I am in a lot of pain from a pinched sciatic nerve caused by piriformis syndrome. Have had a steroid injection already not much help. What can I do?

EMG,PT, botox, surg. Make sure you had quality EMG ruling out lumbosacral radiculopathy. Then physical therapy involving strengthening of the pelvic and hip region and stretching of the piriformis. Besides Ultrasound-guided glucocorticoid injections, botulin toxin injections have been used. If all of the above fail, a surgery (piriformis tenotomy) can be pursued if symptoms are that persistent and debilitating.