Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T12:27:55.888Z Has data issue: false hasContentIssue false

Chapter 33 - Treatment of Plantar Fasciitis/Plantar Fasciopathy with Botulinum Neurotoxins

Published online by Cambridge University Press:  02 November 2023

By
Delaram Safarpour ,
Shivam Om Mittal  and
Bahman Jabbari
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
Get access

Summary

Plantar fasciitis (PF) is the most common cause of chronic heel pain, predominantly impacting those who perform heavy footwork, are avid runners or lare ong-distance walkers. Overuse injury leads to repetitive microtears of the plantar fascia near the calcaneus, irritating pain fibers and producing secondary inflammation. Patients typically have intense heel pain, described as aching, jabbing or burning. Pain usually starts with the first few steps in the morning and is reproduced by palpation of the median tubercle of the calcaneum and with dorsiflexion of the toes.

Conventional treatments such as ice, heel cup orthoses, deep-tissue massage and night splints, periods of immobilization and stretching/strengthening exercise programs can reduce pain satisfactorily. Persistent discomfort may respond to treatments such as ultrasound, iontophoresis and phonophoresis. More severe and recalcitrant cases require extracorporeal shock wave therapy (ECSWT) or local corticosteroid injections. When medical approaches fail, surgery is advocated but can only offer modest results.

This chapter reviews pertinent studies to date on the application of botulinum neurotoxin to plantar fasciitis, and discusses injection technique and dosing, including the WRAMC–Yale technique for injecting the soleus muscle, along with the plantar fascia. Clear anatomical illustrations are provided.

Keywords

Plantar fasciitisplantar fasciopathy,plantar fasciaabductor hallucisflexor digitorum brevisbotulinum neurotoxinonabotulinumtoxinABotoxincobotulinumtoxinA
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 269 - 274
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbasian, M, Baghbani, S, Barangi, S et al. (2020). Outcomes of ultrasound-guided gastrocnemius injection with botulinum toxin for chronic plantar fasciitis. Foot Ankle Int, 41, 63–8. http://doi.org/10.1177/1071100719875220CrossRefGoogle ScholarPubMed
Ahmad, J, Ahmad, SH, Jones, K (2017). Treatment of plantar fasciitis with botulinum toxin. Foot Ankle Int, 38, 1–7. http://doi.org/10.1177/1071100716666364Google Scholar
Babcock, MS, Foster, L, Pasquina, P, Jabbari, B (2005). Treatment of pain attributed to plantar fasciitis with botulinum toxin a: a short-term, randomized, placebo-controlled, double-blind study. Am J Phys Med Rehabil, 84, 649–54. http://doi.org/10.1097/01.phm.0000176339.73591.d7CrossRefGoogle ScholarPubMed
Bolívar, YA, Munuera, PV, Padillo, JP (2013). Relationship between tightness of the posterior muscles of the lower limb and plantar fasciitis. Foot Ankle Int, 34, 42–8. http://doi.org/10.1177/1071100712459173CrossRefGoogle ScholarPubMed
Díaz-Llopis, IV, Rodríguez-Ruíz, CM, Mulet-Perry, S et al. (2012). Randomized controlled study of the efficacy of the injection of botulinum toxin type A versus corticosteroids in chronic plantar fasciitis: results at one and six months. Clin Rehabil, 26, 594–606. http://doi.org/10.1177/0269215511426159CrossRefGoogle ScholarPubMed
Díaz-Llopis, IV, Gómez-Gallego, D, Mondéjar-Gómez, FJ et al. (2013). Botulinum toxin type A in chronic plantar fasciitis: clinical effects one year after injection. Clin Rehabil, 27, 681–5. http://doi.org/10.1177/0269215512469217Google Scholar
Elizondo-Rodríguez, J, Simental-Mendía, M, Peña-Martínez, V et al. (2021). Comparison of botulinum toxin a, corticosteroid, and anesthetic injection for plantar fasciitis. Foot Ankle Int, 42, 305–13. http://doi.org/10.1177/1071100720961093CrossRefGoogle ScholarPubMed
Gronseth, G, French, J (2008). Practice parameters and technology assessments: what they are, what they are not, and why you should care. Neurology, 71, 1639–43. http://doi.org/10.1212/01.wnl.0000336535.27773.c0Google Scholar
Goff, JD, Crawford, R (2011). Diagnosis and treatment of plantar fasciitis. Am Fam Physician, 84, 676–82. PMID: 21916393Google ScholarPubMed
Huang, YC, Wei, SH, Wang, HK, Lieu, FK (2010). Ultrasonographic guided botulinum toxin type A treatment for plantar fasciitis: an outcome-based investigation for treating pain and gait changes. J Rehabil Med, 42, 136–-40. http://doi.org/10.2340/16501977-0491CrossRefGoogle ScholarPubMed
Jabbari, B (2008). Botulinum neurotoxins in the treatment of refractory pain. Nat Clin Pract Neurol, 4, 676–85. http://doi.org/10.1038/ncpneuro0948Google Scholar
Mahowald, S, Legge, BS, Grady, JF (2011). The correlation between plantar fascia thickness and symptoms of plantar fasciitis. J Am Podiatr Med Assoc, 101, 385–9. http://doi.org/10.7547/1010385CrossRefGoogle ScholarPubMed
Monteagudo, M, de Albornoz, PM, Gutierrez, B, Tabuenca, J, Álvarez, I (2018). Plantar fasciopathy: a current concepts review. EFORT Open Rev, 3, 485–93.Google Scholar
Safarpour, Y, Jabbari, B (2018). Botulinum toxin treatment of pain syndromes – an evidence-based review. Toxicon, 147, 120–8. http://doi.org/10.1016/j.toxicon.2018.01.017CrossRefGoogle ScholarPubMed
Seyler, TM, Smith, BP, Marker, DR et al. (2008). Botulinum neurotoxin as a therapeutic modality in orthopaedic surgery: more than twenty years of experience. Bone Joint Surg Am, 90 (Suppl 4), 133–45. http://doi.org/10.2106/JBJS.H.00901Google Scholar
Young, C (2012). In the clinic. Plantar fasciitis. Ann Intern Med, 156, 1–16.Google Scholar
Williams, PL, Banister, LH, Berry, MM (1995). Plantar fasciitis and plantar muscles of the foot. In Gray’s Anatomy, 38th ed. Edinburgh: Churchill Livingston, pp. 1284–6Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×