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Study: Botulinum toxin A decreases plantar fasciitis pain more than steroids

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Researchers from Mexico have found that injections of botulinum toxin A applied intramuscularly were more effective than steroids in the treatment of plantar fasciitis, according to this study.

“We found that a combination of BTX-A [botulinum toxin A] applications into the gastroc-soleus complex and plantar fascia stretching exercises yielded better results for the treatment of plantar fasciitis than intralesional steroids,” Carlos Acosta-Olivo, MD, PhD, from the Autonomous University in Nuevo Leon, Mexico, stated in a press release.

The researchers enrolled 40 patients in the study. After removing patients lost to follow-up, 19 patients were injected with BTX-A and 17 patients received steroid injections, with both groups performing the same stretching exercises. At the first two follow-up times, Acosta-Olivo and colleagues reported no significant differences in improvement between the BTX-A and steroid groups.

However, results from the BTX-A group at 2-month follow-up showed significantly improved VAS scores over the steroid group, at 1.51 points in the BTX-A group compared to 3.24 points in the steroid group. Acosta-Olivo and colleagues noted in the study that the stretching exercises were important to the success of the treatment. Results from the fourth and fifth follow-ups showed further improved VAS scores; the steroid group score 3.6 and 3.7 points, respectively, over the BTX-A group that scored 1.6 points and 1.5 points at fourth and fifth follow-up visits, respectively.

At final follow-up, the BTX-A group scored 1.1 points and the steroid group had a VAS pain score of 3.8 points. Maryland Foot and Ankle scale, Foot and Ankle Disability Index and American Orthopaedic Foot and Ankle Society scores in these patients showed similar improvement in the BTX-A group over the steroid group starting with the second follow-up visit.

Reference:

Elizondo-Rodriguez J. Foot Ankle Int. 2013;doi:10.1177/1071100712460215.

Disclosure: The authors have no relevant financial disclosures.