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

• Published in: Clinical rehabilitation 2012-07, Vol.26 (7), p.594-606
• Main Authors: Díaz-Llopis, Ismael V, Rodríguez-Ruíz, Carmen M, Mulet-Perry, Sandra, Mondéjar-Gómez, Francisco J, Climent-Barberá, Jose M, Cholbi-LLobel, Francisco
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - therapeutic use; Attitudes; Botulinum toxin; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - therapeutic use; Chronic pain; Corticosteroids; Efficacy; Fasciitis, Plantar - drug therapy; Female; Foot diseases; Health; Hospitals; Humans; Injections, Intramuscular - methods; Male; Middle Aged; Neuromuscular Agents - administration & dosage; Neuromuscular Agents - therapeutic use; Pain; Pain - drug therapy; Plantar fasciitis; Rehabilitation; Single-Blind Method; Steroids; Surgeons; Time; Treatment Outcome
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215511426159

Objective: To determine the efficacy of botulinum toxin type A in chronic plantar fasciitis compared to the local injection of a corticosteroid plus local anaesthetic. Methods: Patients with a clinical diagnosis of plantar fasciitis made at least six months earlier were selected to enter a randomized, single-blind study of treatment with injections of botulinum toxin type A or corticosteroid. There were 28 patients in each treatment group. Patients were evaluated at one month using the Foot Health Square Questionnaire and those with no clinical response subsequently received a second injection with the drug of the other arm of the study, creating two new treatment groups. Re-evaluation was performed at six months. Results: One month after injection there was a clear clinical improvement in both treatment groups but it was greater in the botulinum toxin group, with a significant difference for the pain item (P = 0.069), though not in other items. At six months, patients treated with botulinum toxin type A had continued to improve in all items, whereas the corticosteroid group lost part of the improvement achieved at one month (improvement with botulinum toxin vs. corticosteroid: pain 19.10/–6.84 (P = 0.001), function 16.00/–8.80 (P