How can Botox injections treat plantar fasciitis?

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Botulinum Toxin A is a neurotoxin that blocks the release of the neurotransmitter acetylcholine in overactive muscles. Motor neurons release acetylcholine to activate muscles at the neuromuscular junction; Botulinum Toxin A 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. Botulinum Toxin A injection into the calf muscle relaxes contracture in the calf muscle, thus reducing tensile strain on the plantar fascia as a result of muscle relaxation. Additionally, Botulinum Toxin A 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 Botulinum Toxin A injections to treat plantar fasciitis, check out our article published in Lower Extremity Review here

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Are there risks to Botox injection?

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Botulinum toxin A injection is generally very safe when injected into the lower limb muscles. Major adverse effects are very uncommon when injection is administered by a suitably qualified clinician.  A review of all published studies investigating the use of botulinum toxin A for plantar fasciitis demonstrates no major adverse effects in a total of 243 patients. Possible risks may include:

• pain at the injection site

• localised inflammation (bruising, bleedling, swelling)

• infection

• muscle weakness

• headache

• nerve injury

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Our Verdict

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Botulinum Toxin A is an incredibly effective treatment option for plantar fasciitis. The evidence for this type of injection therapy 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, Botulinum Toxin A 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, Botulinum Toxin A injection is not indicated by the Food and Drug Administration for treating plantar fasciitis. Nevertheless, Botulinum Toxin A 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.

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At The Heel Pain Expert, we provide Botulinum Toxin A injections. If you would like to discuss this option contact us or schedule a call.