moro,  \"Pia Fondazione Cardinale G. Panico\", Tricase, Lecce 73039, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Fiore","sequence":"additional","affiliation":[{"name":"Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari 70120, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Ranieri","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Section, \"OORR\" Hospital, University of Foggia,  Foggia 71100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2015,8,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"821","DOI":"10.3928\/0147-7447-20020801-12","article-title":"Piriformis syndrome","volume":"25","author":"Foster","year":"2002","journal-title":"Orthopedics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1002\/mus.21318","article-title":"Piriformis syndrome, diagnosis and treatment","volume":"40","author":"Kirschner","year":"2009","journal-title":"Muscle Nerve"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1097\/00002060-200210000-00006","article-title":"Botulinum toxin type A use in piriformis muscle syndrome: A pilot study","volume":"81","author":"Childers","year":"2002","journal-title":"Am. 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