Botox Injection Therapy

How can Botox injections treat plantar fasciitis?

Botox is a neurotoxin that blocks release of the neurotransmitter acetylcholine in overactive muscles. Motor neurons release acetylcholine to activate muscles at the neuromuscular junction; Botox, when injected, causes relaxation of muscles and other local soft tissue. A body of evidence identifies tightness in calf muscles as a causative factor in plantar fasciitis. Botox injection into the calf aims to relax contracture in calf muscles, thus reducing tensile strain on the plantar fascia as a result of muscle relaxation. Additionally, Botox can be injected into the muscles of the foot to achieve the same effect. If you're interested in learning more about the research investigating Botox injections to treat plantar fasciitis, check out my article published in Lower Extremity Review Magazine here

Are there risks to Botox injection?

Botox injection is generally safe; major adverse effects are uncommon when injection is administered by a suitably qualified clinician. There is a possibility (although highly unlikely) that the effect of botulinum toxin will spread to other parts of the body and cause botulism-like signs and symptoms including;

  • muscle weakness all over the body

  • vision problems

  • difficulty speaking or swallowing

  • difficulty breathing

  • loss of bladder control.

My Verdict

Botox is an incredibly effective treatment option for plantar fasciitis. The evidence for Botox injection as a treatment for plantar fasciitis is sufficiently strong to support its use. Nearly all current studies of moderate- to high-quality  demonstrate significant success with this treatment option. The reason it is so effective is that it addresses the main underlying causative factor of plantar fasciitis, which is calf muscle contracture.

Despite this conclusion, Botox injection is not a commonly used treatment option and—in the United Kingdom—is not widely available for treating plantar fasciitis; in the United States, Botox injection is not indicated by the Food and Drug Administration for treating plantar fasciitis. Nevertheless, Botox injection deserves greater study and consideration for its applicability to clinical practice for treating plantar fasciitis. This therapy might replace commonly used corticosteroid injection for plantar fasciitis, which has 1) a lower success rate over the long term and 2) an increased risk of harmful effects, including plantar fascia rupture.

The most effective Botox injection technique remains in question. In some studies, plantar fascia and surrounding tissue were injected directly; in others, the calf muscles were injected. To determine which technique is better, it will be necessary to conduct a head-to-head trial of these 2 techniques.

I currently do not offer this treatment option but if you are interested in this treatment get in touch and I will advise on a recognised provider in your local area.