Is Botulinum Toxin Injection Effective in Reducing Pain in Patients Diagnosed with Plantar Fasciitis?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not botulinum toxin injection is effective in reducing pain in patients diagnosed with plantar fasciitis. STUDY DESIGN: Review of three randomized controlled trials (RCTs) comparing the efficacy of botulinum toxin injections versus corticosteroid injections for improving pain and dysfunction in those diagnosed with plantar fasciitis. DATA SOURCES: All articles were presented in English and were taken from peer reviewed sources using PubMed. All articles were published from 2012-2017. OUTCOMES: Outcomes of investigation measured are pain score measured using the VASvisual analog scale and Foot Health Status Questionnaire. RESULTS: Ahmad et al. found significant improvement in subjective pain scores following the administration of botulinum toxin injected into the plantar fascia after a period of six months and one year when compared to a placebo of saline. Diaz-Llopis et al. found significant improvement in subjective pain scores following the administration of botulinum toxin injected into the plantar fascia after a period of six months when compared to a corticosteroid. Elizondo-Rodriguez et al. found significant improvement in subjective pain scores following the administration of botulinum toxin injected into the plantar fascia after a period of six months when compared to a corticosteroid. CONCLUSIONS: These three studies showed a significant improvement in subjective pain scores after a minimum period of six months and formalized physical therapy program. The efficacy of botulinum toxin in the treatment of plantar fasciitis is apparent but more research is needed with larger sample sizes to solidify the hypothesis that botulinum toxin injection should be an accepted treatment option across the industry