Botox has been investigated as a potential treatment for pain associated with plantar fasciitis.
Botox is well-known for its use in cosmetic procedures, however more and more research is investigating the use of Botox in treating multiple pain-related conditions, such as plantar fasciitis.
Plantar fasciitis is a common cause of chronic pain located in the heel of the foot. Typically considered an over-use injury, this condition is likely to occur due to changes in activity, and is associated with microtears in the plantar fascia.
Plantar fasciitis is typically treated using stretches, ice application, massage therapy, and night splints. In some cases, corticosteroid injections or even surgery are necessary. Corticosteroid treatment can result in serious side-effects, including muscle damage and nerve injury, while surgery is not always successful.
Botox has been increasingly used as a treatment for a wide range of both muscular and neuropathic pain, with demonstrated pain-reducing and anti-inflammatory effects.
In a clinical trial investigating the effect of Botox on plantar fasciitis-associated pain and functional ability, 27 patients who had plantar fasciitis in both feet were treated with Botox in one foot and saline in the other. The treatments were randomly assigned using computer software so that the patients and doctors were unaware of which treatment was being administered to each foot. According to the results of the study, Botox significantly improved pain and function with no side effects reported. These results were observed up to eight weeks after treatment.
In another clinical trial, doctors used ultrasound to guide the injections of Botox into the plantar fascia of patients suffering from chronic unilateral plantar fasciitis. This study reported significant reductions in patient-reported pain as well as plantar fascia thickness at an initial three-week follow-up, which lasted up to three months.
More recently, a randomized, controlled clinical trial assessed Botox for plantar fasciitis in a group of 50 patients. Half of these patients were randomly assigned to receive Botox, while half received a saline injection as a control comparison. Six months post-treatment, the self-reported physical function of the affected foot was significantly improved, and associated pain was dramatically reduced, from 7.2 to 3.6 out of 10. These results were also seen when patients were assessed at 12 months post-treatment. The study reported not only significant improvement in foot function and pain but also a reduction in the need to surgically treat the plantar fasciitis.
Written by Deborah Tallarigo, PhD
Babcock, MS., et.al., (2005). Treatment of Pain Attributed to Plantar Fasciitis with Botulinum Toxin A: A Short-Term, Randomized, Placebo-Controlled, Double-Blind Study. American Journal of Physical Medicine & Rehabilitation. DOI: 10.1097/01.phm.0000176339.73591.d7
Wang, H-K., et.al., (2010). Ultrasonographic guided botulinum toxin type A for plantar fasciitis: An outcome-based investigation for treating pain and gait changes. J Rehabil Med, 42: 136–140
Ahmad, J., et.al., (2016). Treatment of Plantar Fasciitis With Botulinum Toxin: A Randomized, Controlled Study. Foot & Ankle International, DOI: 10.1177/1071100716666364)
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