Outcomes of Ultrasound-Guided Gastrocnemius Injection With Botulinum Toxin for Chronic Plantar Fasciitis

Abstract

Background: The objective of this study was to determine whether the injection of botulinum toxin A (BTA) in the medial head of the gastrocnemius muscle could yield improvements in function and disability in patients with chronic plantar fasciitis with follow-up 12 months after treatment. Methods: Thirty-two patients with chronic plantar fasciitis were included in the study and randomly allocated to the BTA and placebo groups. The visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) scores were used to evaluate pain levels pre- and postinjection as well as function of the foot, respectively. Patients were also asked to rate their treatment satisfaction 1 year after injection. The range of dorsiflexion was measured before and 12 months after the injection. Results: At the 12-month follow-up, the mean VAS decreased from 7.8 to 4 in the placebo group and from 8 to 0.33 in the BTA group. Furthermore, the mean AOFAS scores increased from 48.4 to 65.3 in the placebo group and from 45.5 to 90.6 in the BTA group. The postinjection scores in the BTA group were significantly higher than those in the placebo group ( P < .001). Patient satisfaction in the BTA group was higher than that in the placebo group at the 12-month follow-up. Conclusion: In patients with chronic plantar fasciitis, the use of BTA had a positive effect on improvement in pain and foot function 1 year after treatment. Level of Evidence: Level I, prospective randomized controlled trial.

Advances in botulinum toxin type A for the treatment of pain

“…Thirty-two patients with chronic plantar fasciitis were randomized to the BTX-A and placebo groups, and 70 U of BTX-A was administered into the medial head of the gastrocnemius muscle under ultrasound guidance. The outcome of the present study showed that local injection of BTX-A into the gastrocnemius muscle had a positive effect on improving pain and foot function in the patients, and the effect lasted for over a year (Abbasian et al, 2019).…”

Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis

“…Ninety-four randomized controlled trials (5397 participants) assessed pain in the short term as an outcome. Of these, 51 randomized controlled trials (2937 participants) compared 14 different therapeutic interventions to the control group in the short term: acupuncture ( n = 69 19,20,23 ); botulinum toxin ( n = 161 27,31,33,34 ); corticosteroid injection ( n = 244 107,108,168,186 ) ; dry needling ( n = 215 39,41,42 ); extracorporeal shock wave therapy ( n = 863 54,55,65,71,72,75,78,81,84,166 ); low-dye taping ( n = 213 106,115,119,231 ); low-level laser therapy ( n = 231 122,125,133,129,132 ); micronized dehydrated human amnion/chorion membrane injection ( n = 175 92,93 ), myofascial releases ( n = 101 212,214,215,222 ); orthosis ( n = 259 141,148,160,162 ); platelet-rich plasma ( n = 110 181,186 ); radiofrequency ( n = 87 236,237 ); stretching ( n = 112 230,231 ); and therapeutic ultrasound ( n = 97 250,251 ). A summary of the meta-analysis performed to compare interventions versus controls is shown in Table 2.…”

Foot and Ankle Injections in Athletes

“…Recently, botulinum toxin A injection into the medial gastrocnemius resulted in decreased VAS, increased AOFAS scores, and improved dorsiflexion when compared with a saline injection alone. 1 Athletic performance did not decrease.…”