Efficacy of Botulinum Toxin-A Versus Methyl Prednisolone Acetate Injection in Reducing Pain and Improving Functional Outcome in Plantar Fasciitis

OBJECTIVE: The efficacy of Botulinum Toxin-A Versus Methyl Prednisolone Acetate injection in reducing pain and improving functional outcome in plantar fasciitis. STUDY DESIGN: A Randomized Controlled Study. SAMPLE SIZE: 100 participants with plantar fasciitis divided into two groups by simplified randomized controlled method. METHODS: Participants in group 1 received 50 units of Botulinum Toxin-A which is mixed with given normal saline and group 2 received 40mg Methyl Prednisolone Acetate around plantar fascia close to calcaneal tuberosity. Participants are followed up at 1 month, 2 month, 4 month and 6month after intervention. Plantar fascia thickness before and after intervention done at 6 months by using Ultrasonagram. OUTCOME MEASURES: Visual analogue pain scale (VAS) and Foot ankle ability measure score (FAAM) are done at follow up months. RESULTS: This study shows statistically significant changes in both groups in first 4 months but the Botulinum Toxin-A group shows better pain relief and functional improvement ( p value < 0.0001) and it is maintained at 6 months in comparison to Methyl prednisolone acetate group (p value < 0.001). No side effects are noted in Botulinum Toxin-A group. CONCLUSION: Botulinum Toxin-A injection is found to be cost effective in chronic plantar fasciitis and it yields significant pain relief and functional improvement and it is maintained at 6 months when compared with steroid where there is significant decline in functional improvement after 4 months