Botox beats steroids for painful foot condition, plantar fasciitis

A Comparison of Botulinum Toxin A and Intralesional Steroids for the Treatment of Plantar Fasciitis: A Randomized, Double-Blinded Study

From Foot & Ankle International

Plantar fasciitis is the most frequent cause of chronic heel pain, leaving many sufferers unable to put their best foot forward for months at a time. Now this study suggests that physicians should turn to Botox rather than steroids to offer patients the fastest road to recovery. Physicians may suggest various therapies for this condition, including applying steroids, regular stretching exercises or injecting botulinum toxin A (BTX-A), also known as Botox. The researchers set up a prospective, experimental, randomized, double-blinded, and controlled clinical trial, where patients were treated either with steroids or with Botox for their painful feet. Both groups were shown the same series of physical exercises to help their recovery. After six months, patients who received Botox injections were the clear winners, demonstrating more rapid and sustained improvement than their counterparts on the steroid regime.


Background: The objective of this study was to compare intramuscularly applied botulinum toxin A (BTX-A) in the gastroc-soleus complex with intralesional steroids for the treatment of plantar fasciitis.

Methods: The patients were randomly divided into 2 groups according to the treatment received. The patients were evaluated over 6 months. The evaluation scores included the Visual Analog Scale (VAS), Maryland Foot and Ankle, Foot and Ankle Disability Index (FADI), and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, patients were instructed to perform plantar fascia stretching exercises over the course of the study. The final number of patients was 36, of whom 19 received BTX-A (10 men and 9 women) and 17 (6 men and 11 women) received steroids.

Results: When compared to patients who received steroids, the patients who received BTX-A exhibited more rapid and sustained improvement over the duration of the study.

Conclusion: A combination of BTX-A and plantar fascia stretching exercises yielded better results for the treatment of plantar fasciitis than intralesional steroids.

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Article details

Jorge Elizondo-Rodriguez, MD1, Yariel Araujo-Lopez, MD1, J. Alberto Moreno-Gonzalez, MD1, Eloy Cardenas-Estrada, MD, PhD1, Oscar Mendoza-Lemus, MD, PhD1, & Carlos Acosta-Olivo, MD, PhD1 (2013). A Comparison of Botulinum Toxin A and Intralesional Steroids for the Treatment of Plantar Fasciitis A Randomized, Double-Blinded Study Foot & Ankle International , 34 (1) : 10.1177/1071100712460215

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